From the Guidelines
Hypoallergenic formula is a specialized infant formula designed for babies who have milk protein allergies or intolerances, and I recommend starting with extensively hydrolyzed formulas like Nutramigen, Alimentum, or Pregestimil as first-line options for most infants with suspected cow's milk protein allergy. These formulas contain proteins that have been broken down into smaller peptides, making them less likely to trigger allergic reactions 1. For severe cases where babies don't tolerate extensively hydrolyzed formulas, amino acid-based formulas such as Neocate, EleCare, or PurAmino may be necessary, as they contain individual amino acids rather than peptides, virtually eliminating allergic potential 1. Some key points to consider when using hypoallergenic formulas include:
- Allowing 2-4 weeks to observe improvement in symptoms like excessive crying, vomiting, diarrhea, blood in stool, eczema, or poor weight gain
- Continuing the formula for at least 6 months before attempting to reintroduce regular formula, as most infants outgrow milk protein allergies by 3-5 years of age
- The protein molecules in hypoallergenic formulas are either broken down or eliminated entirely, preventing the immune system from recognizing them as allergens and triggering an allergic response 1. It's also important to note that the use of hydrolyzed infant formulas may have a small effect on reducing allergy in infants and children, but the evidence is not conclusive, and the decision to use these formulas should be made on a case-by-case basis, considering the individual child's needs and risk factors 1.
From the Research
Definition of Hypoallergenic Formula
A hypoallergenic formula is a type of infant formula that is designed to reduce the risk of an allergic reaction in infants who are allergic to cow's milk protein [ 2, 3,4,5,6 ].
Types of Hypoallergenic Formulas
There are several types of hypoallergenic formulas available, including:
- Extensively hydrolyzed formulas (eHF) [ 2, 3,4,6 ]
- Amino acid formulas (AAF) [ 2, 3 ]
- Rice hydrolysed formulas (rHF) [ 2 ]
Characteristics of Hypoallergenic Formulas
Hypoallergenic formulas are characterized by their ability to reduce the risk of an allergic reaction in infants who are allergic to cow's milk protein. They are typically made by enzymatic hydrolysis of different protein sources, followed by further processing such as heat treatment and/or ultrafiltration 4.
Criteria for Hypoallergenicity
The criteria for hypoallergenicity include the ability of the formula to be tolerated by at least 90% of infants with documented cow's milk protein allergy 4, 5, 6.
Use of Hypoallergenic Formulas
Hypoallergenic formulas are recommended for infants who are allergic to cow's milk protein, and are often used as a substitute for breast milk or other infant formulas [ 2, 3,4,5,6 ].
Benefits of Hypoallergenic Formulas
The benefits of hypoallergenic formulas include: