Proper Preparation of Nutramigen
Nutramigen should be prepared according to standard powdered infant formula preparation guidelines: use one level scoop of powder (provided in the can) to 2 fluid ounces of water, mix thoroughly, and use immediately or refrigerate prepared formula at 2-8°C for no more than 24 hours.
Standard Preparation Instructions
- Mix one unpacked, level scoop of Nutramigen powder with 2 fluid ounces (60 mL) of water to achieve the standard 20 calories per ounce dilution 1
- Use clean, sanitized bottles and preparation surfaces to minimize bacterial contamination risk 1
- Shake or stir the formula thoroughly until powder is completely dissolved before feeding 1
Formula Forms and Handling
Nutramigen is available in three forms, each with specific handling requirements 1:
- Powder form: Requires mixing with water as described above; most economical but requires most manipulation and carries highest contamination risk 1
- Liquid concentrate: Requires dilution with equal parts water; intermediate convenience 1
- Ready-to-feed: No preparation needed; safest option with lowest contamination risk but most expensive 1
Storage and Safety Guidelines
- Prepared formula must be used immediately or stored at 2-8°C (refrigerated) and used within 24 hours 1
- Each manipulation step during formula preparation introduces potential bacterial contamination 1
- Discard any formula left in the bottle after feeding; do not save for later use 1
- Unopened powder cans should be stored in a cool, dry place 1
Clinical Context
Nutramigen is an extensively hydrolyzed casein formula designed for infants with cow's milk protein allergy 2, 3. The formula has demonstrated:
- 80-90% success rate in managing cow's milk protein allergy when used as first-line treatment in formula-fed infants 4
- Well-tolerated with appropriate growth parameters in infants with confirmed cow's milk allergy 5
- No allergic reactions observed in controlled studies of infants with cow's milk allergy 5
Critical Preparation Pitfalls to Avoid
- Never use more or less powder than specified (1 scoop per 2 oz water), as this alters caloric density and osmolality, potentially causing feeding intolerance or inadequate nutrition 1
- Never use unpurified or contaminated water sources; use sterile or boiled-then-cooled water for immunocompromised or very young infants 1
- Never prepare formula in advance for more than 24 hours, as this increases bacterial growth risk 1
- Do not pack or heap the scoop; use only a level scoop to ensure accurate concentration 1
Special Considerations
- Nutramigen contains maize-derived ingredients (corn starch) that may contain trace zein proteins, though clinical relevance remains unclear 6
- The formula is lactose-free and suitable for infants requiring lactose restriction 7
- Individual formula recipes and dilution instructions vary by product, so always verify specific mixing ratios on the product label 1