Food Allergy Living Blog Tagged Results


Baby Formula and Food Thickeners: What are the options?

Posted 6.17.10 | Christine Graham-Garo

baby being fed
To follow up on Mallory’s post on Dysphagia, GERD, and Silent Aspiration in children, I wanted to use this post to discuss the use of thickeners to help with the treatment of GERD/GER, dysphagia and aspiration. I'll also share some commercially available thickeners.

If your little one is showing signs of GERD/GER, dysphagia or aspiration, you should always see a doctor to determine exactly what condition needs to be treated. One thing to remember is that children with Eosinophilic Esophagitis (EoE) can also have symptoms of dysphagia and often have symptoms very similar to that of GERD.

EoE is caused by food allergies and can be managed effectively by eliminating the allergens in your child’s diet. Thickening their food or formula may not be needed once the allergens are removed if the reflux also comes under control. Be sure to check with your child's doctor and/or speech pathologist to see if a food thickener is appropriate for your little one before trying one.

Thickening Foods and Liquids

If your child does have GERD/GER, dysphagia or aspiration, the healthcare team may recommend altering the thickness of food and liquids to help make them easier to swallow. When fluids are too thin, some children have trouble using their tongues and the muscles that help to swallow correctly, causing liquid to get caught in the airway passage and then get into their lungs. Thickening the formula and other fluids can help the liquids stay together during swallowing, decreasing the risk of aspiration, which is when fluid or food getting into the lungs (where it should not be!).

For infants with reflux symptoms, adding dry rice cereal or oat cereal to their formula or expressed breast milk to thicken it may be suggested by some healthcare professionals. It's important to note that there is not consensus on this, and not all healthcare teams agree that this is an acceptable approach. If your team suggests this, you should ask them what amount of cereal they recommended you add to your little one's bottle to help with reflux. You can read more about adding thickeners to Neocate here.

There are also some commercial thickeners on the market that may be options, depending on your child's age. It is important to read labels and call the company that makes the thickener if your child has food allergies to ensure the thickener doesn't contain any of their allergens. A few options in the market, and the manufacturer recommendations on who can use the product, include:

  • GelMix (not for use with infants under 42 weeks gestational age or with infants under six pounds)
  • ThickenUp (only appropriate for use in individuals greater than 3 years old)
  • Thick-It (not appropriate for use with premature infants, consult your physician before using with any infant)
  • SimplyThick (NOT intended for use with children under 12 years with a history of NEC, with preterm infants, or term infants under 12 months)

We do not have any specific commercial thickeners that we recommend for Neocate products. Any should work, and if your healthcare team recommends that the Neocate you use should be thickened, ask them what they recommend.

We hope this helped! What other questions do you have about thickeners?

- Christine
Nutrition Specialist

Understanding How Infant Taste Buds Work

Posted 2.4.10 | Mallory West

Ever wonder if your infant has the capacity to really taste his or her food? Well, this post will address the sense of taste in infancy!

To start, let’s review the basics of the “gustatory system”. Taste buds on the tongue relay information to the brain, which is perceived as taste.

The 5 basic tastes of any human are:

  • sweet
  • salty
  • sour
  • bitter
  • savory (aka umami).

Research shows that infants are born with a predisposition to accept sweet tastes, such as breast milk. Infants also have a predisposition to reject new foods, a phenomenon known as “neophobia”[1]. During infancy, almost all foods are “new” so it’s no wonder that introducing a new food or formula may result in some resistance from your baby.

The good news is that this neophobia can be overcome by repeated exposure to the food. In other words, taste preferences aren’t set in stone; they are constantly evolving. With repeated experience, infants accept and may even prefer the previously rejected food. One study observed mothers who presented a particular food daily over a period of time. The researchers found that it took 15 feedings for the infants to accept the new food readily.

Therefore, whether you are introducing solids or switching over to Neocate from another formula, don’t be discouraged! It is not only ok, but normal for your little one to reject the new food at first. Just be patient and persistent and continue to present the food in a positive manner.

An interesting tidbit: An infant’s perception of bitter taste is developed several months after birth. A study found that newborn infants did not reject the taste of bitter, while older infants did[2]. Another study identified the time period for this developmental change to be around 4 months of age[3]. The researchers found that infants who were put on a specialized, broken down formula (which have a slightly bitter taste due to the broken down protein) before the age of 4 months transitioned to the new formula with no resistance.

After this age, the infants identify the change in taste and moms may have to be a bit craftier to transition their little one onto the new formula. The researchers pointed out that a gradual transition, where the new formula is mixed with the previous formula, helps older infants to accept the new formula. This allows infants taste buds to gradually and repeatedly be exposed to the new flavor and associates the flavor with something that they already like (the previous formula).

What tastes did your child prefer when you first began introducing foods? Have you noticed any change in their taste preferences as they get older?

- Mallory

[1] Birch, L. L. (2002). Acquisition of food preferences and eating patterns in children. In C. G. Fairburn, & K. D. Brownell (Eds.), Eating disorders and obesity (2nd ed., pp. 75-79). New York, NY: The Guilford Press.
[2] Beauchamp GK, Cowart BJ, Kajiura H. Early developmental change in bitter taste responses in human infants. Dev Psychobiol. 1992 Jul;25(5):375-86.
[3] Beauchamp GK, Griffin CE, Mennella JA. Flavor Programming During Infancy. PEDIATRICS Vol. 113 No. 4 April 2004, pp. 840-845

Lessons from Developmental Psychology

Posted 12.3.09 | Mallory West

Recently I was volunteering at a local organization which provides respite care to families of children with special needs. There was a baby in the center who had recently been switched from a milk-based formula to a soy-based alternative. The caregiver was explaining that the baby didn’t seem to like the formula and that she didn’t blame him because it tasted awful. Everybody smelled the formula and made disgusted faces, making a huge deal about how terrible it was that the baby had to drink it. And all I kept thinking was, well of course the baby doesn’t like it! How many of us would want to eat or drink something when everyone around us thinks it’s gross.

I wanted to share this with you because parents often call us for advice on transitioning their baby to Neocate. Hopefully, this entry will provide some helpful guidance if you are making that switch.

First and foremost, it’s important to remember that if your baby is prescribed a special formula, it’s because of a medical condition which makes him or her unable to tolerate typical formula. The special formulation of Neocate makes it taste different from standard formulas, but it’s also this special formulation which provides relief and allows your baby to grow, thrive and be healthy. So how can you help make the transition smoother?

The answer is a lesson of developmental psychology! Research shows that although children are born with predispositions for certain food preferences, the majority of food preferences are shaped by experience1. A child’s food acceptance and preference are strongly influenced by the way their parents present these foods. Children learn to accept and prefer foods which are presented repeatedly and in a positive manner. At the same time, if a food is presented in a negative context, the child is likely to dislike and reject the new food (which is the most likely reason for the baby I described above not wanting the formula).

Therefore, if you present the new formula positively, even tasting it yourself and showing a pleasant response, your child is much more likely to accept and even like it. Likewise, if you display your distaste for the formula in front of your baby (for example making a disgusted face and exclaiming “this formula tastes gross!”), your baby is likely to learn to dislike it as well.

So, the takeaways are:

  1. When introducing a new formula to your baby, remember to keep a positive and supportive demeanor. Try not to make unpleasant facial expressions or negative comments in front of the baby.
  2. Remember that children learn to accept foods which are presented repeatedly so don’t be discouraged if your baby doesn’t accept the new formula right away.

Keeping these tips in mind will hopefully make the formula transition much more pleasant for your baby and as a result, much more pleasant for you too!

Do any of you have tips for helping with the transition to Neocate? We’d love to hear them!


1. Birch, LL. Development of Food Acceptance Patterns in the First Years of Life. Proc Nutr Soc. 1998 Nov;57(4):617-24.

Why I’m Thankful – Part Four

Posted 11.26.09 | Nutrition Specialist

Happy Thanksgiving! This month, my colleagues Sarah, Mallory, Christine and I decided to do a series of “Why I’m Thankful” blogs. I hope my post finds you in good health and enjoying the long, holiday weekend!

To start off, I am thankful for my family and friends — without them I would not be the person I am today. They bring support, happiness and laughter into my life.

Like Mallory, I am also thankful for the improvements in science and how far we’ve come. When I was a little girl, I suffered from milk allergies and was very underweight. My family did everything they could to ensure I gained weight properly and I was able to thrive without milk in my diet. Still, it was quite a struggle, as I’m sure you know firsthand from your experiences with your little ones! Like so many allergy kids, as time passed I finally outgrew my allergies and eventually I even outgrew my nickname “Spaghetti Legs”. This came as a huge relief to both me (after years of being unable to do so, I could finally eat ice cream!) and my family.

Neocate formulas and Duocal would have been optimal for my growth; however, they were not available when I needed it. Both Neocate and Duocal provide families with options I did not have when growing up with a milk allergy and underweight. Families can rely on our hypoallergenic, amino acid-based formulas and not have to worry that their child isn’t getting the proper nutrition they need to grow properly. Although I wasn’t able to benefit from Neocate or EO28 Splash, I am so thankful the families I talk to everyday are able to feed their children these formulas which are able to alleviate some of the stress of parenting a child with food allergies.

Lastly, I’m thankful for you! Since starting here at Nutricia, I have learned more about your families, and been able to provide resources and assistance to make your lives easier. It has been a joy getting to know you and helping your little ones!

What are you thankful for this Thanksgiving?

- Nita

Why I Am Thankful – Part Three

Posted 11.19.09 | Christine Graham-Garo

You may have read Sarah and Mallory’s “Why I’m Thankful” posts over the last couple weeks. In case you missed them, we are sharing what we are most thankful for in our lives. Here are my reasons for being thankful this Thanksgiving!

First and foremost I am thankful for my family and friends. I am fortunate to have such a supportive and loving family.

Another important thing I am thankful for is my health When I was just 8 years old I was diagnosed as a type 1 Diabetic. At the time it was a very new and frightening thing. The fact that I had to live with diabetes for the rest of my life (and give myself insulin injections on a daily basis) was a big adjustment for me and my family to deal with.

Although I have been diabetic for about 20 years, I have made it my goal to make sure my diabetes is controlled. Besides the fact I have this condition, I am fairly healthy otherwise. I always feel it could have been much worse for me, and I am thankful that it wasn’t. With the future of medical science, more and more tools are being introduced to help diabetics control their sugars (as well as help manage other conditions). I make sure to eat a balanced meal and exercise daily (although that may be easier said than done!). With the help of my family I have been able to live a full life regardless of my condition.

Finally, I am thankful for the fact that I can help families in need. As a nutrition specialist for Nutricia North America, specializing in infant nutrition, I am able to help many families by educating them about our formulas. Everything from explaining to parents and caregivers how to use and mix the formula correctly, what to expect when their child is on it, and how to make sure they are doing everything correctly, has truly helped Neocate families and it’s extremely rewarding to know that I’m a part of that process. I have always wanted to use my knowledge of nutrition to help people make the best decisions for their health. Being a nutrition specialist has helped me to do that and I am so thankful for it.

- Christine

To Sterilize or Not to Sterilize?

Posted 6.25.09 | Christine Graham-Garo

Over the last year I’ve received several phone calls from parents asking whether or not they need to sterilize the water for their child’s infant formula. And the confusion is completely understandable…depending on who you are talking to, you’ll most likely get a different answer.

I always recommend that parents take the extra precaution and boil the water for all preparations of the formula – In my mind, better to play it safe when it comes to your child’s health. (And as a side note, purified water, bottled water and nursery water, are not sterile, so make sure you boil them as well).

However, I’ve seen other manufacturers of infant formula state on their cans to “Ask your baby’s doctor if you need to boil (sterilize) water for formula and bottle preparations.”

Since this seems to be a topic of confusion, I thought I’d share some recommendations from the World Health Organization that I typically provide parents:


Cleaned equipment can be sterilized using a commercial sterilizer (follow manufacturer's instructions), or a pan and boiling water:

Step 1: Fill a large pan with water

Step 2: Place the cleaned feeding and preparation equipment into the water. Make sure that the equipment is completely covered with water and that no air bubbles are trapped. Step 3: Cover the pan with a lid and bring to a rolling boil, making sure the pan does not boil dry.

Step 4: Keep the pan covered until the feeding equipment is needed.

If you are interested in checking out the World Health Organization’s pamphlet with these steps and other guidelines for preparing formula for bottle feeding at home, click here.

If you have any questions about proper sterilization techniques for your child’s infant formula let us know. I encourage you to post a comment so others can see your question as well.

- Christine

eBay Scam Follow-up

Posted 3.12.09 | Christine Graham-Garo

A few months ago, my fellow blogger wrote an entry on online formula scams. A man from Omaha, Nebraska was selling Neocate on eBay to parents, but after making the sale never shipped the formula. Luckily, they caught the man back then but his sentence was just announced.Joseph A. Boylan, 33, was charged with one count of a felony theft by deception and was sentenced to five years probation.

To read the entire article, click here.

  • This is just a friendly reminder about the dangers of buying formula from bidding sites:
  • While you might find prices to be slightly cheaper on these sites, you have no way of verifying who is selling you the product;
  • The formula may not have been stored properly, which could cause the ingredients to be altered;
  • The person selling the formula could have tampered with the product making it dangerous for your little one to drink; and
  • The formula could be expired.

To be on the safe side, purchase your formula from the manufacturer’s Web site or from your local pharmacy so that you are confident that the formula is safe and that you are getting what you ordered.

- Christine

Your Child Is Growing Up and It’s Time To Switch Formulas?

Posted 1.6.09 | Christine Graham-Garo

*Please note an updated version of this blog is available at: Transitioning from Neocate Infant to Neocate Junior

Often, I get calls from curious parents regarding up-age products, which are products for babies that are one year of age and up. Our conversation is very similar to this:

“My little one with an allergy is about to turn one years old. Can I keep him on the same formula or should I switch to a different one? If I have to put him on a new formula, how do I do it?” – Parent

“The answer is simple and only involves two things: New formula and weaning.” – Nutrition Specialist

Of course, it’s not that simple. But it isn’t as hard as many would think. And honestly, the process usually depends on your child.

Depending on what formula your child is on now, you can usually just switch it to the product next in line. Here at Nutricia infants with milk protein allergies are on Neocate Infant. Once a child turns one, parents can then switch their formula to Necoate Junior or EO28 Splash.

Since each child is different, my formula suggestions are always on a case-by-case basis and of course depend on a doctor’s recommendation. However, for instance, if your child still has malabsorption issues, I would often recommend Neocate Junior because it contains a higher amount of vitamins and minerals.

After you make the formula choice, you need to begin weaning your little one. Again, the process of weaning is not set in stone; however, you usually start by giving your child a combination of new formula and old formula until he or she is completely comfortable on the new formula. For example, you could start off with 25% new formula and 75% old formula. If that works for your little one, slowly keep increasing the amount of new formula. If your child gives resistance, switch to less of the new formula and more of the old. Basically, you can create your own weaning recipe!

What have your experiences been like switching to up-age formulas? I’d love to know!

And as always, if you have any questions, send them my way!

- Christine

FDA Issues Another Warning…

Posted 9.23.08 | Nutrition Specialist

I know it might seem like we write about formula fraud quite often, but we just want to make sure your little ones are safe! Here’s another warning from the U.S. Food and Drug Administration (FDA) about avoiding infant formulas imported from China.

To see the official FDA warning, click here.

The warning does not affect any of the six companies regulated by the FDA that have been approved to distribute formula in the U.S. (Abbott Nutrition, Mead Johnson Nutritionals, Nestle USA, PBM Nutritionals, Solus Products and Nutricia) so don’t be too alarmed! I would suggest, however, avoiding any formula not made by these six FDA approved manufacturers.

To make sure you are getting the safe and appropriate formula for your little one, check out these reminders:

Know where your formula comes from;
- Be aware of online formula scams;
- Be wary of borrowing or buying formula from a friend; and
- Check the expiration dates.

It might seem OK to borrow some formula from a friend or buy it from a Web site like eBay; however, you can never know if it was stored properly or exactly where it came from. It’s always better to err on the side of caution and purchase a formula from the proper Web site, store or pharmacy.

If you have any questions, shoot them on over!

- Nita

Formula 411 for Food Allergy Families

Posted 8.15.08 | Nutrition Specialist

When my wife and I were expecting our first child, a lot of questions went through our minds, such as “My God, what have we done!”

Just kidding, we knew from the first kick Vincent would be awesome.

But we did ask ourselves a lot of big questions, including just how many ways are there to manufacture a sippy cup? And how do two people choose one from the entire wall of sippy cups at Babies R Us? What exact temperature should the bath water be? And how many IQ points is the kid going to lose if we paint the nursery the wrong color?

When you find out your baby has a food allergy, there’s a whole new set of questions. And just what exactly do you feed the little guy or gal is at the top of the list.

If you’re a breastfeeding mother, you’ll need to work with your healthcare team to identify everything the baby is allergic to and remove all those foods from your diet. If the baby relies on formula for some or all of his diet, you’ll need to make a formula change. But what do you change to?

Here’s the 411 on the different types of formula and what you should know about them if you’re a food allergy family.

Cow’s milk formula
This is most of the formula you’ll find in the grocery story aisle. It’s based on cow’s milk and fine for most healthy babies. But milk allergy is the most common food allergy among babies. So that milk, which contains full protein chains, is bad news for a food allergy baby.

Soy formula
This formula is based on soy instead of cow’s milk so it is dairy-free, but it is still not recommended for a food allergy baby, since as many as 70% of babies with a milk allergy also have a soy allergy.

Hydrolysate formula
Instead of the full protein chains in cow’s milk formula, hydrolysate formulas have protein chains that are broken into smaller pieces. This makes the formula easier for some food allergy babies to digest, but it doesn’t help everyone.

Amino acid-based formula
This formula doesn’t contain any protein chains at all. Instead it contains the individual amino acids that make up a protein. Essentially, it is baby’s nutrition in its simplest form and the absolute easiest thing for a milk allergy baby (or any baby with gastrointestinal issues) to digest. Using an amino acid-based formula like Neocate typically clears up a milk allergy baby’s gastrointestinal symptoms in 3-5 days and any skin rash associated with the food allergy within 2 weeks.

This is the basic rundown. If you have any further questions, feel free to post a comment below.

Be well,
Dr. Y

“100% Milk-Free Environment”

Posted 7.1.08 | Sarah O'Brien

These words are music to allergy parent’s ears…

However, did you know that some formulas made for babies with milk allergies are NOT produced in an entirely milk-free environment? Many allergy moms and dads don’t realize this.

We surveyed parents of kids with food allergies recently and were surprised at the results:

57% of parents thought their child’s formula was manufactured in a 100% milk-free environment, but when we asked about the specific products, only 38% of them were actually manufactured 100% dairy-free.

At the same time, 99% of the parents surveyed said they were concerned about the risk of their children consuming a food allergen. No surprised there!

Vigilant allergy parents have a lot to look out for – from the fine print on food labels to how/where everything you put into your child’s mouth is manufactured. It is definitely tiresome, but definitely worth it.

Since food allergies cause roughly 30,000 emergency room visits a year, this is something to take note of! As an allergy parent, remember that advertising can be tricky. As of right now, Neocate Infant, Necoate Jr. and EO28 Splash are the only amino-acid based products that are manufactured in a 100% milk-free environment.

Overall, make sure you double check your choice of formula for your child with your pediatrician. You can never be too careful with food allergies!

- Sarah

Double Check Labels and Expiration Dates Please!

Posted 6.20.08 | Sarah O'Brien

Milk in bottled water! CVS selling expired baby formula! Recently, there have been a few news stories that are quite shocking.

As an allergy parent, you’re a pro at reading food labels. However, most people wouldn’t think to check the label on a bottle of water. Now, you might have to. Click here to check out the article on Allergy Moms. Apparently, Special K Protein Water contains milk!

Some people are big on checking expirations dates. However, others don’t think twice about it. This is causing a big stir in New York where both CVS and Rite Aid have been selling expired products. Click here to read the article from Reuters. The expired products being sold included milk, eggs, baby formula, cold medicines, allergy treatments and other over-the-counter medicines.

It’s important to remember to be a conscious consumer -- especially when shopping for your little one! If a bottle of water has milk in it, I wonder what else does?

- Sarah

Elimination Diet vs. Elemental Diet

Posted 10.25.11 | Rob McCandlish, RDN

If your little one uses any of the Neocate products, you’ve probably heard the term “elemental diet.”  And if your son or daughter has eosinophilic esophagitis (EoE), you’ve probably also heard of an “elimination diet.”  These two aren’t always the same, so here’s a quick primer on the two.

Elemental Diet

The term “elemental diet” is a historic term that was used to refer to diets where the component nutrients were broken down into their “elements.”  Another term is “semi-elemental.”  In terms of nutrition, a semi-elemental formula, or hydrolysate, is one that has proteins that are partly broken down, or hydrolyzed.  These can be partially or extensively hydrolyzed.  An elemental formula, then, is one that contains only amino acids, the building blocks of protein.  Elemental formulas can also have some fats which are easier for the body to absorb than those found in the standard diet.

Now, technically speaking, elements are atoms, like you would see on the Periodic Table of the Elements.  So, technically, Neocate is not elemental, because it’s made of molecules, not individual atoms.  So in the strictest sense Neocate isn’t elemental: no formula is!  But, many health care professionals still use this term.  The more accurate term for Neocate, which you’ll see on our website, is amino acid-based formula.

Elimination Diet

An elimination diet is one in which one or several foods are eliminated from the diet.  There is no one “elimination diet:” it often varies from patient to patient.  Elimination diets can be based on the results of specific allergy testing (a tailored elimination diet), or more loosely based on common food allergies.  For instance, a six-food elimination diet is often used.  The idea behind an elimination diet, commonly used with EoE, is that you give the body a break from certain offending foods so that inflammation can calm down.  This works best if ALL foods that are causing a response are eliminated, which is why the six-food elimination diet isn’t quite as effective as a tailored elimination diet.

Where the lines get blurry between these two terms is that sometimes an elemental diet is used as a total elimination diet (so ALL food is eliminated!).  Basically a child might go on an elemental diet for a period of weeks, after which they usually start adding foods back to the diet one at a time.  That way there is no mistaking an allergic response to a specific food.  On top of this, an elemental formula like E028 Splash might be added to a six food or tailored elimination diet, to help make sure a child gets all of his/her essential nutrients when foods like dairy are removed.  What’s interesting is that studies have shown that the best response in EoE is to a fully amino acid-based diet.

Do you have any questions about the differences between elemental and elimination diets?

- Rob

[Image source]

Baby Formula Prep Machines and Neocate Mixing

Posted 12.15.16 | Nutrition Specialist

Technology – what would we do without it! Today we have appliances designed solely to brew our coffee, to shuck an ear of corn, and to open soup cans. I’ve even seen countertop appliances designed to cook frozen pizzas that do nothing else! And really, who can blame us. We’re busy. We have full-time jobs, busy families, full social calendars, and no free time. Add a new infant to the mix, and you need 24 hours to get things done with no time left over to sleep.

It’s a given, then, that we look for ways and devices to help simplify parenting. If you’ve ever had to prepare a bottle of formula in the middle of the night while trying to comfort a crying infant, you know how challenging this can be. Companies know this and have come up with ways to simplify tasks that come with parenting infants. There are now appliances that can steam and puree baby foods, wash and dry baby bottles, and also prepare bottles of infant formula.

Which begs the question: Can you trust an appliance from an independent company to prepare any infant formula? And how about specialized formulas, like Neocate? Today, we’ll walk through some points to consider and share our perspective on this question.

Infant formula prep appliances

What are they, and what do they do? Appliances that are designed to prepare infant formula were introduced in the United States several years ago. The premise? They make bottle prep much simpler. They save you time by reducing the number of steps you have to take when you’re in desperate need of a bottle.

How do they work? There are several types of appliances available. Here is a basic rundown of the functions they perform:

1.     Some baby formula prep machines are designed to work with very specific capsules of infant formula, and not with any other infant formulas. That appliance clearly cannot be used for any other off-the-shelf powdered infant formula. It’s similar to some of the automatic coffee and espresso appliances available these days, which have pods.

2.     Other appliances are designed to be very simple to operate too. Whenever you need a bottle of formula you press a button and, in no time at all, you have a bottle of warm, prepared formula ready to go – no muss, no fuss. These appliances are designed to be universal – used with almost all powdered infant formulas:

  • An enclosed container holds infant formula powder.
  • A reservoir holds water
  • The appliance heats water to a certain temperature
  • The appliance is intended to dispense the right amount of powder and warm water to prepare formula at the standard concentration

3.     Still other appliances will dispense heated water into a bottle to which you manually add powdered infant formula, saving you the step of warming and measuring out the water. These appliances are designed to be universal – used with any powdered infant formula.

  • An enclosed container holds water.
  • You place the bottle under a dispenser
  • The appliance dispenses a small amount of very hot water.
  • You add the powdered infant formula.
  • The appliance then dispenses the remaining water

All of these “universal” appliances - not the very specific type that we described first with the formula pods - are meant to remove some or all of the hassles of measuring the powder, heating water, measuring the water, and/or mixing the formula. What’s not to love?

A perusal of online reviews shows that these appliances haven’t always worked as well as buyers might hope. Some models also seem to have been discontinued in the US in the past. Another drawback is that some of the appliances require regular and, in some cases, pretty comprehensive cleaning.

These appliances offer a number of different volume options, for example as little as 2 to as much as 11 ounces. The ones that dispense powder also have instructions for settings designed to dispense the right amount of formula powder. This is important, because too little or too much powder can lead to formula that’s too dilute or too concentrated. This can pose serious health risks for infants.

What we recommend

Nutricia cannot recommend the use of automated infant formula prep appliances to prepare Neocate. As a company that makes specialized formulas for infants with unique medical conditions, we take the health and safety of our customers and your little ones very seriously.

Factor 1: Mixing accuracy

Nutricia cannot ensure that the amount of Neocate powder dispensed by any of these appliances is accurate. The manufacturers of these appliances may state otherwise. The scoops that we provide with our Neocate formulas are validated for use with these formulas. (Even more accurate than the scoops provided are scales that measure in grams.) Just as important is the volume of water, which should also be measured accurately and can affect formula concentration.

Factor 2: Temperature

Some of the infant formula prep appliances dispense a small amount of water that is very hot (about 158°F, or 70°C). This is based on recommendations followed in some parts of the world to use very hot water when preparing powdered infant formula. However, this is not standard practice in the United States.

For now we cannot recommend using water above 122°F (50°C) when mixing powdered Neocate products. (For Neocate Syneo Infant this is 104°F, or 40°C.) Following questions about higher water temperatures, we conducted small-scale tests on a few specific heat-sensitive nutrients mixing Neocate with water at the high temperature of 158°F (70°C).

We found the high temperature had an impact on those nutrients. While the effect during these tests did not lower the nutrient levels below the amounts stated on the label, at this time we cannot recommend exposing Neocate powders to water above 122°F, or 50°C (104°F, or 40°C, for Neocate Syneo Infant). Aside from the potential impact on heat-sensitive nutrients, there is also the possibility that using such hot water can slightly affect the taste, smell, and ability to remain in solution (i.e. to not separate).

In closing…

While these are our recommendations, we understand that automated infant formula prep appliances seem incredibly convenient. Our best guidance if you are interested in using one of these appliances is to check with your healthcare team. Share the information we’ve outlined above with them. While we don’t recommend these appliances, your healthcare team can assess the potential drawbacks to help determine if any of them might be appropriate for you.

We hope this helps, but feel free to ask any additional questions in the comments, below!


Challenging Changes - Transitioning to Neocate

Posted 7.10.15 | Nutrition Specialist

Infancy is a time marked by rapid growth, requiring important nutrition in the form of breast milk and/or infant formula. You may need to make changes from breast feeding to Neocate, or from another formula to Neocate, due to cow milk or food allergies and related symptoms, or you may need to add Neocate to an elimination diet.

Any transition to a new formula, like Neocate, can present challenges. Many parents come to us with questions about the taste of Neocate. Infants, especially older infants, can have trouble changing to a formula with a different taste and consistency to what they're used to. We can't provide medical advice, so the first and most important thing to do is to talk to your healthcare team! We've got a great resource, below, but here are a few points:

  • Some feeding specialists and pediatricians often recommend sticking with the straight Neocate - it depends on the clinician - it often is just a matter of time for many infants to adjust to Neocate's taste. Like the unfamiliar taste of a new vegetable, it can take up to 15-20 times before they get used to the new taste of Neocate.
  • We can’t provide recommendations for changing the flavor of Neocate Infant DHA/ARA – formula manufacturers are prohibited from flavoring or artificially sweetening infant formulas. It’s best to discuss with your child’s healthcare team to see if they have recommendations.
  • Some clinicians make recommendations for changing the taste of the formula, but we cannot recommend this. Again please discuss with your healthcare team.
  • When it's necessary to supplement breast milk with Neocate Infant DHA/ARA, many parents see success when they express breast milk, mix it with prepared Neocate according to the healthcare professional's instructions, and feed the infant using a bottle. That way the “taste” and feeding method are consistent between feedings. A baby may be more likely to refuse the bottle if she goes back and forth from breast to bottle feeding, especially if the bottle feeds are only Neocate Infant DHA/ARA.


Because parents come up with lots of questions for these transition scenarios, we have worked with a Feeding Specialist in developing helpful tips to use in these transition situations. You can find two printable, 2-page documents with helpful tips titled ‘A Guide to Transitioning to Neocate’ and ‘Feeding Tips for a Successful Transition’ on this page of helpful resources.


The key strategy for many transitions is a process called 'fading.' Fading involves adding the new formula (Neocate) to the old one in increasing amounts over time. It's important to talk to your LO's healthcare team to see if they recommend fading, and if it might work for you. (Sometimes, especially if food allergy symptoms are challenging, they may not want you to keep the old formula in your baby's diet.) Here are some of the highlights:

  • First, remember that schedules and routines are important when embarking on a transition. Keeping consistent with these will have an impact on your success. Be patient and relax.
  • The overall goal is to have your child accept the new combination as they work their way into the overall change. This might require lessening the first amount of Neocate that’s introduced, however; try to avoid returning to 100% of the previous product.
  • Transition times will vary between children. Some may readily accept the new combination while others may require more time. The goal is to move forward with success even if the pace is very gradual.
  • Transitions can impact the digestive system and can be marked by changes in body outputs- stools, gas and spit-up. These might be something new, or changes to existing habits. See our FAQs page and read the ‘What you may see’ entry for more details.
  • If changes feel a little too unsettling, talk to your healthcare provider or ask them to refer you to a Feeding Specialist.

Below are links to further posts from our Food Allergy Living blog that address transitions.

As always, if you have questions about using Neocate products, please give our Nutrition Services team a call at 1-800-365-7354, Mo-Fr, 8:30am-5:00pm, EST. We can't give medical advice, but we can answer your questions about using the products!

What tips have you found helpful in your transition?

-Jody L. Benitz, MS, RDN

Image from Abigail Batchelder

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.