When a Cows’ Milk Protein Allergy (CMPA) is suspected, one of the first actions taken to confirm or discard the diagnosis is the introduction of hypoallergenic formula.
The brand of formula prescribed for your baby is usually decided by local supplier contract rather than a case by case basis. The powers that be within the NHS have designed a flow chart for GP’s and dieticians to ensure that children presenting with symptoms of CMPA are prescribed a suitable milk.
Hydrolysed Cows’ Milk Formulas are the first port of call when investigating and treating suspected mild to moderate CMPA. Rather than being dairy free, these formulas contain the cows’ milk proteins, casein and whey, in a hydrolysed- extensively broken down- form.
Hydrolysed cows’ milk formulas are nutritionally complete and contain everything your baby needs for healthy growth and development. The flavour of hydrolysed formula is less pleasant that that of normal infant forumulas but is well tolerated by most infants. Where possible, the NHS prefers babies to be prescribed hydrolysed cows’ milk formula. It’s significantly cheaper than formula prescribed for babies who aren’t able to tolerate hydrolysed formulas and is associated with better outcomes when reintroducing normal dairy later in childhood.
Not every baby will be able to tolerate extensively hydrolysed cows’ milk formula though. It’s thought that the immune systems of severely allergic babies are still able to identify the proteins in this formula in spite of the hydrolysing process.
In this instance, the baby will likely see an initial improvement in their symptoms when starting hydrolysed formula but it won’t be sustained. The original worriesome symptoms will start to return after a week or more using the formula.
The next step for these babies, is the introduction of an elemental or amino acid based formula. These formulas contain no dairy and are designed for babies with severe allergy. They are made up of amino acids sourced from plants that are easily absorbed. These formulas are also nutrionally complete and contain everything your baby needs to grow and thrive.
The flavour, however, leaves much to be desired and encouraging babies to accept this formula can be trying. Your GP or dietician will be able to offer advise about how best to introduce elemental formula.
While associated with poorer outcomes when reintroducing cows’ milk at a later stage, this is a lesser concern for babies with a severe cows’ milk allergy.
Aptamil Pepti 1
Elemental/ Amino Acid Formula–
Nutramigen PurAmino (Soy oil and coconut based)
SMA Alfamino (Canola and soy oil based)
Neocate LCP (Coconut, canola and sunflower oil based)
!! This page is for your information only and is in no way intended to replace medical advise from your GP and dietician.