Signs and Symptoms for Using Amino Acid-Based Formulas for Cow Milk Allergy

Signs and symptoms of using Amino Acid-Based formulas can vary. Therefore, when a baby first shows possible signs and symptoms of a cow milk allergy, parents wonder, how do doctors diagnose it and choose the best management option?

Let us review potential indicators healthcare professionals could look to determine if hypoallergenic amino acid-based formulas (AAF) like Neocate can help manage cow milk allergy.

Before we jump into these, let’s quickly review some types of baby formulas that are available. Formulas vary by the kind of protein that’ used and the extent to which protein is broken down. The type of protein determines how allergenic a formula is. Some of these formulas are available on store shelves, while others should be used under medical supervision and require a doctor’s recommendation. 

Types of formula: 

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Protein Structures in Formulas Milk/Formula Protein Type Allergic Reaction

Regular formula with whole protein

Majority delivered from cow milk protein

Cow / Soy Milk Protein

Cow milk protein
Goat milk protein
Whole Protein
Casein or Whey

Most Allergenic

Least Allergenic

Soy Milk Whole soy Protein & soy isolate

Hydrolyzed Formula

Majority delivered from cow milk protein

Majority delivered from cow milk protein

Extensively hydrolyzed Fragments of cow milk protein
Casein hydrolysates
whey hydrolysates

Neocate Amino Acid-Based Formula

Amino-acid based formula

100% non-allergenic free amino acid-based

Amino acid-based formula like Neocate 100% free amino acids

If you’re still curious, read more about the different types of baby formulas.

How does your little one’s doctor know which formula to recommend first? Let’s explore some of the signs and symptoms doctors look to consider Neocate:

  • An infant with food allergies often shows more than one of these indicators. These are the signs and symptoms a doctor looks for to consider Neocate:

Symptoms Not Resolved on an Extensively Hydrolyzed Formula (eHF)

Crying baby

Symptoms for using amino acid-based formula

Healthcare professionals often refer to medical guidelines for managing food allergies. These recommend that, if food allergy symptoms don’t sufficiently improve on an eHF, then the Health care professional considers an amino acid-based formula like Neocate. The reason? If a child “fails” on one eHF, they will probably “fail” on other eHFs. (“Failure” means symptoms don’t fully resolve.)

If your child is taking an eHF and you still see possible signs and symptoms of a cow milk allergy, please discuss with your doctor.

Severe gastrointestinal (GI) Symptoms

Reflux Baby

Symptoms for using Amino Acid-Based formulas

Cow milk allergy signs and symptoms often relate to the digestive tract (GI tract). The gastrointestinal tract is the passageway going from the mouth to the anus that allows food digestion. Also called the digestive tract, it encompasses the mouth, esophagus, stomach, small intestine or duodenum, jejunum, ileum, large intestine or colon, rectum, and anus.

Some of these signs can be severe and might indicate the need for an amino acid-based formula like Neocate.

Your doctor will decide what signs are severe such as blood in the stool or severe gastroesophageal reflux. Other severe GI symptoms, like vomiting or reflux, may indicate cow milk allergy that’s part of other conditions (FPIES and EoE, respectively).

Failure to Thrive

Symptoms - Failure to thrive

Symptoms for using Amino Acid-Based formulas

 “Failure to thrive” or “growth failure” or “faltering growth” describes a child who is not gaining weight or growing at the rate expected. 

Children whose severe food allergies aren’t under control may have a failure to thrive.

Failure to thrive is associated with signs and symptoms of food allergies. So, medical guidelines suggest that choosing an amino acid-based formula, like Neocate, can help address the symptoms. The guidelines also suggest amino acid-based formulas may reduce the risk of failure to thrive in these infants when they don’t tolerate eHFs.

Severe Eczema

Eczema, or atopic dermatitis, is a skin rash. Some patients have both eczema and food allergies. Roughly one-third of children with moderate-to-severe eczema also develop food allergies. It can be hard to link worsening eczema to foods because eczema flares can delay in appearing.

Some medical guidelines recommend that an amino acid-based formula like Neocate should be the first choice for infants with severe eczema. What’s more, this applies particularly to those infants who are failing to thrive. What if a breastfeeding infant has eczema and CMA is suspected? In those cases where a formula is needed, an amino acid-based formula like Neocateis recommended.

Multiple Food Allergies

8 common food allergy types

Symptoms for using Amino Acid-Based formulas

Did you know that about one third, or 33%, of cow milk allergy patients, may develop allergies to other foods? In such cases, these patients have multiple food allergies (MFA). Also, the more foods a child is allergic to, the higher the likelihood that they will fail an eHF. Guidance is that infants with multiple food allergies should use an amino acid-based formula like Neocate.

Symptoms when Breastfeeding

Breast milk is the preferred nutrition for infants, and Nutricia supports breastfeeding wherever possible. Incidentally, breastfed infants can develop cow milk allergy to protein fragments of milk in breast milk. 

If you experience symptoms while breastfeeding consult a doctor.


Symptoms for using amino acid based formulas for cow milk allergy

Symptoms for using Amino Acid-Based formulas

Anaphylaxis reactions to food allergens can be severe and life-threatening, and an acute reaction caused by cow milk happens between 1%-9% of CMA cases. In patients who have had anaphylaxis to cow milk, guidelines recommend a hypoallergenic amino acid-based formula, like Neocate.

My Baby Has One or More of These Signs and Symptoms for using amino Acid-Based formula – What Should I Do?

If you suspect food allergies, ask your child’s doctor for a thorough evaluation. They can assess whether your child is showing signs and symptoms of food allergies. Here is a list of questions you can ask that might be helpful while you wait for a diagnosis.

Once diagnosed, the doctor might recommend Neocate Syneo Infant, the first and only hypoallergenic formula with the benefits of prebiotics and probiotics. Read more about Neocate Syneo Infant and what makes it unique.

If you have an older child diagnosed with food allergies, your doctor may recommend Neocate Splash.

Neocate Splash is the first and only hypoallergenic amino acid-based formula that’s ready to drink. Learn more about great-tasting, convenient Neocate Splash.

Have more questions about symptoms for using amino acid-based formula? Ask us in the comments below! Visit F.A.R.E. (Food Allergy Research and Education) for more information about CMA. 

-Rob McCandlish, RDN

Rob McCandlish is a member of the Medical team at Nutricia North America

Symptoms for using Amino Acid-Based formulas

 Rob McCandlish is a registered dietitian nutritionist (RDN) who joined Nutricia in 2010. He has spent years talking with Neocate families, working with Neocate products, and learning about the science behind Neocate and food allergy research. Rob has two nephews who both used Neocate for their cow milk allergies!


Published: 08/31/2018
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