Food Allergy Living Blog Tagged Results

infant formula

All About Diarrhea

Posted 3.31.11 | Rob McCandlish, RDN

Here at Neocate, we get lots of questions about diapers. I mean lots! Many questions relate to constipation or diarrhea. We’ve posted about constipation in the past, but I thought it would be helpful to pull together our past comments on diarrhea, as well as provide some more medical information on the topic courtesy of the National Institutes of Health, or NIH.

Defining “Diarrhea”

Simply defined, diarrhea is loose, watery stools. It also means having these loose stools three or more times a day. There are more specific guidelines, but most people know diarrhea when they see it. Diarrhea happens to everyone, usually about once a year for adults and twice a year for young children.

Typically, diarrhea is acute, meaning that it lasts one or two days and then goes away. This type of diarrhea is typically caused by an infection. If diarrhea lasts more than two days, it can be something more serious. Diarrhea lasting more than two to four weeks – chronic diarrhea – may be a symptom of a chronic disease or condition.

The concern with diarrhea, especially when it lasts more than two days, is a risk of dehydration. Our bodies absorb most of the water and some minerals at the end of our digestive tract. When we have diarrhea we can’t absorb those things, leading to dehydration, which can be serious.

Diarrhea in Infants

New parents quickly become experts at several things, one of which is changing diapers. Since infants go through about eight diapers a day, parents easily pick up on anything abnormal. Every baby’s stools are different in terms of how watery they are, which makes defining diarrhea in infants difficult. To keep it simple, diarrhea is typically a sudden onset of frequent bowel movements that are more watery than usual.

The risk of dehydration from diarrhea is much higher in children than most adults, and especially in infants. Since infants can’t tell us what they’re feeling, it’s important to keep an eye out for signs of dehydration. With children and infants, you shouldn’t hesitate to call their healthcare provider if you have concerns. For infants under 4 months, the recommendation is that you contact the doctor at the first sign of diarrhea or dehydration.

Diarrhea and Food Allergies

Pulling this all together, diarrhea is one of the top signs of a food allergy, especially for infants. In infants with food allergies, diarrhea often lasts more than just a few days and may even be combined with other symptoms. It’s not uncommon to also see blood or mucus in the stool. Diarrhea can also result from lactose intolerance, which is not as severe as a food allergy, but which may also require a change in diet.

Like we hear from many Neocate parents, diarrhea is often one of the first signs to clear up after they start using Neocate. This is because Neocate doesn’t contain any lactose (or any dairy at all!) or whole proteins. These substances would normally cause a reaction in the body that leads to poor absorption and diarrhea. Infants are able to absorb the nutrients they need from Neocate without the bad reaction that often results in diarrhea. Most parents tell us that the switch to Neocate has meant more solid stools and many fewer diapers.

- Rob

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What does Hypoallergenic Mean?

Posted 3.30.17 | Nutrition Specialist

Most consumers today believe that a product labeled as hypoallergenic will not cause an allergic reaction, but is this really true?

Let’s start with the basics. The technical definition of “hypoallergenic” is that a product is less likely to cause an allergic reaction, or will cause fewer allergic reactions. There are few federal standards that regulate the use of this term for consumer goods. For many products, like cosmetics, the term “hypoallergenic” may be used without ANY evidence or support. Some companies will use certain tests for a product to support that it’s hypoallergenic.

For infant formulas, however, you can rest assured that the term “hypoallergenic” can ONLY be used when certain criteria are met.

What is a Hypoallergenic Infant Formula?

When it comes to infant formulas, based on calls our nutrition specialists receive on a regular basis, many people think the term hypoallergenic means the product is totally void of any and all things that could trigger an allergic reaction. The reality is a bit more complex.

For an infant formula to claim hypoallergenicity it needs to go through study in a clinical trial. The requirements have been based on recommendations by the According to the American Academy of Pediatrics (AAP). According to the AAP, a hypoallergenic infant formula must:

  • Be studied in a clinical trial
  • Be studied in patients with documented cow milk allergy
  • Have been shown to be tolerated by at least 90% of the patients

“Tolerated” means that the formula did not cause an allergic reaction, or that those with cow milk allergy did not have defined symptoms, such as hives, anaphylaxis, or other symptoms of a food allergy.  Only infant formulas made with free amino acids – like Neocate – or extensively hydrolyzed protein, also called peptides, have met the necessary criteria in these studies and can be classified as hypoallergenic. 

Other infant formulas are NOT hypoallergenic. These include formulas made with whole dairy protein, formulas made with soy protein, and formulas made with partially hydrolyzed protein. (Hydrolyzed protein comes from dairy protein, but partially hydrolyzed protein is not broken down as much as extensively hydrolyzed protein.)

Difference Between a Hydrolyzed Formula and Amino Acid-Based Formula

Hydrolyzed formulas are made using protein from dairy, but the milk proteins in those formulas have been broken down into smaller fragments. The body’s immune system may not detect the smaller protein fragments as being an allergen. In some patients with a cow milk allergy, the body still reacts to the protein fragments in extensively hydrolyzed formula, resulting in allergic reactions.

Amino acid-based formulas, which used to be called elemental formulas, use only amino acids as the source of protein. Amino acids are the building blocks of protein, and are too small for the body to recognize as being foreign. They are the least allergenic form of protein.

To help you visualize the difference between these two types of formulas, picture a pearl necklace. In this example our necklace represents the strand of amino acids that make a protein.  If you take the necklace and break it into smaller length strands where several pearls are connected, this would look like the peptides used in partially-hydrolyzed formulas. Even shorter strands of a few pearls will look like the smaller peptides used in an extensively hydrolyzed formula.

If you start with individual pearls, then you have a visual example of an amino acid-based formula. In an amino acid-based formula like Neocate, none of the amino acids are attached to each other. In Neocate, the amino acids are NOT derived from dairy protein. The amino acids in Neocate are synthetic, meaning they’re not derived from meat. Most of them are made from plant sugars, and some are completely synthetic.

Here’s another way to look at infant formulas and their potential for triggering an allergic reaction:

Can a Child React to a Hypoallergenic Infant Formula?

It is possible for a child with food allergies react to formulas made with hydrolyzed protein, or peptides. Amino acid-based formulas, on the other hand, are the least allergenic type of formula, meaning they’re least likely to cause a food allergy reaction.

While two types of infant formulas can claim to be hypoallergenic, based on the information above you can see that the term alone doesn’t guarantee that there will NOT be an allergic reaction. It’s important to look at your child’s individual case and discuss with your healthcare professional the type of hypoallergenic formula – amino acid-based or extensively hydrolyzed - that would best fit your needs.

Here are some additional resources that can be helpful if you are currently evaluating various formula types

New Neocate Cans with BPA-Free Lining

Posted 12.22.09 | Nutrition Specialist

In light of parent concerns about Bisphenol A (BPA) in infant formula packaging, Nutricia announced that we’re taking the extra step to protect your little ones by packaging our powdered products in cans with BPA-free lining.

Nutricia has provided a complete list of BPA-Free powdered Neocate products that will come in the new cans.

Our hope is that this change will help provide extra peace of mind to the many families with children with milk allergies and other gastrointestinal, metabolic and neurological conditions that require specialized nutrition. If you have any other questions about the new BPA-free lining, give us a call or ask us in the comments section.

- Nita

DHA and ARA: What are they and why are they in infant formula?

Posted 3.12.13 | Mallory West

If your baby consumes Neocate or another infant formula, you have most likely heard of DHA and ARA. You may be wondering “What are DHA and ARA?” and “Why are they added to infant formula?” We’ll fill you in with today’s post!

Docosahexaenoic acid, better known as DHA, and arachidonic acid, better known as ARA, are fatty acids found in breast milk, as well as in some foods, like fish and eggs. (Fatty acids combine to make fat molecules.) Both DHA and ARA are classified as long-chain polyunsaturated fatty acids, or PUFAs, a special type of fatty acid. They each play important roles in our bodies and health throughout our lifetimes.

The human body can make small amounts of DHA and ARA from α-linolenic acid (ALA) and linoleic acid (LA), respectively. ALA and LA are also classified as PUFAs.  In fact, ALA and LA are known as "essential fatty acids”. They are the only two essential fatty acis, and are essential because, unlike other fatty acids, our bodies cannot make them, so they MUST be obtained from our diet. ALA and LA are found various foods, as well as in breast milk and in infant formulas.  

DHA and ARA play very important roles in early brain and eye development, although they aren't yet classified as "essential." The levels of DHA and ARA in the brain rapidly increase during the last trimester of pregnancy and throughout the first two years of life. While breast milk naturally contains ALA and LA, it also contains DHA and ARA. Generally the more fish in a lactating mom's diet, the higher the levels of DHA and ARA in her breast milk.

It turns out that infants create very little DHA and ARA from the ALA and LA they get from breast milk and/or infant formula. Years ago, infant formulas contained ALA and LA, but no DHA or ARA. Research from back then found higher blood levels of DHA and ARA in breast-fed infants in comparison to formula-fed infants, and there's also evidence that there may be some benefits to having preformed DHA and ARA during infancy.

Because of these findings, almost all infant formulas are now fortified with pre-formed DHA and ARA. Although experts agree that breast milk is the ideal nutrition for infants, and we agree, there are some situations where breast feeding is not possible or has to be supplemented with infant formula. One great example is infants with severe and/or multiple food allergies. In such cases where an infant formula is needed, experts recommend using an infant formula which contains between 0.2% and 0.5% of total fatty acids as DHA, and at least as much ARA as DHA (Koletzko, 2008).

For those of you with little ones drinking Neocate, you can feel confident that the levels of DHA and ARA fall right in the middle of this range. In fact, the level of DHA in Neocate infant formulas is comparable to the worldwide average found in breast milk of about 0.32% (Brenna, 2007). Here are the levels of DHA and ARA in Neocate infant formulas available in the United states, expressed both as a percentage and as milligrams in 100 calories (5 fluid ounces of formula, when prepared as directed):

  Neocate® Infant DHA/ARA Neocate® SyneoTM Infant
DHA, % Total Fatty Acids 0.35% 0.35%
DHA per 100 calories 16.9 mg 16.2 mg
ARA, % Total Fatty Acids 0.35% 0.35%
ARA per 100 calories 16.9 mg 16.2 mg

The use of DHA and ARA in infant formulas is supported by the US Food and Drug and Administration (FDA), the World Health Organization, the National Academy of Sciences, the American Dietetic Association, and various other regulatory bodies around the world.

You might have also come across EPA, or eicosapentaenoic acid (what a mouthful!), in your readings. EPA is another type of fatty acid. The human body can make EPA from ALA, and the human body can then convert EPA into DHA. EPA in the diet is naturally found in fish. EPA is not yet added to any infant formulas in the US, as ALA and DHA are already in formula. If it were ever added to formula, the guidance from scientists is that there should not be any mroe EPA than DHA in the formula.

We hope this helps answer your questions about DHA and ARA, but feel free to ask if you have any more!

-Mallory & Rob, Nutrition Specialists                                                                                                                              




  1. FDA/CFSAN Office of Nutritional Products, Labeling and Dietary Supplements July 2002.
  2. The US Food and Drug Administration. Questions & Answers for Consumers Concerning Infant Formula.   Updated December 14, 2012. Accessed March 3, 2013.
  3. International Formula Council (IFC) Statement on DHA/ARA and Infant Formula. Published March 1, 2010. Accessed March 12, 2013.
  4. Koletzko B, et al. The roles of long-chain polyunsaturated fatty acids in pregnancy, lactation and infancy: review of current knowledge and consensus recommendations. J Perinat Med. 2008;36:5-14.
  5. Uauy R et al. Term infant studies of DHA and ARA supplementation on neurodevelopment: results of randomized controlled trials. J Pediatr. 2003 Oct;143(4 Suppl):S17-25.
  6. Birch EE, et al. The DIAMOND (DHA Intake And Measurement Of Neural Development) Study: a double-masked, randomized controlled clinical trial of the maturation of infant visual acuity as a function of the dietary level of docosahexaenoic acid. Am J Clin Nutr. 2010;91:848-59.
  7. Brenna JT, et al. Docosahexaenoic and arachidonic acid concentrations in human breast milk worldwide. Am J Clin Nutr. 2007;85:1457-64.

What Makes Neocate Special? An Overview of Different Types of Baby Formulas

Posted 2.18.16 | Nutrition Specialist

Walking down the baby formula aisle in any grocery story can be an overwhelming experience. We all know choosing the right nutrition for your child is important. But how can you tell the difference between various types of formula if breastfeeding isn’t an option for you?

Nutrition questions and choosing the right feeding path can overwhelm even the most seasoned parent. As a family living with food allergies, you know better than most that an allergy, or multiple allergies, to food quickly multiplies the questions you encounter regarding food and nutrition.

The number of options when looking at infant formulas does not make the choice any easier. But fear not! Nutricia is here to help you. Let’s take a look at the main types of infant formulas, and how they are different. 

Cow milk-based formula: Most infant formulas available in the grocery story aisle are cow milk based. That means they are made from cow milk that is altered to resemble breast milk. However, cow milk-based formulas might not be suitable for many families dealing with food allergies. This is due to the protein found in milk. Milk protein is one of the most common food allergens, especially for infants.

Soy-based formula: When avoiding milk proteins, dairy foods, or perhaps animal proteins in general, soy-based infant formulas are often brought up as an option. This formula type is based on soy instead of cow’s milk so it is dairy-free. Unfortunately, up to 50% of children with an allergy to cow milk are also allergic to soy protein[1]. This makes soy-based infant formulas not suitable for babies with food allergies.

Protein hydrolysate formula: These types of infant formulas contain protein that has been broken down (hydrolyzed) into smaller pieces. There are infant formula options for partially broken down (partially hydrolyzed), and extensively broken down (extensively hydrolyzed) proteins. Breaking down the protein chains makes these types of formulas easier to digest and can reduce the chance of an allergic reaction for babies with food allergies. While these formulas are a bit easier for digestive systems, it’s important to remember that even the partial proteins can cause an allergic reaction in some children.

What makes Neocate Special?: Neocate is classified as amino acid-based formula. This means our formula doesn’t contain any intact protein chains and is made from the original building blocks of all proteins called amino acids. Amino acids are the most basic form of protein, the easiest form for human digestion. What makes Neocate hypoallergenic? 1) Using 100% amino acids as the source of protein, and 2) leaving out proteins and even small protein fragments that can cause an allergic reaction.

If you are a visual person like me, you may find this chart helpful in illustrating the differences in infant formulas that we just discussed.

Here’s another way to look at infant formulas and their potential for triggering an allergic reaction:

Now that you know the basic types of infant formulas, you will have the knowledge to make the right nutrition choice for your child and be prepared for the discussion with your healthcare team.

Need additional resources?

I personally find that our Parent’s Toolbox page is a great place to get started when trying to understand your child’s allergy symptoms. If you have more general questions about food allergies, then start with our overview on the Basics of Food Allergies.

We have also pulled answers to many of the general Neocate questions we hear on our FAQs page.

New to Neocate?

If you are ready to get started using Neocate, we have a variety of information available at your disposal:

Our team of Nutrition Specialists are here to help answer any questions you may have. Feel free to give us a call at 1-800-365-7354 or comment below!

- Kristin Crosby, MS, RDN

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[1] Niggemann B, et al. Pediatr Allergy Immunol. 2001; 12:78-82.


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.