When Should You Give Your Baby Elemental Formulas?
Updated December 30, 2014.
Parents often change their baby's formula, going from one brand to another or one type of formula to another. For example, if their baby is gassy, fussy, or spitting up, they may change her formula from Similac Advance to Enfamil Lipil and then to Nestle Good Start Supreme.
However, most of these formula changes, like when a baby just has simple colic, are usually unnecessary. On the other hand, with some medical conditions, such as galactosemia, a formula change is essential.
A formula change can also be a good idea if a baby has other true medical problem, such as:
- cow's milk protein allergy
- soy protein allergy
- lactose intolerance
- acid reflux
In these cases, you are switching formula to avoid something that your baby is having an allergy or intolerance to. If you switch from one brand of formula to another, such as going from Similac Advance to Enfamil Lipil, since they are both cow's milk-based formula, you will likely not notice any improvement in any symptoms your baby is having. That is why it is usually a good idea to talk to your pediatrician before switching your baby's formula.
In addition to making sure a formula switch is really necessary, your pediatrician can help you pick which formula to switch to, whether it is to a soy, lactose free, reduced lactose such as Enfamil Gentlease Lipil, or added rice (Similac Sensitive RS or Enfamil AR Lipil) formula.
Elemental Formulas
Babies sometimes can't tolerate any of the standard baby formulas, such as Similac Advance, Enfamil Gentlease Lipil, or Nestle Good Start Supreme Soy.
These babies likely have both a cow's milk protein allergy and a soy protein allergy and will need an elemental or hydrolyzed protein formula, such as:
- Nutramigen Lipil
- Alimentum Advance
In addition to being lactose free, these formulas are hypoallergenic and are made of proteins that are extensively broken down. They work well for symptoms that could be due to a formula intolerance, such as excessive crying, diarrhea, and problems sleeping.
On the downside, these formulas are much more expensive than standard baby formula. Nutramigen and Alimentum, for example, can cost about $26 to $30 for a 16-oz. can, while you can expect to pay just $14 to $15 for Enfamil Lipil, Nestle Good Start Supreme, or Similac Advance.
Nutramigen AA
What happens when your baby continues to have problems when she has already tried an elemental formula like Nutramigen or Alimentum? It used mean finding Neocate, an non-allergenic formula made up of 100% free amino acids.
There is another choice now. Nutramigen AA Lipil is another amino acid based formula that can help infants who have a severe cow's milk protein allergy and/or multiple food protein allergies (soy, gluten, and milk, for example).
Parents who need these formulas can be in for a surprise, as Neocate and Nutramigen AA Lipil are even more expensive than other elemental formulas -- about $39 a can. They can be hard to find too, and often mean asking a pharmacist to order them for you or ordering them online:
- buy Nutramigen AA online
- buy Neocate online (Manufacturer's site)
On the plus side, insurance companies will sometimes pay for Nutramigen AA and Neocate if it is a medical necessity that your baby have it. In fact, insurance companies in Illinois and Minnesota are required by law to provide coverage for amino acid-based formulas when babies have certain medical disorders.
An evaluation by a pediatric gastroenterologist can be helpful if you think that your baby needs an amino acid-based formula, such as Nutramigen AA.
Sources:
American Academy of Pediatrics Clinical Report. Effects of Early Nutritional Interventions on the Development of Atopic Disease in Infants and Children: The Role of Maternal Dietary Restriction, Breastfeeding, Timing of Introduction of Complementary Foods, and Hydrolyzed Formulas. PEDIATRICS Vol. 121 No. 1 January 2008, pp. 183-191.
American Academy of Pediatrics Policy Statement. Hypoallergenic Infant Formulas. Pediatrics 2000 106: 346-349.
American Academy of Pediatrics Policy Statement. Soy Protein-based Formulas: Recommendations for Use in Infant Feeding. Pediatrics 1998 101: 148-153.
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