Making sense of all of those formulas

Infant feeding, formula and allergies – recognizing and correcting.

There are a variety of medical reasons an infant may need to be on a specialized infant formula. Sorting through the different options can be a daunting task. Below are some of the more common reasons, a child may need a specialized formula and some information from Michigan State University Extension related to the formulas.

Food allergies

Typically, food allergies present with intense fussiness and colic, or frequent and projectile vomiting after drinking formula. Hypoallergenic formulas often help. In these formulas, the milk proteins are broken down into very tiny particles, making them easier to digest. Generally, having a food allergy means being allergic to a specific protein that is in the food and hypoallergenic formulas can help with the symptoms.

If an infant is allergic to milk proteins, then providing a soy-based formula may resolve problems.

Gastrointestinal disorder (GERD), reflux, malabsorption

Typically, GERD and reflux are evident when an infant is continually spitting up (what seems like) everything that has been put into their mouth. This can be very concerning for parents as they worry that their baby is not growing. Some formulas facilitate better digestion of the formula. These formulas are partially hydrolyzed, making them easier to digest. Some formulas that are used for children with reflux contain rice starches that form a thickening agent, making them easier to digest in infants with acid reflux.

Failure to thrive (FTT)

FTT is when a child’s current weight or rate of weight gain is significantly below that of other children of similar age and sex. If a doctor determines a child is FTT, the child’s daily caloric intake needs to be increased. Typically, children with FTT need 50 percent more than the recommended daily caloric intake based on their expected weight. In the case of FTT, it is not necessarily the type of formula, more that the infant needs the concentration to be different to get enough calories in during the day. Mixing the formula to provide a denser calorie count is important.

The below is more reliable information from regarding the three types of hypoallergenic formulas:

Extensively Hydrolyzed Formulas (EHFs)

EHFs are formulas that are based on milk or soy protein that have been broken down using heat and enzymes, resulting in a hypoallergenic product. Examples include Nutramigen, Pregestimil, Similac, Alimentum Advance and Peptamen.

Elemental Formulas (EFs)

Elemental formulas are made from free amino-acids, rather than broken down proteins making them well tolerated by infants and young children with severe food allergies, including those with eosinophilic esophagitis. EFs have also been used in an attempt to prevent or delay the onset of allergic disease. Examples include Neocate, Elecare, Vivonex and Nutramigen AA. These are also lactose-free, making them even easier to digest for infants with allergy issues.

Partially Hydrolyzed Formulas (PHFs)

PHFs are thought to be easier to digest than conventional formulas. However, PHFs may still cause allergic symptoms in children allergic to milk and/or soy formulas, and therefore are not truly hypoallergenic. PHFs may have a role in preventing the development of allergy in infants at high risk for the development of allergic disease. Examples include Carnation Good Start, Enfamil Gentlease and Carnation Good Start Soy.

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