What is the difference between a relocation in treatment and Pregestimil (enzymatically hydrolyzed protein formula)?

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Last updated: April 11, 2025View editorial policy

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From the Guidelines

Pregestimil is the recommended choice for infants with severe malabsorption issues, protein allergies, or conditions like short bowel syndrome, due to its extensively hydrolyzed proteins and medium-chain triglycerides (MCTs) that facilitate easier digestion and absorption. When considering the management of gastroesophageal reflux in children, as outlined in the American Academy of Pediatrics (AAP) guideline released in 2014 1, it's crucial to assess the effectiveness of treatment and exclude other diagnoses. For infants with GERD symptoms, modifying maternal diet in breastfed infants and changing formula in formula-fed infants are recommended strategies. An extensively hydrolyzed protein or amino acid–based formula, such as Pregestimil, may be appropriate for formula-fed infants.

  • Key considerations for formula selection include:
    • Extent of protein hydrolysis
    • Presence of MCTs for easier fat absorption
    • Specific nutritional needs based on the infant's condition
  • In contrast to Pregestimil, Relocate is not a recognized infant formula brand in major markets, and its efficacy and safety for infants with digestive issues are not established in the provided evidence.
  • The AAP guideline 1 emphasizes the importance of a two- to four-week trial of a maternal exclusion diet or formula change to assess symptom improvement, highlighting the need for a systematic approach to managing GERD in infants.

From the Research

Relocate vs Pregestimil

  • There are no direct comparisons between Relocate and Pregestimil in the provided studies.
  • However, the studies discuss the use of hypoallergenic formulas, including extensively hydrolyzed formulas (EHF) and amino acid formulas (AAF), in the treatment of cow's milk protein allergy (CMPA) 2, 3, 4, 5.
  • A study published in 2018 found that whey-based lactose-containing EHFs were ranked as the most palatable by healthcare professionals 3.
  • Another study published in 2023 found that clinicians reported satisfaction with treatment in 95% of patients using an EHF and 97% of patients using an AAF 4.
  • The use of AAFs is recommended as the first therapeutic option in severe cases of CMPA, such as anaphylaxis, acute and chronic severe food protein-induced enterocolitis syndrome, and eosinophilic esophagitis not responding to an extended exclusion diet 5.
  • It is essential to note that the provided studies do not mention Relocate or Pregestimil specifically, and the information provided is general to hypoallergenic formulas and their use in CMPA treatment.
  • One study published in 2017 discussed pushing/bearing down methods for the second stage of labor, which is not relevant to the comparison of Relocate and Pregestimil 6.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

When Should Infants with Cow's Milk Protein Allergy Use an Amino Acid Formula? A Practical Guide.

The journal of allergy and clinical immunology. In practice, 2018

Research

Palatability of hypoallergenic formulas for cow's milk allergy and healthcare professional recommendation.

Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology, 2018

Research

Pushing/bearing down methods for the second stage of labour.

The Cochrane database of systematic reviews, 2017

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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