From the Guidelines
Neocate is the preferred choice for infants with severe food allergies or eosinophilic esophagitis due to its amino acid-based composition, which has been shown to be highly effective in resolving symptoms and histologic resolution of esophageal eosinophilia. The use of an amino acid-based formula, such as Neocate, is currently the gold standard in determining whether food antigens are responsible for eosinophilic esophagitis in patients who do not respond to diet elimination of specific antigens 1. In contrast, Pregestimil is an extensively hydrolyzed formula that may not be as effective in severe allergic reactions or eosinophilic esophagitis.
Some key differences between Neocate and Pregestimil include:
- Composition: Neocate is an amino acid-based formula, while Pregestimil is an extensively hydrolyzed formula
- Indications: Neocate is typically recommended for infants with severe cow's milk protein allergy, multiple food allergies, eosinophilic esophagitis, or when extensively hydrolyzed formulas have failed, while Pregestimil is often prescribed for babies with fat malabsorption issues, short bowel syndrome, or other digestive disorders
- Efficacy: Neocate has been shown to be highly effective in resolving symptoms and histologic resolution of esophageal eosinophilia, with a success rate of 92%-98% in children 1
It's worth noting that the choice between Neocate and Pregestimil depends on the specific medical condition of the infant, and both formulas require a physician's guidance as they are significantly more expensive than standard formulas and should only be used when medically necessary. Additionally, recent studies have highlighted the importance of breastfed infants in preventing food allergies, and the use of partially or extensively hydrolyzed infant formulas for preventing food allergies is still limited 1.
From the Research
Comparison of Neocate and Pregestimil
- Neocate is an amino acid-based formula, which has been shown to be well-tolerated and effective in managing cow's milk allergy (CMA) in infants and children 2.
- Pregestimil is an extensively hydrolyzed protein formula, which is also used as a substitute for cow's milk in infants with CMA.
- A study compared the use of an amino acid-based formula (similar to Neocate) to an extensively hydrolyzed protein formula (similar to Pregestimil) in infants with CMA, and found that the amino acid-based formula was effective in supporting healthy weight gain and improving allergic symptoms in infants who did not respond to the extensively hydrolyzed protein formula 3.
- Another study found that an amino acid-based formula (including synbiotics) was safe and well-tolerated in infants with IgE-mediated CMA, and that it did not differ significantly from a standard amino acid-based formula in terms of tolerance development to cow's milk 4.
- Expert recommendations suggest that amino acid-based formulas (such as Neocate) should be considered as a first-line therapeutic option in severe forms of CMA, including anaphylaxis, acute and chronic severe food protein-induced enterocolitis syndrome, and CMA associated with multiple food allergy 5.
Key Differences
- Neocate is an amino acid-based formula, while Pregestimil is an extensively hydrolyzed protein formula.
- Amino acid-based formulas (such as Neocate) have been shown to be effective in managing severe forms of CMA, while extensively hydrolyzed protein formulas (such as Pregestimil) may not be tolerated by all infants with CMA.
- The choice between Neocate and Pregestimil may depend on the individual infant's needs and medical history, and should be made in consultation with a healthcare professional 6.