Baby Formula Allergy

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Infants with food allergies to milk and/or soy have limited options when it comes to the choice of baby formulas. There are 3 major groups of hypoallergenic formulas that are helpful for infants with or at risk of food allergies. Similar types of products are available for older children as well, but this information is not included in this article.

Extensively Hydrolyzed Formulas (EHF's)

EHF's are formulas that are based on milk or soy protein that has been broken down by a number of methods, including heat and enzymes. These processes result in a formula that is hypoallergenic and tolerated by the overwhelming majority of infants with food allergies to milk and/or soy. Allergic reactions, while rare, are still possible, however. Examples of EHF's include Nutramigen, Pregestimil, Similac Alimentum Advance, and Peptamen.

Elemental Formulas (EF's)

Elemental formulas are formulas made from free amino acids, rather than broken down proteins. These formulas are well-tolerated by infants and young children with severe food allergies, including those with eosinophilic esophagitis. EFs have also been used in an attempt to prevent or delay the onset of allergic disease, particularly food allergy and atopic dermatitis, in children at high risk for developing allergic disease. Examples of EFs include Neocate, Elecare, Vivonex, and Nutramigen AA.

Partially Hydrolyzed Formulas (PHF's)

PHFs have been touted as being easier to digest than conventional formulas. However, PHFs may still cause allergic symptoms in children allergic to milk and/or soy formulas, and therefore should not be considered hypoallergenic. PHFs may have a role in preventing the development of allergy in infants at high risk for the development of the allergic disease. Examples of PHFs include Carnation Good Start, Enfamil Gentlease, and Carnation Good Start Soy.

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  • Bahna SL. Hypoallergenic Formulas: Optimal Choices for Treatment Versus Preventon. Ann Allergy Asthma Immunol. 2008; 101:453-9.