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Hypoallergenic Baby Formula

The proteins in hypoallergenic baby formula are broken down into smaller particles, making them less likely to cause an allergic reaction in babies with cow’s milk allergies. Extensive processing makes these proteins easier to digest.

Last Modified: September 8, 2022
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What Is Hypoallergenic Baby Formula?

Manufacturers designed hypoallergenic baby formula for babies with food intolerances and allergies to proteins found in cow’s milk. Cow’s milk protein intolerance is one of the most common food allergies.

Many hypoallergenic baby formulas are still made with cow’s milk and aren’t the same as lactose-free baby formula, but the proteins are extensively hydrolyzed. This process pre-digests cow’s milk proteins and makes protein particles very small, making them less likely to trigger allergies.

Even if hypoallergenic baby formula is designed for babies with allergies, some babies may still react to it. In these cases, parents and caregivers should speak to their baby’s medical provider for more health information and to find a suitable replacement.

Breastfeeding is an option for babies with cow’s milk allergies. However, mothers will have to remove dairy and soy from their diets because babies may react to any allergy causing proteins that make their way into the mother’s breast milk.

Types of Hypoallergenic Baby Formulas

There are three types of hypoallergenic baby formulas: partially hydrolyzed, extensively hydrolyzed and amino acid-based formulas. These are classified by how the proteins are processed, and all types contain complete nutrition for infants. However, experts caution that partially hydrolyzed formulas aren’t truly hypoallergenic and could still cause significant reactions. They are not used for babies with cow’s milk allergy.

Extensively hydrolyzed formulas break down casein, the protein found in cow’s milk, into smaller pieces that babies can tolerate. About 90% of babies who are allergic to cow’s milk can tolerate these formulas, according to the Asthma and Allergy Foundation of America.

Babies who can’t tolerated extensively hydrolyzed formulas are more likely to do well with amino acid-based baby formula. These formulas, also called elemental formulas, are made of the basic building blocks of protein called amino acids. The formulas are suitable for babies with cow’s milk allergy and soy allergies.

How Do I Know if My Baby Is Allergic to Formula?

You will know if your baby is allergic to formula, particularly cow’s milk formula, if they develop allergy symptoms within the first week of consuming the formula. Formula-fed babies have a higher risk of developing a milk allergy than babies who are breastfed.

But breastfeeding mothers who consume dairy may still pass on cow’s milk protein to their babies through breast milk, causing a reaction. Doctors will perform blood tests and stool tests to diagnose allergies. Sometimes, medical providers will also perform a skin test.

Allergy Symptoms

Signs of a cow’s milk allergy, or other allergic reactions to a specific formula, may manifest as digestive issues, breathing problems and skin rashes.

Symptoms of baby formula allergies include:
  • Blood in the stool
  • Coughing
  • Diarrhea
  • Drop in blood pressure
  • Hives or other skin rash
  • Hoarseness
  • Wheezing
  • Itchy, watery or swollen eyes
  • Lightheadedness or loss of consciousness (from low blood pressure)
  • Swelling
  • Throat tightness
  • Trouble breathing
  • Upset stomach
  • Vomiting

Individual babies may have different symptoms, and some may be milder than others. Serious allergic reactions include trouble breathing and severe rashes. Parents and caregivers should seek emergency care for serious symptoms. If your baby is at risk for serious allergies, medical providers may prescribe epinephrine auto injectors, such as an EpiPen, for emergency situations.

Symptoms of cow’s milk allergy, such as digestive issues and bloody stool, also resemble the symptoms of a serious digestive disease called necrotizing enterocolitis. NEC can be fatal and is more common in premature babies fed cow’s milk baby formula or preemie formula. Some parents filed baby formula lawsuits against manufacturers Abbott and Mead Johnson after their infants developed NEC.

Lawsuit Information
Lawsuits are being filed by parents whose children were diagnosed with necrotizing enterocolitis (NEC) after consuming cow's milk-based formula. Learn more.
View Lawsuits

Can Babies be Allergic to Hypoallergenic Formula?

About 10% of babies may still be allergic to extensively hydrolyzed hypoallergenic formula because it still contains milk protein. In these babies, cow’s milk allergies may be severe enough to cause swelling and trouble breathing, or anaphylaxis.

For infants with severe allergies who cannot tolerate extensively hydrolyzed formula, experts recommend amino acid-based formulas. These formulas aren’t made with peptides from cow’s milk.

Switching to Hypoallergenic Formula

If your baby manifests symptoms of cow’s milk allergy or soy allergies, their doctor may recommend switching to hypoallergenic formula, breastfeeding or a mix of both. Some babies may do well with soy-based formulas or amino acid-based formulas instead of hydrolyzed formulas if they have a very severe cow’s milk allergy.

Babies who transition to hypoallergenic formula typically have few side effects, and they don’t require much transition time from their old formula. But it’s important to talk to your baby’s doctor before switching formulas to get advice on the best way to transition your baby to their new diet.

It’s a good idea to monitor your baby’s bowel movements and feeding habits to make sure they don’t have any discomfort or baby formula side effects from the new formula.

What to Expect from Hypoallergenic Formulas

Typically, a baby with cow’s milk allergy who switches to hypoallergenic formula will start to feel better within 48 hours. They will be less fussy and colicky. Other symptoms such as bloody stool or skin issues may take up to four weeks to clear up.

Parents and caregivers may notice a few differences after switching their infant to hypoallergenic formula. The formula may have a different color, smell and a bitter taste. This is normal because hypoallergenic formulas are processed differently. Some infants, especially older infants, may take some time to adjust to the new taste of hypoallergenic formula.

The smell, consistency and color of the baby’s stool may also change. Red, white or black stools are uncommon and could be a sign of a problem, so contact your baby’s doctor right away.

It may be more difficult to find hypoallergenic baby formula because of baby formula recalls and shortages. Don’t try to make homemade baby formula. Instead, ask your doctor for advice on how to handle shortages and recalls.

Please seek the advice of a medical professional before making health care decisions.