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We are happy to announce that we have a new addition to our Nutricia Product Coverage Navigator program! The program assists patients in obtaining insurance coverage for Nutricia products, including Neocate. When we first launched in November 2010, the program was only available in New York and Texas, but now it is offered in Massachusetts!

If you are a resident of Massachusetts, New York or Texas please call 1-800-365-7354 for help with:

• Obtaining prior authorization for any and all Nutricia products, including Neocate Infant, Neocate Junior and EO28 Splash;
• Answering questions regarding claims submissions;
• Drafting letters of medical necessity;
• Providing instructions on how to correct billing errors;
• Interceding with the insurance company on complex reimbursement matters; and
• Appealing a denied claim.

If you don’t live in Massachusetts, New York or Texas, please visit the Neocate website where you will find tips for obtaining coverage and details about reimbursement legislation.

- Sarah

Last week for our Ingredient Series, Christine wrote about the fats in Neocate. In this post, I’ll expand on that and explain DHA and ARA in more detail.

As you may know, the Neocate Infant formula is available in the original formulation and the updated formulation, which contains DHA and ARA.

Docosahexaenoic acid and arachidonic acid, better known as DHA and ARA, are types of fats (lipids) called long-chain polyunsaturated fatty acids (often abbreviated as “PUFAs”). DHA is an omega-3 fatty acid and ARA is an omega-6 fatty acid.

These fatty acids are found naturally in human breast milk and several other foods. Fish, especially cold water fish, have very high amounts of DHA. Eggs are also a natural source of DHA, but to a lesser degree than fish. ARA is found mostly in animal products, such as eggs, meat and fish.

It has been known for many years that long-chain polyunsaturated fatty acids (DHA and ARA in particular) accumulate in the brain and eye of the fetus during gestation, especially during the last trimester of pregnancy.[1] More recent studies show that DHA and ARA may play an important role for brain and eye development during infancy as well.[2] Breast-fed infants receive DHA and ARA from their moms and studies show that breast-fed infants typically have higher blood levels of DHA and ARA in comparison to infants fed formulas without DHA and ARA. For this reason, and because of the important role DHA and ARA are thought to play with brain and eye development, many infant formulas are now fortified with DHA and ARA to more closely resemble the intake of breast-fed infants.

The DHA and ARA found in Neocate Infant with DHA and ARA are vegetarian and non-GMO (meaning they are not derived from genetically-modified sources). The source of DHA is C. Cohnii Oil and the source of ARA is M. Alpina Oil.

So now when you see the “DHA and ARA” banner on your can of Neocate (if you use the Neocate Infant with DHA and ARA), you’ll know exactly what it means!

We hope you found our Ingredient Series helpful. If you are curious about anything else in Neocate please ask us in the comments!

-Mallory

[1] FDA/CFSAN Office of Nutritional Products, Labeling and Dietary Supplements July 2002
[2] Alan S. Ryan, James D. Astwood, Sheila Gautier, Connye N. Kuratko, Edward B. Nelson, Norman Salem . Effects of long-chain polyunsaturated fatty acid supplementation on neurodevelopment in childhood: A review of human studies. Prostaglandins, Leukotrienes and Essential Fatty Acids - 26 February 2010 (10.1016/j.plefa.2010.02.007

Ken began to develop an itchy, red rash on his face when he was just two months old. The condition had worsened by the time he was four months old. Poor baby Ken was miserable, always crying and rubbing and scratching his face.

Since Ken’s parents had actually been through this before with their older son R.J., this time they knew just what to do.

“Since his older brother R.J. had the same problem and it improved so quickly with Neocate we were at ease knowing that Neocate would work for Ken as well,” said R.J.’s and Ken’s father.

Ken Before Neocate

At four months old, when Ken’s rash worsened, his parents switched him to Neocate, an elemental formula for infants and children with allergies to the protein in milk and soy products, which had been successful for Ken’s big brother RJ.

Some of the most common symptoms of milk protein allergy are vomiting, diarrhea, bloody stool and other gastrointestinal issues. However, many babies-like Ken and his older brother R.J.-experience painful skin rashes as a symptom of milk protein allergy, which can be relieved by removing the allergens from the diet. For Ken and R.J. the rash went away when they switched to Neocate, which contains individual amino acids instead of the protein chains they were allergic to.

“Within a few days, Ken’s face cleared up and he was no longer rubbing and scratching, Neocate was all it took to resolve the problem,” said R.J.’s and Ken’s father.

Ken and RJ After Neocate

Before Neocate Ken couldn’t help but rub and scratch at it his eczema. Now, thanks to his pediatrician and some help from big brother R.J. he is a happy healthy baby.

“Neocate products are invaluable to our family, R.J. is now four years old and thriving on Neocate One+ while Ken is rash free on Neocate Infant,” said R.J.’s and Ken’s father.

If you want to share your before and after photos, we’d love to see them! Send us an email at FoodAllergyLiving@shsna.com.

From time to time, parents of children with allergies, who use our products, ask me if I’ve ever tried the Neocate formulas. We here at Nutricia have certainly tasted them all, but tasting and consuming are two different things. After lots of questions from parents about what their little one is feeling and whether or not it’s normal, and given my indiscriminate palate, I decided it was time to really give Neocate a try.

My plan? To go on a nothing-but-Neocate diet for two days. What, exactly, would be allowed? Neocate: specifically any of the Neocate products, the flavor packets, and the flavors straws. What wasn’t allowed? Anything else. Well, almost anything else. I decided I would still be allowed tea (lack of caffeine could be a real problem!). I also decided that, given my usually high fiber intake, I would also be allowed to supplement my Neocate diet with fiber. I found an inulin fiber supplement: the same type of fiber that’s included in Neocate Junior with Prebiotics. Some folks might say this is cheating, but I took the advice that I (as a Registered Dietitian) would give anyone: to avoid a sudden and drastic change in fiber intake, up or down. 

With these rules in mind, I used my approximate calorie needs to design a “meal plan” and dove right in.

Day 1 Menu: 

• Morning Snack: Neocate Infant with DHA and ARA
• Breakfast: Neocate Infant with DHA and ARA
• Lunch: Neocate Infant with DHA and ARA + Lemon-Lime Flavor Packet
• Dessert: Neocate Nutra + Neocate Junior Chocolate (“Chocolate Pudding”)
• Afternoon Snack: E028 Splash Orange-Pineapple
• Appetizer: Neocate Junior with Prebiotics + Grapefruit Flavor Packet
• Dinner: E028 Splash Grape + Neocate Junior Chocolate (“Chocolate Covered Raisin”)
• Dessert: Neocate Junior with Prebiotics + Cookies ‘n Cream Flavor Straw

Day 1 Experience:

The day started with Neocate Infant with DHA and ARA. Does this taste like standard infant formula or milk? Nope. Because the Neocate products have amino acids instead of whole protein, Neocate Infant with DHA and ARA has a different taste and a thinner texture. To me it has a grassy undertone, which isn’t so bad, and is something most infants either don’t notice or get used to after a few days. Smaller amounts were fine, but a full 350 calories of plain Neocate Infant was a bit much, even for me: by my last “meal” of Neocate Infant at lunch I decided I could use the help of our Lemon-Lime Flavor Packet. So far, so good. I was surprised that I wasn’t ravenous as the day progressed – I had my doubts that an all-liquid diet would keep me satisfied, but it really did. I managed to go to bed without having any real cravings that day. No stomachaches and nothing out of the ordinary.

Day 2 Menu:

• Morning Snack: E028 Splash Tropical Fruit
• Breakfast: E028 Splash Orange-Pineapple + Neocate Junior + Strawberry & Banana Flavor Straws (“Fruit Salad”)
• Lunch: Neocate Junior Tropical
• Dessert: Neocate Nutra + Neocate Junior with Prebiotics + Cherry Vanilla Flavor Packet (“Chocolate-covered Cherry Pudding”)
• Snack: E028 Splash Tropical Fruit
• Appetizer: Neocate Junior with Prebiotics + Strawberry & Banana Flavor Straws
• Dinner: E028 Splash Orange-Pineapple + Strawberry Flavor Straw + Junior with Prebiotics
• Dessert: Neocate Nutra + Neocate Junior Chocolate + Strawberry Flavor Straw (“Chocolate-covered Strawberry Pudding”)

Day 2 Experience:

This day started with some definite hunger, but the morning snack took care of that. When I arrived at work I found a donut on my desk – so began the cravings for solid food. It was definitely difficult to avoid the snacks around the office that day, but I made it through. The toughest part was probably dinner time. I usually handle food preparation in our house, so having to cook dinner and not partake in enjoying it was difficult.

By the end of the day all of the different flavors began to taste pretty similar to me, probably because I tried to do too many flavor mash-ups. I will say that I definitely found the EO28 Splash an easy option. It seems silly, but it was so much nicer to grab a Splash instead of having to prepare a meal.

All things considered, the Neocate diet wasn’t nearly as difficult as I thought, and actually made life easier. I really appreciated having all of the different flavor options and the simplicity of Splash in a ready-to-go format. That said, a third day might have gotten a little routine, so I have a great deal of respect for the patients who have to stay on an elemental diet for an extended period of time, especially those children who have had “real” food, know what it tastes like, and have to give it up.

And the question many parents would like to ask: How did I feel after two days of Neocate? Pretty normal, actually. My stomach felt a bit more “active” at times, but I never felt queasy, had diarrhea or constipation, or really felt any different than I usually do. I didn’t experience any big swings in hunger or fullness, and it was nice not worrying about whether or not I was getting a balanced meal: Neocate took care of that for me. For parents of children who are going from a more typical diet to Neocate (such as those with EE who are starting an elimination diet) you may want to check with your child’s healthcare team about using Neocate Junior with Prebiotics, which has fiber to help maintain gut health. 

How about you: have you ever tried a full serving of Neocate? If so, what did you think? Feel free to share any questions you have about my experience!

- Rob

We would like to let you know that Nutricia North America is currently transitioning Neocate Infant original formulation families to Neocate Infant DHA & ARA.  Neocate Infant original will be discontinued October 1, 2011.

Neocate Infant DHA & ARA provides the same nutritional advantages as Neocate Infant original and has the added benefit of DHA and ARA.  DHA and ARA are two nutrients present in breast milk and are known to help brain and eye development.

As always, be sure to consult with your physician before switching formulas.  We are also informing healthcare professionals and have requested that they transition their patients to Neocate Infant DHA & ARA immediately.

If you have further questions or need assistance with transitioning, please feel free to contact us at 1-800-Neocate (Monday through Friday 8:30 am - 8:00 pm EST) and ask to speak with our nutrition specialist.

- Sarah

The most common questions we get have to do with product details so, we decided to start a product series that will hopefully answer a lot of your questions.

Today we are going to start with our Neocate Infant product.  Neocate Infant is a special formula designed for the specific nutrient needs of infants with milk protein allergy, multiple food protein intolerance (e.g. allergies to soy protein, hydrolyzed protein in other infant formulas) and food allergy associated conditions such as gastroesophageal reflux disease, atopic dermatitis (a type of skin rash), eosinophilic esophagitis, short bowel syndrome and other GI disorders.

Neocate is described on the label as:

• Hypoallergenic: The formula is less likely to cause an allergic response.
• Nutritionally Complete: All of the essential nutrients needed to grow and develop are supplied by the formula when consumed in adequate amounts.
• Elemental: Ingredients are broken down to their simplest and purest form so they are easier for the body to process and digest.
• Amino Acid-based: Amino acids are the non-allergenic building blocks for all protein.

With over 50 published studies (an going), we are proud to say that Neocate is the most studied amino acid-based formula available.  In clinical studies an elimination diet using Neocate has been shown to improve gastrointestinal symptoms of cow milk allergy such as diarrhea, blood in the stools and vomiting associated with milk protein allergies in just 3 days and improving gastroesophageal reflux and skin irritations, such as eczema and atopic dermatitis in just 14 days.

To see how Neocate Infant has helped other families cope with the challenges of food allergies and GI issues we recommend reading RJ, Olivia and Luke's testimonials.

Below you will find the Neocate Infant mixing instructions, nutrient profile and ingredients.  Additional information and frequently asked questions can be found in our Neocate Parent Guide.

Easy Preparation

(click here to watch our Neocate Infant mixing video):

Neocate Infant may be mixed with warm or cool sterile water.*  Do not boil formula or use a microwave to prepare or warm formula.  For standard dilution, use enclosed scoop (4.75 g) to mix one level scoop per fluid ounce of prepared formula.

How to make a 5 fluid ounce bottle:

1. Add 5 scoops of Neocate Infant to a clean, sterile container.
2. Fill up to the 5 fluid ounce line with warm or cool sterile water.
3. Shake for 15-20 seconds or until the powder dissolves.  Add additional water if necessary to make final volume and shake again.

*Boiling is the preferred method for sterilizing water, bottles, nipples and mixing utensils.

Freshly mixed formula is best.  Refrigerate pre-mixed formula immediately and use within 24 hours of mixing.  Shake immediately before use.  Throw away formula left in the bottle one hour after feeding.  Tube feeding hang time should not exceed 4 hours.

Nutrient Profile:

Ingredients:

Corn Syrup Solids (57%), Refined Vegetable Oil (Medium Chain Triglycerides (Palm Kernel and/or Coconut Oil) (7%), High Oleic Sunflower (7%), Soy (6%)), Calcium Phosphate Dibasic (2.5%), and less than 2% of each of the following: L-Arginine L-Aspartate, Tripotassium Citrate, L-Leucine, L-Lysine Acetate, L-Glutamine, L-Proline, L-Valine, Glycine, L-Isoleucine, CAEM (an Emulsifier), L-Threonine, L-Penylalanine, L-Tyrosine, L-Serine, L-Histidine, L-Alanine, Sodium Chloride, L-Cystine, L-Tryptophan, L-Methionine, Magnesium Acetate, Magnesium L-Aspartate, Potassium Chloride, M. Alpina Oil*, Choline Bitartrate, M-Inositol, C. Cohnii Oil**, L-Ascorbic Acid, Ferrous Sulfate, Zinc Sulfate, Taurine, L-Carnitine, Sunflower Oil, Niacinamide, DL-Alpha Tocopheryl Acetate, Calcium D-Pantothenate, Cupric Sulfate, Manganese Sulfate, Pyridoxine Hydrochloride, Riboflavin, Vitamin A Acetate, Thiamine Chloride Hydrochloride, Ascorbyl Palmitate, Potassium Iodide, Chromium Sulfate,Mixed Tocopherols, DL-Alpha Tocopherol, Phylloquinone, Sodium Molybdate, Folic Acid, Sodium Hydrogen Selenite, D-Biotin, Vitamin D3,Cyanocobalamin.

*A Source of Arachidonic Acid (ARA)

**A Source of Docosahexaenoic Acid (DHA)

As you know, in 2008 we introduced Neocate Infant DHA & ARA.  DHA and ARA are two fatty acids naturally found in breast milk that have been shown to help promote brain and eye development.  The addition of DHA and ARA does not change the other properties of the formula (i.e. taste, texture, hypoallergenicity), but it does provide an extra boost to benefit your little one!  As a consequence, in October 2011, Nutricia North America announced and began the discontinuation of Neocate Infant original and over the past few months we’ve been proactively transitioning original formulation families toNeocate Infant DHA & ARA. 

We wanted to remind you of this and let you know that we have run through all of our stock of the Neocate Infant original.  We are no longer selling the Neocate Infant without DHA and ARA.

We encourage you to discuss alternative options such as, Neocate Infant DHA & ARAwith your child’s doctor or dietitian.  Or, if your child is over the age of 1 year, we have Neocate Junior Unflavored or Neocate Junior Unflavored with Prebiotic fiber.

If you have further questions or need assistance with transitioning, please feel free to contact us at 1-800-NEOCATE (Monday through Friday 8:30 A.M. – 7:00 P.M. EST)and ask to speak with our nutrition specialists.

-Sarah

As you know, in 2008 we introduced Neocate Infant DHA & ARA.  DHA and ARA are two fatty acids naturally found in breast milk that have been shown to help promote brain and eye development.  The addition of DHA and ARA does not change the other properties of the formula (i.e. taste, texture, hypoallergenicity), but it does provide an extra boost to benefit your little one!  As a consequence, in October 2011, Nutricia North America announced and began the discontinuation of Neocate Infant original and over the past few months we’ve been proactively transitioning original formulation families toNeocate Infant DHA & ARA. 

We wanted to remind you of this and let you know that we have run through all of our stock of the Neocate Infant original.  We are no longer selling the Neocate Infant without DHA and ARA.

We encourage you to discuss alternative options such as, Neocate Infant DHA & ARAwith your child’s doctor or dietitian.  Or, if your child is over the age of 1 year, we have Neocate Junior Unflavored or Neocate Junior Unflavored with Prebiotic fiber.

If you have further questions or need assistance with transitioning, please feel free to contact us at 1-800-NEOCATE (Monday through Friday 8:30 A.M. – 7:00 P.M. EST)and ask to speak with our nutrition specialists.

-Sarah