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Neocate Mixing & Storage Questions Answered – Round 2

Posted 4.28.16 | Nutrition Specialist

When it comes to mixing and storing formula, we’ve heard every question, usually more than once! A few months ago, we answered questions about mixing and storing Neocate products. This post was so popular that it helped spark additional questions from our Facebook followers as well as comments posted on our blog.

So here we go, Round 2!

Once Neocate formulas are prepared, how long until they go bad? Can I keep them longer in the fridge?

The important thing to remember is that our recommendations help to make sure that Neocate stays fresh and that it doesn’t have time to “go bad.” (Good Neocate is a nice guy; Bad Neocate is just plain mean!) “Going bad” is a nice way of saying that a food or formula sat around too long, and bacteria showed up and multiplied! This can make food or formula taste bad, smell bad, and possibly make you sick. Here’s a breakdown of the times we recommend:

24 hours – This is the amount of time that prepared Neocate powdered formulas can stay in the fridge, IF you put them in right after mixing. This also applies to Neocate Splash that’s been opened, but not if anyone has taken a drink directly from the container! If Neocate has been in the fridge longer than 24 hours, we recommend throwing it out.

4 hours – This is the amount of time that prepared Neocate powdered formulas (or opened or poured Neocate Splash) can sit out at room temperature. This can be either after being freshly mixed, or after being removed from the fridge. If it’s been on the counter at room temperature longer than 4 hours, throw it out!

1 hour – This is the amount of time that Neocate can be kept after someone starts to drink it. Like it or not, our mouths are full of bacteria that just love nutrient-rich formulas like Neocate. Once your baby, child, or you take a drink, start the clock and throw out what’s left after 1 hour. Safety first!

Can I make Neocate in advance and use it at a later time?

Sure! As long as you follow the rules above for storage times, you can prepare Neocate formulas in advance. We always recommend that freshly prepared formula is best, but we know it’s not always easy to mix it exactly when you need it. For further guidance, check with your healthcare team!

Note: We don’t recommend preparing Neocate Nutra - our hypoallergenic semi-solid - in advance, because the texture will actually become thicker over time AND thicker with refrigeration. However, the storage instructions for Neocate Nutra would be the same as for the Neocate formulas if your healthcare team is okay with the thicker texture.


Once I’ve mixed Neocate to store for later, do I put it straight into the fridge or do I need to cool it down first?

It’s best to cool the prepared Neocate quickly to get it below the “danger zone” at which bacteria grow best. Straight into the fridge for a bottle is fine, regardless of the water temperature used. That’s because small items will cool quickly in a fridge. However, if you mix a large volume of Neocate, such as for a full day, and store it in a large container, it will cool pretty slowly in the fridge. Here are two options:

  1. Use cold water to prepare the Neocate, so it doesn’t have much cooling to do.
  2. If you prepare the Neocate formula with warm or room temperature water, start by pouring it into the container you’ll store it in. Put the lid on. Then fill a large bowl or pot with ice water. Nestle the container with Neocate in the ice water. Rotate it every few minutes. This will cool it down quicker than the cold air in the refrigerator would. After about 20-30 minutes, it should be plenty cold, and you can move it to the fridge.

It’s important to note not to use hot water when mixing your formula.
(See what temperature water should be when used to mix Neocate formulas.)

What temperature should the fridge be when storing Neocate?

Ooh, good question! We actually don’t get this one very often. For storing anything perishable (food, leftovers, prepared Neocate, you name it), a refrigerator should maintain a temperature below 40° F (4° C).

Did you know that some spots in your refrigerator are colder than others? It’s true! In general, the door is the warmest part of the fridge. The coldest parts can vary based on the layout of the fridge (i.e. where the freezer and icemaker are).

Want a surefire way to know if your fridge is cold enough? Take it’s temperature! Place a cup of water in the fridge, add a thermometer, and wait a few hours. You can even move it around to different parts of the fridge to see the differences – just make sure you give the water a few hours to adjust to the new “climate.”

What is the best temperature for storing Neocate Splash? Can Neocate Splash drink boxes be stored in the refrigerator?

The best temperature for storing unopened Neocate Splash long term is room temperature. That’s because some nutrients don’t hold up well under heat, and some don’t do well in cold. So keep Neocate Splash away from sunny windows, air vents, hot appliances, and cold, drafty spaces. That goes for unopened cans of other Neocate products, too!

That said, you can put unopened Neocate Splash in the refrigerator ahead of time to cool down, such as for tomorrow’s lunch box. If it hasn’t been opened, we suggest you can keep it refrigerated for up to a week. This is because we just don’t know the effects that cold (but not freezing) temperatures over extended periods of time might have on levels of some nutrients. Remember though: If the drink box is open, it can only be refrigerated for up to 24 hours, but no more. And if someone has already taken a drink from the box, you’ve got 1 hour!

How should I prepare Neocate when going on a trip?

Ooh, you’re going on a trip? Where? Can we come? No, seriously, you don’t have to bring us with you, but feel free to share a picture of you traveling with Neocate on our Facebook or Instagram!

When you are going on a trip with prepared Neocate formula, follow these rules:

  • Mix no more Neocate formula than you need in 24 hours - otherwise you’ll have to toss what's left!
  • Keep it cold – below 40° F (4° C) – and store it for no more than 24 hours. That means you’ll need a well-insulated cooler and plenty of cold freezer packs or bags of ice.
  • If you use powdered Neocate formula, take extra cans, just in case.
  • If you use Neocate Splash, take extra drink boxes, just in case.
  • If you use Neocate Splash, keep unopened drink boxes away from extreme temperatures. That means don’t throw it in the trunk in the extreme heat of summer or bitter cold of winter for long periods of time, like road trips.
  • Check out this post about flying with Neocate for more helpful tips.

Can you store Neocate frozen?

We don’t recommend it. Why, you ask? Plenty of other foods can be kept safely in the freezer longer than they can in the fridge, so why not Neocate? The short answer to this question is: we don’t know. Okay, that’s not a very fair answer, and it’s not the whole truth! The mid-range answer is that freezing temperatures can affect Neocate’s quality in ways we can’t predict. Still want more information, or don’t believe us? Here goes…

Freezing temperatures (below 32° F, or 0° C) can affect some nutrient levels. Some vitamins just don’t hold up well under really cold temperatures, and home freezers can actually get very cold! Also, frozen Neocate that thaws may discolor and/or separate into different layers. Gray Neocate in layers is not appealing! We cannot guarantee nutrient content or quality of Neocate products when frozen, which is why we don’t recommend it.

That said, some recipes that call for Neocate products are frozen, and frozen treats can be downright delicious. Ask your healthcare team for advice before you prepare Neocate in any of these recipes, or any way other than as directed on the packaging or as we suggest above. Find more information about cooking with Neocate here.

Can I still use Neocate past the expiration date?

Nope! We absolutely don’t budge on this one. If you don’t like this simple, straightforward answer, you can read this post that spells out in detail why we can’t recommend using Neocate past the expiration date.

How do I ensure Neocate dissolves properly?

Like any powdered formulas, sometimes clogged nipples happen. Following these steps can help ensure that Neocate formulas dissolve well:

  • In general, the warmer the water, the better the vitamins, minerals, and amino acids in Neocate powders will dissolve.
  • The warmest water you should use is 122° F (50° C) to ensure the nutrient levels are not affected. (Water that temperature is pretty warm, but not uncomfortbly hot is our best description without pulling out a thermometer)
  • DO NOT use boiling water to prepare Neocate powders. While Neocate powders dissolve REALLY well in boiling water, it destroys a lot of important nutrients.
  • Stir or shake vigorously for the best solubility.
  • You can try allowing formula freshly mixed to "rest" for a few minutes and then give it another vigorous stir or shake.
  • If you still have trouble after trying the above tips, give us a call at 800.Neocate to let us know!

Again, if we didn’t answer your question, check this post with other common questions to see if we cover it there. If not, we’re happy to help in the comments section below! What other questions do you have about mixing, preparing, serving, or storing Neocate?


You can trust me! I've worked at Nutricia as part of the Medical Affairs team since 2010! My job is answering Neocate questions, and if I don't know the answer to your question, I know where to get it! I'm also a Registered Dietitian Nutritionist.

Why Neocate Dropped the Soy Oil

Posted 1.17.16 | Nutrition Specialist

Loads of parents and caregivers, and even some healthcare professionals, contact us asking about the various ingredients in our Neocate products. Here are some common questions we receive:

  • Why do you include ___ as an ingredient? (It provides nutrition is almost always the answer.)
  • Does Neocate use GMOs? (Nope!)
  • Do Neocate products contain soy? (No way!)   

That last question is one of my favorites, because our answer is so unique. Many of you may be aware that a lot of infants with a cow milk allergy also are allergic to soy. This is sometimes termed milk soy protein intolerance (MSPI). For many, many years Neocate families have asked us over and over if we could remove the soy oil from Neocate Infant. They told us that, while the medical community told them soy oil was okay, they were still wary. On top of requests from parents, some healthcare professionals also asked us if it would be possible to remove soy oil (more on that below). I'll tell you the history behind removing soy oil from Neocate Infant, and I'll also try to answer some questions from a medical perspective about soy oil for those with a soy allergy.

Why did Neocate use soy oil in the past?

For about 20 years, Neocate Infant products in the United States contained soy oil. The oil was very highly refined, and the refining process is designed to remove all of the protein, which is the part of food that the body responds to in an allergic reaction. The soy oil was essential because it provides special types of fats that human infants need to get from their diet. If a baby can't breast feed and drinks formula instead, the formula is required by law to contain these essential fats.  For many years, soy oil was really the only good source of essential fat that was also permitted for infant formulas. In fact, every infant formula in the United States uses soy oil to provide essential fats.

What changed?

I mentioned that Neocate Infant used soy oil, but other Neocate products for older children did not. That's because those products contain canola oil as a source of essential fat instead of soy oil. Canola oil is an excellent source of essential fat, and can be used in foods for children and older people in the US, but had not been able to be used for infant formulas. You know what's really weird? Neocate Infant products in other countries used canola oil instead of soy oil for years! 

At Nutricia, we thought it would be great if canola oil were suitable for use in Neocate Infant too, but there has to be a lot of evidence for the ingredients that can be used in infant formulas, and the evidence has to be given to the Federal Drug Administration (FDA). Basically, nobody had ever told the FDA that they would like to use canola oil in an infant formula as a source of essential fat. We decided that we wanted to do what we could to replace the soy oil with canola oil in Neocate Infant, because it was important to our customers. This involved working with experts and compiling loads of research and information to provide the FDA to support the safety of canola oil.

Ultimately, we were able to provide the FDA with the available research and with answers to all of their questions. Based on the long history of safe use in other countries and the fact that canola oil is a great source of essential fats, we were able to remove the soy oil in Neocate Infant DHA/ARA! In 2013, we finally launched an improved version of Neocate Infant DHA/ARA. Among other nutritional improvements, soy oil was not in the formula. The formula contained canola oil instead, and had higher levels of essential fats.

What does the medical community say?

As I mentioned above, soy oil is recognized by the medical community as being suitable for patients with soy allergies. The soy oil used in infant formulas is highly refined, whereas some grocery oils labeled "cold pressed" or "unfiltered" are not. Professional allergy organizations have published guidance for allergic patients indicating that refined soy oil is acceptable for most patients. In fact, the FDA exempts highly refined soy oil from being labeled as an allergen, due to the available research indicating safety.

Despite this, many healthcare professionals told us that it is confusing for families who find it easy to avoid products with "soy" on the label. They informed us that many families are inherently suspicious of infant formulas that contain soy oil if their infant has a soy allergy. It can be very difficult for healthcare teams to reassure parents that the soy oil used in infant formulas is "safe" for an infant with a soy protein allergy, especially if the family has been through many allergy symptoms and unsuccessful formula switches. Families want the greatest assurance possible that a formula is "safe." 

Many healthcare professionals have thanked us for removing soy oil from Neocate Infant. They know that the soy oil was safe, but felt it would be much easier to provide a parent with an infant formula that didn't contain any ingredients derived from soy, regardless of the inherent safety of the ingredient. The fact that the improved Neocate Infant formula contained higher levels of essential fats was an added nutritional bonus. To this day, Neocate Infant is the only infant formula available in the U.S. that does not contain soy oil. We feel it was worth the time and effort to remove soy oil from Neocate Infant, and we're glad to say that there is no soy oil in the entire Neocate product line.

Do you find it reassuring that Neocate products do not contain soy oil?


Image source

Read my bio here.

Food Allergies and Cross-Reactivity – Do You Have to Avoid Related Foods?

Posted 12.22.15 | Nutrition Specialist

Food allergies can involve many types of responses; you may get a rash when eating a certain food or it could be life threatening, like anaphylaxis. Finding foods that will not cause an allergic reaction for you or your child when dealing with multiple food allergies can be challenging. You may be afraid that trying a new food will cause another serious reaction, and may ask your allergist what foods are “safest” to try first. Allergists wonder about reactions to new foods the same way you do! So how does one approach such a stressful situation?

Having allergic reactions to two foods that have related proteins is called “cross-reactivity” and the reactions can be called “cross-reactions.” It can be hard for a medical team to tell families what new foods are “safest” to try, and which ones pose a greater likelihood of cross-reactions. To help, allergists have conducted research into how likely people with a given food allergy are to react to other foods. Family allergists may use this data to help determine what advice to give their patients about trialing new foods. In some cases the data reveals a significant chance of having an allergic reaction (or at least a positive allergy test) to a new food that’s related to another food. For example, if you are allergic to cashews, you may also be allergic to pistachios and/or mango.(1) There are many "families" of foods that may be linked, so it is best to consult with your healthcare provider to determine the extent of your food allergy and the potential for cross-reactivity.   

How to Spot Foods That Might Cause Allergic Cross-Reactivity

The table to the right shows the potential cross-reactivity between some common, related foods, and was developed by an allergist at the Jaffe Food Allergy Institute at the Mount Sinai School of Medicine in New York.(2) Clinicians might use a table like this when answering questions from families about the likelihood of an allergic reaction to a new food.

To use this table, a clinician would look for your food allergen in the left column. The column on the right gives an indication of the risk that there will be an allergic reaction to one of the foods that are listed in the center column. For example, for a patient allergic to cow milk, the available research shows there is a 92% chance the patient will have an allergic reaction (or a positive allergy test) to goat milk, but only a 4% chance of an allergic reaction to mare (horse) milk and a 10% chance of an allergic reaction to beef and beef products. It may be low risk to eat a hamburger if you have an allergy to cow milk but it will be unknown unless you try.

As always, speak to your healthcare team to discuss your food allergies and those foods that the team is comfortable for you to consumer and those that they would like you to avoid.

What is the best way to introduce new foods to the diet?

As always, consult with your healthcare provider to discuss your food allergies and those foods that are ok to introduce and those that may be potentially harmful. There may be some foods that they are comfortable to have you introduce in small amounts at home, often waiting for a few days before introducing another new food. However, an oral food challenge may be recommended for those who experience anaphylaxis or other severe reactions with foods. Oral food challenges should only be done under strict medical supervision (e.g. in a doctor’s office) and involve trials with small amounts of the food causing the allergy or a potential cross-reactive food. Pending the results, you may or may not be able to consume that food in the future.

Do you or your loved ones have experience with allergic reactions to related foods?

-Ellen Avery, MS, RD, CNSC


2. Sicherer SH. Clinical implications of cross-reactive food allergens. J Allergy Clin Immunol. 2001;108(6):881-90.

About Neocate

Posted 8.27.15 | Nutrition Specialist

Have you ever wondered what makes Neocate different than standard nutritional formulas? This is a very good question and definitely worth sharing.

All of our Neocate products are “elemental” formulas, or to be more specific “amino acid-based” formulas. The term ‘amino acids’ may bring back some memories from high school biology or chemistry class. Amino acids are essentially the building blocks of protein. The reason free amino acids are so important in some medical conditions is due to the fact that intact protein, in most cases, is what is responsible for triggering a food allergic response. Neocate is considered to be a hypoallergenic formula, as it does not contain any intact protein. In addition to the hypoallergenic nature of an elemental formula, the free amino acids make digestion and absorption easier as the protein is already in its most broken down form. It’s also important to mention that our bodies are able to use the amino acids in the same way that they use intact protein for healthy growth and development.

There are a number of reasons why an individual might need an elemental formula such as Neocate, such as:

  • Cow milk allergy (CMA) and/or soy milk allergy
  • Multiple food protein allergy
  • Short bowel syndrome (SBS)
  • Eosinophilic esophagitis (EoE)

This isn’t a complete list. Neocate products are sources of essential nutrients, and are often used as a sole source of nutrition (meaning they are used to meet all of an individual’s nutritional needs with no other source of nutrition). Of course, the amount of a Neocate product needed should be prescribed by a healthcare professional to ensure a patient consumes an amount needed to meet specific nutritional goals.

What makes Neocate products unique? Many reasons, but one that stands out to me the most is that Neocate powdered products are made in our own, dedicated facility that is 100% dairy-protein free. We also know that none of the ingredients in the Neocate products are derived from wheat, barley, rye, fish, shellfish, tree nuts, peanuts, or eggs; removing the risk of cross contamination with those allergens.

If you would like to read a little more about what makes Neocate products different, check out a page on our Neocate web site that I think you’ll find to be pretty helpful:

The various types of formulas available can be overwhelming and definitely cause some confusion. Please don’t hesitate to let us know if you have any questions by leaving a comment below!

- Kendra Valle, RDN

Mixing Neocate: A Simple How-To Guide

Posted 8.4.15 | Nutrition Specialist

Are you mixing Neocate correctly? It is important to mix Neocate appropriately to ensure your little one is receiving the nutrition she needs to thrive. My goal with today’s post is to make your life just a little easier by providing tips on how to properly prepare Neocate. If others help in your little one’s care (i.e. grandparents, day care providers, home health nurse, etc.), feel free to share this blog so that they are also aware of the necessary steps to take.

First and foremost, let’s discuss the basic steps for preparing Neocate:

  1. To begin with, wash your hands thoroughly and clean the preparation area.
  2. Pour the required amount of cooled, boiled water into a sterilized feeding bottle/container (or just warm or cool water – not boiled - for Neocate Junior).
  3. Next, add the prescribed amount of scoops of Neocate to the water (all scoops should be leveled and unpacked).
  4. Lastly, place the cap on the bottle/container and shake until the powder dissolves.

We are occasionally asked whether or not the cooled, boiled water (a.k.a. sterilized water) is a must when preparing Neocate Infant DHA/ARA. We suggest using sterile water for safety reasons, a recommendation that’s been made by several large healthcare professional groups (such as the American Academy of Pediatrics and Center for Disease Control and Prevention) in relation to the preparation of powdered infant formula. For standard bottled waters or for tap water, you can easily sterilize the water by bringing it to a rolling boil for 2 minutes. You should then remove it from the heat and allow the water to cool for about 20-30 minutes to bring it down to a cooler temperature that would be safe for mixing with Neocate Infant formula (below 122’F/50'C). This ensures it is not so hot that it affects nutrients in the formula. Neocate should never be mixed with boiling or recently boiled water. For caregivers who prefer not to sterilize the water, we suggest checking with your little one’s healthcare team for their guidance. As long as they don’t require it, it isn’t absolutely necessary that Neocate Infant DHA/ARA be prepared with sterile water: it’s just our recommendation.

Below you will find various recipes for our Neocate products at their standard dilutions (20 calories per fluid ounce for Neocate Infant DHA/ARA and 30 calories per fluid ounce for Neocate Junior and Neocate Junior with Prebiotics). Occasionally, your healthcare professional may recommend mixing Neocate to be more dilute or more concentrated. If this is the case, your healthcare team will provide the appropriate recipe to meet your child’s needs.

Neocate Infant DHA/ARA:

Neocate Junior, Unflavored:

Neocate Junior with Prebiotics, Unflavored:

Neocate Junior with Prebiotics, Vanilla:

Neocate Junior with Prebiotics, Strawberry:

Neocate Junior, Tropical and Chocolate:

We also have some great mixing demonstrations available on our YouTube page, Here you will find videos of my colleagues demonstrating how to properly prepare our Neocate products.

If you have any questions at all regarding how to mix Neocate, please don’t hesitate to contact our Nutrition Services team at 1-800-NEOCATE, option 2 or

Do you have any questions on preparing or mixing Neocate products?

-Kendra Valle, RDN

Orange you glad you read this post?

Posted 7.31.15 | Nutrition Specialist

Our guest blog today comes from Raquel Durban, a Registered Dietitian specializing in immediate and delayed food allergies in Charlotte, NC.  Raquel is a medical advisory board member for the Food Allergy and Anaphylaxis Connection Team (FAACT) and an active participant in the American Academy of Asthma, Allergy and Immunology (AAAAI), American Partnership for Eosinophilic Disorders (APFED) and International Network for Diet and Nutrition in Allergy (INDANA).  We would like to thank Raquel for this post. 

Think oranges are only for juicing? Think again! Oranges can provide a fun and educational experience to practice using auto-injectable epinephrine! While in clinic one afternoon, a mother pulled out a bag of citrus fruits (oranges and grapefruits work best because of their large size) and her expired auto-injectable epinephrine.

To my surprise and delight, she wanted to inject the oranges with her expired epinephrine devices so that I could "see" her practice and validate her administration. What makes this such a great idea? While the training devices for auto-injectable epinephrine are great teaching aids, the actually devices are heavier than the test devices, as they are filled with epinephrine. Also, the skin and flesh of the citrus fruits mimics a thigh very well.

I wanted to pass along this great idea to other families who might like to practice using expired auto-injectable epinephrine. If practicing with a little one, make sure you give them a helping hand. And after your practice session, please ensure that you dispose of the expired auto-injectable epinephrine correctly by checking with your doctor’s office or pharmacy. Some cities also have household hazardous waste programs that accept medical waste.


Image source: Debbie

Guidance when Cooking with Neocate

Posted 7.23.15 | Nutrition Specialist

We get emails and phone calls almost daily from parents, caregivers, patients and clinicians asking questions like "What happens if we cook with Neocate?" We know that there are a lot of creative ways that some families use Neocate, such as a replacement for cow milk in baked recipes. We've developed a handy one-page document to answer the most common questions that Neocate families want answers to. You can find your own copy of 'Cooking with Neocate' on the 'Recipes and Guides' page of the Neocate website, along with lots of other helpful materials.

As always, we recommend that you check with your healthcare team, because some forms of cooking can affect some nutrient levels in Neocate.

How have you gotten creative in using Neocate products in recipes?


Eosinophilic Esophagitis (EoE) and the Six Food Elimination Diet

Posted 5.15.15 | Christine Graham-Garo

Eosinophilic Esophagitis (EoE) is a condition that is continuing to get more and more attention in the medical community, which means the public is learning more about it too. Unfortunately though, the management options for EoE are not black and white. EoE may be managed either with medication, which has known long-term side effects, or nutrition therapy, which has been shown extremely effective, but may be difficult to follow for some families.

Medications used to manage EoE are all steroids, and at this point no medication has FDA approval for EoE. Steroids have been shown to be effective in managing EoE for more than half of patients. However, steroids may not be the best long-term solution for everyone. Many families who choose to use steroids may mix the medication recommended by their physician with Neocate Nutra. This is because Neocate Nutra thickens, so can help to coat the esophagus with the steroid. This use of Neocate Nutra was even studied by a medical team and you can read about their published research here.

As EoE is a chronic condition, management with nutrition therapy is often discussed and preferred by many families over steroids. Here are nutritional therapy options for EoE:

  • Elemental Diet – A diet consisting almost exclusively of amino acid-based (or elemental) products
  • Elimination Diets – The removal of allergens from the diet.
    1. Tailored Elimination – Elimination of specific allergens based on allergy testing
    2. Six Food Elimination – Elimination of 6 top allergens based on the most common allergens seen in EoE patients

The Six Food Elimination Diet

The 6 Food Elimination diet has been gaining in popularity because it bypasses extensive food allergen testing needed for the Tailored Elimination diet. As you may know, allergy tests (skin prick tests and blood tests) are not perfect. There are often false positives which can make the treatment plan more complicated and time consuming, and some allergens may be missed ('false negatives'). So what the 6 Food Elimination diet proposes is that, off-the-bat, patients eliminate the top 6 allergens seen in EoE patients. The top allergens are milk, soy, eggs, wheat, peanuts/tree nuts, and seafood. One study1 confirms there is a 74% success rate when using this type of nutrition therapy for EoE. (As a point of reference, an Elemental Diet shows a 95-98% success rate based on multiple studies.) Researcers are also looking into 4 Food Elimination diets.

Advantages and Disadvantages to consider

The advantages of using the 6 Food Elimination diet approach are that you can still eat solid foods. It also eliminates the need for extensive skin and blood tests to check for food allergies. Important disadvantages to this diet therapy are that it may unnecessarily remove foods from the diet, and many process foods are out, meaning the diet often involves a lot of preparation and careful reading of ingredient lists. Eliminating so many foods can increase the risk of patients being deficient in one or more nutrients. Also, as many of you may know, it is hard just to remove milk and soy from your diet. Try eliminating SIX different allergens that are found in many foods while maintaining your nutritional status! For this reason, many medical teams that manage patients with EoE encourage their patients to supplement the 6 Food Elimination diet with a nutritionally dense, hypoallergenic elemental product, such as Neocate®. This can help ensure the patient is getting all the protein, vitamins and minerals they need per day while ensuring that no allergic reactions will occur with the elemental products. It is vital that EoE patients are monitored by a dietitian. The dietitian will help calculate how much of the elemental product the patient will need per day and also make sure the nutritional status of the patient is maintained.

Again, since research has found a 74% success rate for the 6 Food Elimination diet, it's possible that symptoms will persist after starting the 6 Food Elimination diet. If this happens, your medical team can help you decide the next best step, which may include a careful review of your diet, possibly eliminating more foods, or starting with a more “allergen safe” diet therapy such as an Elemental diet. After a few weeks on the Elemental diet, most teams will work with you to start reintroducing solid foods to figure out which ones may be contributing to your symptoms.

I hope this helped to shed some light on this nutritional therapy options for EoE. Every person will have their own treatment plan that works for them. Is anyone following an elimination diet now? How is it going for you? Have any tips you can share that may help others manage an elimination diet?


1 Kagawalla AF et al, Effect of six-food elimination diet on clinical and histologic outcomes in eosinophilic esophagitis. Clin Gastroenterol Hepatol 2006:4(9):363-8

Corn Allergy 101

Posted 4.9.15 | Nutrition Specialist

As a Nutrition Specialist here at Nutricia North America, I spend a lot of time talking to patients, parents, and healthcare professionals. Some of the questions I receive most often are “Do Neocate products contain any ingredients derived from corn?” and “Are Neocate products safe for an individual with a corn allergy?” I want to explain a bit more about corn allergy, and then discuss the corn ingredients used in Neocate products.

Corn Protein Allergy

True allergic reactions to corn are rare, and often difficult to diagnose using standard skin or blood tests. True corn allergies are usually the result of the body being unable to tolerate the protein in corn, so you could call them a corn protein allergy. Some individuals seem to have a sensitivity to the carbohydrate in corn, which is even more difficult to diagnose, and not well understood.

Because a true corn protein allergy can be difficult to diagnose through traditional methods, if your allergist suspects a corn allergy, he/she may recommend a food elimination diet in which you avoid corn and any derivatives of corn for a specific period of time (normally two to four weeks). During this time, symptoms will be monitored, specifically to determine if there is an improvement in symptoms while corn is eliminated from the diet.

The next step might be to reintroduce corn foods to your diet to see if symptoms reoccur - this is termed an "oral food challenge," and if you've had severe allergic reactions to food in the past, the allergist may want you to do it in her/his office (called a "supervised trial"). Adding corn foods back into your diet may seem excessive if your symptoms improved on a corn elimination diet, but it's the best, most reliable way to confirm that the corn was the true culprit. If a corn allergy is identified by the allergist, managing the allergy would involve completely avoiding corn and many ingredients derived from corn.

Avoiding Corn

Corn is not among the top eight food allergens in the United States, for which special label information is required by the Food Allergen Labeling and Consumer Protection Act (FALCPA) of 2004. Because corn is not required to be called out on a food label, it is important for an individual with a diagnosed corn allergy to ask the allergist specifically what ingredients to avoid. Some ingredients, which are more refined and contain trace or undetectable amounts of corn protein, may be acceptable for some patients with a corn protein allergy. Ask your allergist for guidance on what corn ingredients to avoid, but here are some common ingredients in foods that are or can be derived from corn:

  • Corn starch
  • Corn syrup
  • Maltodextrin
  • Vegetable oil
  • Cellulose
  • Caramel

Please note, these are just a few examples and not a comprehensive list of ingredients derived from corn. If you are ever unsure as to whether an ingredient is derived from corn or if you should avoid it, it is best to contact the manufacturer to ask if the ingredient is derived from corn.

Neocate Corn FAQs

Now that we've covered a basic understanding of a corn protien allergy, let’s address these frequently asked questions as mentioned earlier. The primary carbohydrate source in each of our Neocate products is derived from corn:

  • The primary carbohydrate source in powdered Neocate products is corn syrup solids
  • The primary carbohydrate source in liquid Neocate products is maltodextrin (from corn)
  • Both corn syrup solids and maltodextrin are derived from corn starch
  • Maltodextrin is structurally similar to corn syrup solids, with slight differences in the degree of refinement
  • An individual who is intolerant to corn carbohydrates would probably not tolerate either maltodextrin or corn syrup solids better than the other
  • Some of the carbohydrate in liquid Neocate products comes from sucrose (table sugar) that comes from beets, so there is less overall corn-derived carbohydrate in these products compared to Neocate powdered products, calorie-for-calorie

Carbohydrates are essential for life, so carbohydrate ingredients are used in almost every nutritional formula.

  • Formulas that do not contain any carbohydrate are used for rare disorders where extremely specialized diets are needed.
  • Corn-derived carbohydrates are used in nutritional formulas as a carbohydrate source because they offer a blend of both simple and complex carbohydrates.
  • Simple carbohydrates are absorbed rapidly, whereas complex carbohydrates are digested and absorbed more gradually.
  • In Neocate products, the carbohydrates are in balance with amino acids (the protein source) and fat to provide a balanced nutritional profile.
  • No Neocate products are completely free of corn-derived ingredients.

That being said, the carbohydrates used in all Neocate products undergo extensive refinement in a multi-step process that includes purification, distillation and drying. This process is designed to remove impurities, including protein and fat that are naturally present in corn. As proteins are what the body responds to in a typical allergic reaction, this removes the trigger for patients with a corn protein allergy. With that said, we cannot make the claim that our Neocate products are completely “corn protein free.” In order to make such a claim, each and every batch would need to be tested for the presence of corn protein, which we do not do. (At this time, there is no validated lab test for corn protein.)

We cannot say with certainty that Neocate is “safe” for you or your child – that’s a question for your healthcare team. It is important to note that leaders in food allergy diagnosis and management indicate that true corn protein allergy is rare, and find a majority of patients with corn protein allergies tolerate refined corn syrup solids with no allergy symptoms. In practice, these healthcare teams do not counsel patients who are allergic to corn to restrict corn syrup solids from their diet. If you have questions about the safety of the corn syrup solids or maltodextrin in Neocate, it would be best to discuss this with your healthcare team, especially your allergist, to see if they recommend a supervised trial of a corn elimination diet or other testing to see if Neocate is appropriate.

Since we’re on the topic of corn, I figured I would mention two facts that are of importance to many Neocate families. The corn from which Neocate's carbohydrate ingredients are sourced is certified by the suppliers not to be genetically modified. In addition, the corn syrup solids used in Neocate products would not be expected to contain fructose and are not the same as “high fructose corn syrup” or “HFCS”. HFCS is produced from corn starch in which about half of the glucose molecules have been chemically converted to fructose. Many consumers prefer to avoid HFCS for a number of reasons, and we do not use this ingredient in Neocate products.

-Kendra Valle, RDN

Image source: Liz West


How to Travel with Neocate

Posted 2.27.15 | Rob McCandlish, RDN

by Kathleen Smith, RDN, LDN

As the weather starts to warm up and you start to consider travelling, you have lots to consider: where to go, how to get there, and what to pack. Whether you travel by car, bus, train or plane, an advance plan for the transportation and amount of Neocate you or your family member will need for your trip will save you from additional trip stress.

Get ready...

First things first, calculate exactly how much formula you will need for the entire trip. You don’t want to underestimate and run out of formula, as the chances of a local pharmacy having Neocate are small! (Check here if you find yourself in that situation.) We recommend packing an extra can just in case your travel plans change unexpectedly. You can also ship some Neocate to your destination, either from home or by placing an order with Nutricia (with free shipping!). 

Get set...

Next you will want to plan the amount of prepared formula to bring with you. Neocate powdered formulas can be prepared ahead of time and kept in a refrigerator for up to 24 hours. Prepared Neocate can be kept at room temperature for up to 4 hours as long as the bottle or container has not been “touched” (i.e. no formula has been consumed). So if you have a long flight or car trip, consider bringing a little cooler for your bottles; the cooler should be maintained at a temperature of less than 40°F (as cold as a refrigerator). Also, pack some extra Neocate powder in your formula bag in case of lost luggage or a formula spill.


If you are flying, the Transportation Security Administration (TSA) has regulations about flying with liquids for you or your family member. Formula, breast milk and juice for infants or toddlers are permitted to be brought on board the aircraft. Older individuals (older child, teen or adult) may also travel with Neocate.

Travelers must tell the TSA officer at the beginning of the screening process that they wish to bring formula, breast milk and juice in excess of 3.4 ounces in their carry-on bag. These liquids do not have to fit within a quart-sized bag like other liquids. The formula, breast milk and juice are typically screened by X-ray, and any of these liquids in excess of 3.4 ounces will receive additional screening.

Travelers are encouraged to travel with only the amount of formula, breast milk and juice needed to reach their destination. Ice packs and other accessories required to cool formula, breast milk and juice are also permitted through the screening checkpoint but may be subject to additional screening. 

Some Neocate families have told us that they’ve met TSA officers who aren’t used to seeing an older individual requiring a medical food like Neocate before. If you or your loved one is older, it may also help to bring a doctor’s note explaining that Neocate is medically necessary. TSA recommends that if you plan to travel with large quantities of medically necessary liquids you should coordinate your screening by contacting a Passenger Support Specialist prior to your flight.

For more info:

For more detailed information from TSA about flying with formula, visit prior to your flight.

For more information about the screening of passengers with disabilities and medical conditions, go to Here, passengers will find information about the TSA Cares program, how to secure the services of a Passenger Support Specialist (who is trained in assisting passengers with disabilities and medical conditions through the checkpoint screening process), and what to expect during the security screening process. In addition, passengers may ask to speak to a Passenger Support Specialist or a Supervisory TSO while at the checkpoint if they need assistance. Passengers also may report concerns by emailing TSA’s Disability and Multicultural Division at

We hope you and your family have a safe and wonderful trip! What advice can you share with other families about traveling with Neocate?


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About Us

Food Allergy Living is a resource for parents of children with food allergies, brought to you by Nutricia, the makers of Neocate. For more in-depth information about our purpose & authors, see our About Food Allergy Living page.