When to Use Hypoallergenic or Special Formula?

New parents are often confused about what kind of formula to feed a new baby. It's a common dilemma. There are so many choices, and the sheer volume of information on the topic is enough to confuse anyone. If a baby develops an intolerance to a chosen formula, it can be even more confusing and overwhelming. 

This article will serve as a guide to what exactly special baby formulas are, and more specifically, signs that your little one may need to switch to a hypoallergenic or special infant formula.

Symptoms of Formula Allergies

Allergies to baby formula are typically caused by an intolerance to milk proteins. Although anyone can develop an allergy to anything at any time, milk protein allergies are most often diagnosed in children under 3 years. 

These proteins are generally harmless, but in a sensitive infant, the baby's immune system begins to treat the proteins as invaders, attacking them as foreign substances needing to be neutralized. This response may result in the following allergic reactions and symptoms:

• Skin rashes and eczema
• Gagging, vomiting, and refusal to eat
• Colic
• Wheezing and hives
• Irritability and excessive crying

Cow’s milk allergy diagnosis

Cow's milk allergy is a serious problem. Not only can it cause troubling symptoms and discomfort for the infant, it can contribute to problems with a failure to thrive when the child fails to eat enough to develop and grow.

However, before assuming that a child's feeding problems are caused by a milk allergy, it's important to consult their pediatrician to ensure that it's a cow's milk allergy and not something else, such as lactose intolerance or some other type of digestive system immune disorder like celiac disease.

Once the pediatrician has ruled out other possibilities and confirmed the baby's allergic reactions are indeed the result of a milk protein allergy, they will likely recommend a number of special formula brands to try. Every baby is a unique individual with special formula needs just as unique, so some specialty formulas will work well for one baby but not for another.

Types of Baby Formula

There are four basic types of formula:

• Milk-based
• Soy-based
• Amino acid
• Extensively and partially hydrolyzed

Milk-based are the standard formulas. They hare made with milk proteins and are typically a good option for babies who don't show any allergic reactions to milk.

Soy formula

Soybeans are one of only a very few plant proteins that are complete- proteins. A complete protein has all the amino acids, or protein building blocks, required by the human body for growth and repair.

Although, soy-based formulas are not any less likely to cause general allergic reactions than milk-based ones, they can sometimes be an option for infants with milk protein allergies. However, up to about 15 percent of milk-allergic babies will also still react to soy formula (1). 

There is also another concern about soy formulas. Soy products contain substances called phytoestrogens, which are chemically similar to the natural estrogens produced by human females.

The long-term effects of these plant compounds are unknown and poorly understood, however, some studies have indicated that infants fed soy formulas showed changes in their reproductive system tissues (2).

Partially Hydrolyzed Formula

Hydrolyzation is a chemical term meaning that something has been broken down with water or enzymes into its more elemental compounds. For baby formula, this means that the milk proteins causing the infant's allergic reactions have been reduced to their smaller molecules.

Because the milk proteins are no longer intact, the infant's body is less likely to recognize the milk proteins as invaders and leaves them alone. A partially hydrolyzed formula contains milk proteins that have been broken down somewhat but are still partially intact.

This generally involves two milk proteins called casein and whey, both common allergens in infants with a milk protein allergy. This type of hydrolyzed formula is not suitable for infants with a milk allergy. However, it may be more digestible for infants without milk protein allergy, reducing the incidence of gas and fussy behavior after feeding.

Extensively Hydrolyzed Formula

An extensively hydrolyzed formula breaks casein down into very small pieces and is generally well tolerated by most babies at risk of milk allergy. However, not all babies can tolerate extensively hydrolyzed formula, and it can indeed provoke an allergic response in itself in a few babies, around five to ten percent of the time (3). These types of formulas are often labeled as hypoallergenic formula. 

Hypoallergenic Formula

Although some brands of partially hydrolyzed baby formulas may be labeled as hypoallergenic formula, this is not accurate. A truly hypoallergenic formula must not provoke any kind of allergic reaction in a child at risk of a milk protein allergy, and this qualification doesn't apply to partial hydrolyzation, only to extensively hydrolyzed formulas. Partial hydrolyzation formula may indeed be more digestible for many infants, but it's not a hypoallergenic product as far as baby formula goes.

How Can Hypoallergenic Baby Formula Help?

These infant formulas may help reduce or eliminate a number of problems for the baby:

→   They reduce risk of milk allergy.

→   They may make digestion more comfortable.

→   They may solve allergy problems, clear eczema, and resolve acid reflux.

→   They may reduce breathing problems.

Always consult your pediatrician first if your are considering to switch to a hypoallergenic formula.

Amino acid based formulas

Amino acid based formulas are often indicated for babies and toddlers who either need additional nutritional support or who are unable to tolerate formulas that are hydrolyzed extensively.

Amino acids are the building blocks of proteins. This means that in these types of formulas, the protein is broken down to its most basic parts (even more than in extensively hydrolyzed formula). The baby's immune system doesn't recognize the amino acids as milk proteins and therefore doesn't attack them, avoiding allergic reactions.

European Baby Formula Standards

Many Americans are looking to European brands. There are a number of good reasons for this. 

Organic European baby formulas are made according to strict regulations of the EU and standards known as Biodynamic Organic Farming. This means:

• The entire farm ecosystem is maintained to a high standard
• There are no GMO's
• No use of pesticides or other chemicals to grow crops
• Farmers must observe certain processing procedures

By law, European hypoallergenic formula, or any baby formula, cannot contain any of the following banned ingredients:

• Glucose
• Fructose
• Rice syrup
• Corn syrup 

Why is sugar in baby formula?

Baby formulas must contain some kind of sweetener, or babies will refuse to drink it. Breast milk is naturally sweet, and babies instinctively know that their first food should taste sweet.

In fact, in the days before commercial infant formula was available, mothers unable to breastfeed would use cow's or goat's milk mixed with Karo syrup! That's just a fun fact but it's not a safe option for babies; don't try to make baby formula at home. It won't contain the critical nutrients a baby needs to grow and thrive.  

Natural and Gentle Sweeteners

European formula makers use either lactose, the sugar naturally present in milk, or small amounts of maltodextrin, as much healthier sweeteners for baby formula. 

Stages

Most European formula manufacturers identify their products by stages. Stage 1 is generally from birth to six months. Stage 2 is often for six months to 10 months. At 10 months, the baby is ready for Stage 3. At one year, the baby would use the Stage 4 formula (growing-up formula).

The labels are also written in grams, not ounces, but simple arithmetic solves that issue. The labels may be in a foreign language, such as German in the case of the manufacturer HiPP, but English translations will be provided by sellers.

HiPP 

HiPP is a German formula brand with 50+ years of experience. It is among the most popular formula brands in Europe – for good reason. They produce organic products as closely in composition to breast milk as possible. Parents love this company!

HiPP Hypoallergenic Formula 

HiPP HA hypoallergenic formula is made in Germany and features low allergenic proteins, no added sugar, and it's easy to digest. Designed for babies from birth, it contains all important vitamins (such as A, C, and D), healthy Omega 3 fatty acids that mimic those naturally present in breast milk, and natural lactic acid.

This gentle acid is naturally produced in the human gut by friendly bacteria and contributes to a healthy microbiome, or intestinal environment. Lactic acid is a natural component of probiotics that promote microbiome health. It's thought to help influence the development of a strong immune system in infants (4). Vitamin D enhances calcium absorption. 

HiPP Comfort Formula

This hypoallergenic formula can be used from birth and is designed for infants prone to constipation, bloating, colic and gas. Just as in HA formula, the milk proteins are split for easier digestion and reduces the risk of the allergic response, which may be triggered by whole milk proteins.

It's lactose-reduced, gluten-free, contains essential vitamins and minerals, natural lactic acid cultures and Omega 3 and 6 fatty acids. These special fatty acids are linked to the infant's healthy eye and brain development. The hypoallergenic formula also contains the natural probiotics called galacto-oligosaccharides.

HiPP AR Formula

This specialty formula is designed for infants with acid reflux problems and excessive spitting up after feeding. Naturally thickened with locust bean gum, the denser formula may stay down better than standard, thinner formulas. It can be used under medical supervision from birth on. It's enriched with vitamins A, C, and D, contains fish oil, and Omega 3 and 6 fatty acids and is easy to digest and prepare. 

Takeaways

True, documented milk allergy in infants is rare, occurring perhaps 2 to 3 percent of the time (3). However, when there is a risk for a baby to develop such an allergy, European hypoallergenic formulas are available for parents so all babies can develop, grow strong and thrive. Other types of special formulas are also available for different issues, serving to many baby's special nutritional needs. And remember, talk to your doctor before switching to a hypoallergenic or special formula.

If you have any remaining questions or need more information about hypoallergenic or special please contact us. We are happy to answer them all!

Sources

1) Kids With Food Allergies (2020): Formula Options for Infants and Toddlers With Food Allergies. Available online at https://www.kidswithfoodallergies.org/formula-options-for-infants-with-food-allergies.aspx#:~:text=Partially%20hydrolyzed%20formulas%20take%20cow's,break%20them%20into%20smaller%20pieces.&text=These%20formulas%20are%20NOT%20used%20for%20infants%20allergic%20to%20cow's%20milk.

2) Curran, Erica Jackson (2014): Hypoallergenic Baby Formula Buying Guide. In Parents, 8/3/2014. Available online at https://www.parents.com/baby/feeding/formula/all-about-hypoallergenic-formulas/.

3) Committee on Nutrition (2000): Hypoallergenic Infant Formulas. In Pediatrics 106 (2), pp. 346–349. DOI: 10.1542/peds.106.2.346 

4) Gerber Medial (2021): Lactic Acid Bacteria and ImmuneSystem Modulation. Gerber Medical. Available online at https://medical.gerber.com/nutrition-health-topics/allergy-and-immunity/articles/lactic-acid-bacteria-and-immune-system-modulation/.

5) Healthline (2015): What Are My Formula Options for a Milk Protein Allergy? Available online at https://www.healthline.com/health/allergies/milk-protein-allergy-formula-options#What-are-the-symptoms?/.