You want the best for your baby, but there are many reasons breastfeeding may not be the best option. The decision is only more complicated when your baby has a food intolerance or a food allergy. Your baby’s health and well-being are your top priority, so it’s important to know your options for supplementing breastfeeding or using all formula.
For parents whose infants have food allergies or protein intolerance, finding the right formula can seem daunting. You may find yourself scrutinizing labels trying to find the best fit to meet your little’s nutritional needs without activating their symptoms.
Thankfully, scientists have created hypoallergenic formulas that are safe for babies with various food intolerance and allergies. Your doctor can help, and so can our team of consultants. You can take steps toward a solution by doing some research on your own, too. Read on for a four-step guide to finding a formula that works for your family.
1. Know the Difference Between Hydrolyzed and Elemental Formula
Hydrolyzed Formula
Cow’s milk is one of the most common food allergies in infants. Milk proteins are present in most formulas. Hydrolyzed formulas are labeled as “hypoallergenic,” but these formulas still contain milk proteins. To reduce reactions in babies with food allergies, manufacturers of hydrolyzed formula break whey proteins and casein proteins into smaller pieces, making them easier to digest.
These types of formulas are either partially hydrolyzed or extensively hydrolyzed. In formulas that are extensively hydrolyzed, milk proteins are broken down into even smaller pieces, offering complete nutrition that is easier for babies to tolerate. About 90% of babies who are allergic to cow’s milk proteins can digest extensively hydrolyzed formula [1].
Elemental Formula
If you’ve tried hydrolyzed formula but your baby is still showing symptoms, you might consider an elemental formula, also known as an amino acid-based formula. In elemental formulas, all amino acids are 100% broken down.
Along with cow’s milk, allergies to other proteins also affect many infants. In an elemental formula, all proteins, protein equivalents, and fats are broken into simple building blocks. In essence, the formula is already partially digested for them.
An elemental formula can meet your baby’s nutritional needs even when they can’t digest milk proteins. Elemental formulas do not contain dairy. If your child has been diagnosed with a dairy allergy and cannot tolerate extensively hydrolyzed formula, an elemental formula is a good option.
Elemental formulas do have some drawbacks. Many of them smell bad, and your baby might not want to eat them. They can also cause smelly spit-up and bowel movements.
If your baby won’t eat their formula, try mixing it with their old formula and changing the ratio until they can tolerate the formula on its own. You can also try mixing it with a food you know is safe or try flavoring the formula.
These formulas tend to be more expensive than traditional formulas. In some cases, hypoallergenic formula is up to three times more expensive.
Any formula you try might include ingredients that aggravate your child’s food allergy, so make a list of ingredients and note the brands that cause a reaction to look for a common factor.
2. Check the Formula Ingredients
Amino acid-based formula is more expensive, and some babies don’t like it. Try hydrolyzed formula first. Consider a formula made with goat’s milk rather than cow’s milk. A study published in 2017 indicated that goat’s milk may be easier for infants to digest than cow’s milk [2]. However, it is important to note that a majority of children who react to one will react to the other.
Children with severe protein allergies need amino acid-based formulas. There are several brands of hypoallergenic formulas you can try with your baby. Common ingredients include corn syrup solids, amino acids, sunflower or safflower oil, and triglycerides.
If your child has a soy allergy, you won’t have as many formula options, since many elemental or amino acid-based formulas contain small amounts of soy protein. Some children with cow’s milk allergies are also sensitive to soy, making it challenging to find a good substitution.
Try a rice milk formula, or look for the Neocate line of products. Neocate is a brand of formula that does not contain soy protein, and the formula is made in a dairy-free facility. If you’re concerned about additives and other ingredients, look for organic, non-GMO, corn-syrup-free options. Check your existing formula for DHA, iron, and other essential nutrients, and make sure your substitute formula has these ingredients as well. Alternatively, if your baby is reactive to corn you may have more success with Alimentum Ready-to-Feed which is corn free but does contain soy derivatives.
Once you’ve narrowed down your preferred list of ingredients, shop for different formulas and try feeding them to your baby. You might have trouble bottle feeding at first.
3. Address Bottle Aversions
Some babies don’t like bottle feeding. If you’ve recently transitioned from breastfeeding, your baby might need to adjust, but bottle aversion can strike any time. When your baby refuses to feed from a bottle, it can be extremely stressful. You’re not only worried about the food allergy but also that your little refuses to eat.
You can take steps to address bottle aversions. Common tactics include moving while feeding. Take a walk around the room while gently rocking or bouncing your baby, and try feeding as you move.
Bottle feeding when your little isn’t really hungry might help with the adjustment. Without the added stress of extreme hunger, baby might be more receptive to a bottle.
Experiment with different feeding positions to see if there is one that makes your little more comfortable. You can try holding her upright, cradling him against your arm, or placing them on your lap. Adjust until you find the most comfortable position.
Check the temperature. Your child’s aversion might not be to the bottle itself but the temperature of the formula. Before feeding, test the formula on your wrist to make sure it’s not too hot or too cold, and taste it to make sure it’s OK.
Most importantly, don’t force-feed. Allow your baby to grab the bottle and latch on. Try techniques similar to those used to make babies latch when breastfeeding, such as tickling the nose and waiting for your little to open their mouth.
4. Trial Your Chosen Formula
Trying out different formulas is one of the best ways to learn what works for your baby. Our consultants can help you set up a trial schedule. Whichever route you go, you'll want to be strategic and when to switch and take lots of notes.
Hypoallergenic formulas, particularly amino acid-based products, are more expensive than traditional formulas. It can also take you a while to find the right formula for your needs. Before switching formulas, you should talk to your doctor, who might also be able to send you home with samples. If your doctor doesn’t have any on hand, look for trial sizes or small packages of different formulas so you can test them out to see which one your child likes best.
You’re probably aware of the telltale signs of a food allergy, including constant vomiting, diarrhea, and eczema that won’t clear. When you’re testing out your new formula, give your baby time to adjust. Try the formula for at least a week, and make notes about how it’s working.
You may notice symptoms start to improve right away, which means that you’ve probably chosen a good formula that is right for your child’s particular food allergy. Or, symptoms might not change at all, meaning it’s time to try the next formula.
If you’re using the same type of protein, you can switch to a new formula immediately. If you’re changing protein types and your child isn’t allergic to the old formula, it’s best to mix the new formula with the old formula, starting with a ratio of 3/4 old protein to 1/4 new. Over the course of a few days, gradually change this ratio until you are feeding your baby the new formula. If you could use extra guidance as you set up your trialing schedule, our expert consultants can help.
Once you’ve made the switch, give your child a week to adjust, noting whether symptoms clear up and how well your baby likes the new formula.
It can take a lot of trial and error to find the right brand with the right ingredients. To make sure your baby isn’t allergic to new formulas, monitor their weight. Watch for allergic reactions like persistent vomiting, diarrhea, excess gas, or other digestive problems. Keep in touch with your doctor, noting which ingredients cause these reactions.
It may take some time, but eventually, you will find the right formula.
Free to Feed Is Here to Help
If you’ve done all your research but are still having trouble finding the right formula for your family, our team of experienced professionals is here to help.
We’ll schedule a 30-minute one-on-one consult to talk through your concerns and challenges. We can help you determine if your baby has a food allergy, develop elimination and reintroduction strategies, and outline a specific trialing schedule for your family. Get in touch for expert support as you find the right decision for you.
References:
Vandenplas, Yvan, et al. “Safety and tolerance of a new extensively hydrolyzed rice protein-based formula in the management of infants with cow's milk protein allergy.” European Journal of Pediatrics 173.9 (2014): 1209-1216. https://pubmed.ncbi.nlm.nih.gov/24723091/
Maathuis, Annet, et al. “Protein Digestion and Quality of Goat and Cow Milk Infant Formula and Human Milk Under Simulated Infant Conditions.” Journal of Pediatric Gastroenterology and Nutrition 65.6 (2017): 661-666. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5704675/