Specialized Infant Feeding Guidelines: Formula Selection

Products Indications Contra- Main features

indications
Breastmilk  With very few Mother: Protein:
Breastfeeding

exceptions,  Illegal drug use Whey and casein, with a

breastfeeding is changing ratio over the
 HIV-positive
indicated for all infants duration of lactation
 When extra Infant:
fortification is required  Galactosemia Whey/casein ratios:
infant formula may be Early lactation: 90/10
added to breastmilk Mature lactation: 60/40

Enfamil Infant  Healthy infants born  Cow’s milk Protein:

Routine

>34 weeks gestational protein allergy Intact cow’s milk

Similac Advance age (GA) proteins (casein and
Similac Sensitive whey)

Enfamil Gentlease  Marketed as  Cow’s milk Protein:

intolerance formulas; protein allergy Cow’s milk proteins
Hydrolyzed

Good Start Gentle not truly hypoallergenic partially hydrolyzed into

Partially

Good Start Soothe small peptides

Standard Infant Formulas

Note:
Similac Total Good Start Gentle: Note:
FDA approved for use in Good Start and Similac:
Comfort
reducing risk of atopic 100% whey
dermatitis in high risk
infants
Enfamil A.R.  Uncomplicated gastro  Premature Protein:
esophageal reflux infants <38 Intact cow’s milk
Similac for Spit Up disease (GERD) weeks GA proteins
 Do not
Thickened

Note: concentrate Note:

Decreased efficacy when above 24 kcal/oz Contains rice starch
used with proton-pump which thickens upon
inhibitor medications contact with stomach
(e.g. Prilosec, Prevacid) acid. Formulation
maintains appropriate
nutrient composition as
opposed to adding cereal
to formula.
Enfamil Prosobee  Vegan diet  Prematurity Protein:
 Family preference  Colic Soy protein isolates
Good Start Soy  Galactosemia (Isomil  Constipation
Soy

and Prosobee powder  Cow’s milk Note:

Similac Soy Isomil only) protein-induced All soy formulas are
enteropathy lactose free

These are general guidelines; not intended for use in the treatment of a specific clinical condition or without medical supervision

Oregon Pediatric Nutrition Practice Group 2015 www.eatrightoregon.org

 Specialized Infant Feeding Guidelines: Formula Selection
Products Indications Main features
Alimentum General indications for use: Protein:
(Abbott)  Cow’s milk & soy protein allergy Cow’s milk proteins
Pregestimil  Multiple food allergies hydrolyzed into small
(Mead Johnson)  Intractable diarrhea peptides and supplemented
 Lactose/sucrose intolerance with amino acids
Nutramigen
Product specific indications: Fat:
Hydrolyzed
Extensively

Enflora
(Mead Johnson) Alimentum & Pregestimil: Alimentum: 33% MCT oil
 Cystic fibrosis Pregestimil: 55% MCT oil
 Pancreatic insufficiency
Note:
Special Medical Infant Formulas

 Short gut
 GI immaturity Nutramigen Enflora and
Nutramigen Enflora & Pregestimil Pregestimil:
(powder forms only): Use packed scoops for
 Galactosemia powdered forms
Pregestimil:
 Celiac
 Cholestasis
Elecare Infant  Cow’s milk & soy protein allergy Protein:
(Abbott)  Multiple food protein allergies Synthetic free amino acids
 GERD
Amino Acid

Neocate Infant  Short bowel syndrome Fat:

 Elecare and Neocate:
Free

(Nutricia) Malabsorption
 Eosinophlilic esophagitis 33% MCT oil
PurAmino  Galactosemia
Note:
(Mead Johnson)
Note: Mixing ratios differ from
Limited availability and expensive standard formulas; refer to
manufacturer’s instructions
Breastmilk  Impaired renal function Protein:
 Neonatal hypoglycemia Intact cow’s milk proteins
Low Mineral

Similac PM 60/40
(Abbott) Note:
Breastmilk’s efficient
absorption rate results in a
naturally low mineral content

Similac PM 60/40:
Iron supplementation may be
needed
Enfacare  Birthweight >2000 grams (4.5 lb) and Protein:
Post-discharge

(Mead Johnson) <34 weeks gestational age Intact cow’s milk proteins
Premature

 Can be used until 1 year corrected age

Neosure
(Abbott) Contraindications: Note:
Full term infants and failure to thrive Provides 22 kcal/oz at
infants due to the risk of standard dilution
hypervitaminosis and hypercalcemia

These are general guidelines; not intended for use in the treatment of a specific clinical condition or without medical supervision

Oregon Pediatric Nutrition Practice Group 2015 www.eatrightoregon.org