Hypoallergenic Baby Formulas

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Parents often change their baby's formula, going from one brand to another or one type of formula to another. For example, if their baby is gassy, fussy, or spitting up, they may change their infant's formula from milk to soy-based formula, or to a hypoallergenic or elemental formula.

Changing Your Baby's Formula

Most of formula changes are usually unnecessary, such as changing formulas to treat a thriving baby with simple infantile colic. On the other hand, formula changes can be life-saving in infants born with particular metabolic diseases such as galactosemia.

It is a good idea to talk to your pediatrician before switching your baby's formula.

A formula change may be recommended if a baby has true medical problems, such as:

  • Suspected cow milk protein or soy protein allergy
  • Galactosemia
  • Lactose intolerance (though it's very rare for an infant to be born without the ability to digest lactose, the primary sugar in breast milk)

In these cases, a decision to switch formula is intended to avoid exposing an infant to a particular protein or sugar that may cause inflammation or other symptoms of dietary intolerance. If the new formula contains the same type of protein (milk or soy) or sugar (lactose or galactose) then the infant is very unlikely to experience an improvement in their symptoms.

In addition to making sure a formula switch is really necessary, your pediatrician can help you pick which formula to switch to, whether it is a soy, lactose-free, or reduced lactose formula, such as Enfamil Gentlease, or to one with added rice (Similac for Spit-Up or Enfamil AR).

Hydrolysate Formulas

Some babies cannot tolerate any standard milk or soy-based formulas, including Similac Advance, Enfamil, Gentlease, or Gerber Good Start Soy. What do you do then?

Babies with both a cow's milk protein allergy and a soy protein allergy and will need a hydrolyzed protein formula, such as:

  • Enfamil Nutramigen
  • Gerber Extensive HA
  • Similac Expert Care Alimentum

In addition to being lactose-free, these formulas are hypoallergenic and are made of proteins that are extensively broken down. They may work well for symptoms related to formula intolerance, such as excessive crying, diarrhea, and problems sleeping.

On the downside, these formulas are much more expensive than standard baby formula. Nutramigen, Gerber Extensive HA, and Alimentum, for example, can cost about $26 to $30 for a 16-oz. can, while you can expect to pay just $14 to $15 for Enfamil, Gerber Good Start, or Similac Advance.

Elemental Formulas

What happens when your baby continues to have symptoms after switching to a hypoallergenci formula like Nutramigen or Alimentum? It used to mean finding a formual like Neocate Infant, an elemental formula made up of 100% free amino acids.

There are other elemental formula choices now. PurAmino (formally called Nutramigen AA Lipil) is another amino acid-based formula that can help infants who have a severe cow's milk protein allergy and/or multiple food protein allergies (soy, gluten, and milk, for example). Similac has its own amino acid-based formula too—EleCare.

Parents who need these formulas can be in for a surprise, though, as Elecare, Neocate, and PurAmino are even more expensive than hypoallergenic formulas. They can be hard to find too, and often mean asking a pharmacist to order them for you or ordering them online:

An evaluation by a pediatric gastroenterologist can be helpful if you think that your baby needs an amino acid-based formula, such as PurAmino. They might even have samples of some of these specialized formulas.

A Word From Verywell

On the plus side, insurance companies will sometimes pay for EleCare, Neocate, and PurAmino if it is a medical necessity that your baby has it. In fact, insurance companies in some states, including Illinois and Minnesota, are required by law to provide coverage for amino acid-based formulas when babies have certain medical disorders.

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  1. Texas DHS. Newborn screening case management galactosemia handbook.

By Vincent Iannelli, MD
Vincent Iannelli, MD, is a board-certified pediatrician and fellow of the American Academy of Pediatrics. Dr. Iannelli has cared for children for more than 20 years.