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Hypoallergenic Infant Formula

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Updated May 19, 2014

Baby girl (3-6 months) being fed bottle of milk, portrait, close-up
Ghislain & Marie David de Lossy/Stone/Getty Images

Overview:

Hypoallergenic infant formulas are used to help prevent and treat allergic diseases in babies and, occasionally, in children. They are usually derived from cow's milk, but because of the way their proteins have been broken down, they are well-tolerated by most infants.

Using Hypoallergenic Formulas:

Hypoallergenic formulas are commonly recommended in three situations: for babies born into highly atopic families (those with a high number of allergic conditions like asthma, eczema, hay fever, or food allergies) who won't be breastfed or who need a supplementary formula; for babies who are allergic to or intolerant of proteins in formula or breast milk; or for nutrition in people with eosinophilic esophagitis who are allergic to a great many foods.

Types of Hypoallergenic Formulas:

Hypoallergenic formulas come in three main varieties: partially hydrolyzed, extensively hydrolyzed, and free amino acid-based. Hydrolyzed formulas have had the larger protein chains broken down into shorter, easy-to-digest proteins, while free amino acid-based formulas do not include protein chains at all but rather contain all the basic amino acids. Partially hydrolyzed formulas differ from extensively hydrolyzed formulas in that their protein chains can be longer. Alimentum, Nutramigen, and Pregestimil are among brands of hydrolyzed formulas, while Neocate, Elecare, and Nutramigen AA are amino acid formulas.

Paying for Hypoallergenic Formulas:

Hypoallergenic formulas are far more expensive than regular cow's milk formulas. This is one of their major drawbacks. However, if they are deemed a medical necessity, you may be able to appeal to your insurance company to pay for part of the cost of the formula. (Unfortunately, not all insurance companies will do this even with a doctor's certification of medical need, but some will.)

Working With Your Pediatrician:

Not every child responds well to every hypoallergenic formula. The American Academy of Pediatrics has recommended extensively hydrolyzed formulas for infants who are not breastfed and who cannot tolerate cow's milk formulas due to allergy.

However, a small percentage of babies do not tolerate extensively hydrolyzed formulas well. A 2008 study examined amino acid formulas and determined that babies who did not tolerate the extensively hydrolyzed formula grew well and were healthier when fed an amino acid formula.

What does this mean for your baby? First, make sure that your doctor is aware of the first sign of food allergy symptoms or other feeding-related difficulties (diarrhea, painful or bloody stools, consistent crying with feedings, or other unusual symptoms that seem to recur with every feeding). Second, don't be discouraged if the first formula your doctor tries for your child isn't a good fit: Several options are on the market, and most families do find one that's satisfactory.

Sources:

Burks, Wesley, et al. "Hypoallergenicity and Effects on Growth and Tolerance of a New Amino Acid-Based Formula with Docosahexaenoic Acid and Arachidonic Acid." Journal of Pediatrics. Aug. 2008 153(2): 266-71.

Greer, Frank R., et al. "Effects of Early Nutritional Interventions on the Development of Atopic Disease in Infants and Children: The Role of Maternal Dietary Restriction, Breastfeeding, Timing of Introduction of Complementary Foods, and Hydrolyzed Formulas." Pediatrics. Jan. 2008 121(1): 183-91. 25 Aug. 2008.

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