Susana has been through CMPI and soy intolerance with two of her daughters and has spent the last decade researching food intolerances.
Specialist Infant Formulas
There are a number of reasons for wanting to buy an infant formula that's hypoallergenic, dairy-free or lactose-free.
As well as these types of specialist formulas, there's also goat milk formula, anti spit-up formula and hydrolyzed formula.
But how do you know which one to choose?
These are the most common reasons for choosing one of these formulas:
- your baby has one or more food allergies or intolerances (or you suspect it)
- your baby is gassy, has colic, or spit ups a lot
- your baby gets constipated, has diarrhea or green poop often
- you are vegan and want a vegan diet for your baby
- because of religious food restrictions (Halal or Kosher)
There are a wide selection of specialist baby formulas on the market now, including soy formula, hydrolyzed formula, lactose-free formula, stay down formula, goat's milk formula and hypoallergenic formula.
They are all so much easier to get hold of now that was the case even a few years ago.
**Below you'll find a lot of info about the various types of specialist formulas and which ones to use for which issues.**
Part of being a parent is making sure that your baby gets all the nutrients they need. It seems easy enough. You breastfeed or give formula, you build a healthy bond with your precious baby, and they grow healthy and strong.
But sometimes it isn’t that simple.
When you have a baby that is obviously unhappy and in pain you try everything you can to make them feel better. When no amount of rocking, cuddles or long walks in the fresh air seem to work it's time to look at what baby is eating.
This was the case for us.
My second daughter had acid reflux caused by Cow’s Milk Protein Intolerance (CMPI). And my third daughter had exactly the same but on top of that she also had an intolerance to soy.
The first time round we didn’t discover the cause of my daughter's issues until we went through several hypotheses for what was wrong, several doctors visits and several types of formula.
The second time around we were much more aware of what to look out for and diagnosis was much quicker.
The following information on specialist formulas and the reasons you might need them comes from my many hours of research on the topic and my own quest to find a formula that my babies could tolerate.
Read More From Wehavekids
The one's I have linked to are the ones we have used successfully.
Is it colic, gas, or acid reflux?
Every baby is going to be fussy from time to time. No matter what you try, they are going to get upset tummies. However, there is a difference between being seriously fussy and having colic, gas, or acid reflux.
You know you have a problem when the baby is gulping down the formula, having trouble breathing after eating or seems to be in pain.
Signs of pain are an arched back, wiggling, being unable to sleep, being unsettled, and crying that is inconsolable.
Signs that it is gas or stomach pain are easier to spot. You may notice that your baby is keeping his/her’s knees pulled up to the belly. They are quieter when you hold them or bounce them. Swaddling calms them down.
If your baby is extremely fussy for more than four hours a day, 3 or more days a week, then you should take them to the doctor. This is a sure sign that they have colic, gas, or reflux or even a food intolerance.
Formulas to Try for Colic, Gassiness & Spit Up
Look at the sections below on Lactose Free Formulas, Goat's Milk Formulas, Anti Spit Up Formulas and Partially Hydrolyzed Formulas to help you decide which option would be best for your baby.
Understanding Cow’s Milk Protein Intolerance (CMPI)
CMPI is a food intolerance. Like most food intolerances it causes a range of symptoms – mostly digestive. Whey and casein proteins in milk can be hard for your baby’s stomach to break down.
The baby may produce extra gastric acids in an effort to try to break them down and this can lead to reflux. Or the baby may have difficulty with the proteins further down the digestive system causing cramping and gas.
You may notice that your baby is constipated or has diarrhea (or both), is gassy, has stomach pain or is extremely fussy. There may even be blood or mucous in your baby’s stool.
Many symptoms of CMPI don't occur immediately - they can be delayed up to 48 hours or even more in some cases.
Besides fussy bellies and diaper problems, you may find that your baby’s skin is affected as well. CMPI can result in eczema, hives, and even diaper rash. In extreme cases, breathing problems are a symptom as well.
As we continue, we will discover the different types of formulas that are available. You will notice that we have listed the key points surrounding the formula. There is also a list of what formula brands you can find in the US for each type.
All of these are points I came across researching each product. I decided that if it answered the questions we had, it could help you out as well.
Formulas for CMPI
The most common formulas to use for CMPI are soy, fully hydrolyzed and hypoallergenic.
1. Soy Formula for Dairy or Lactose Intolerance
Soy formula is often the best choice for babies who have a dairy intolerance, whether it's due to milk protein intolerance or milk sugar (lactose) intolerance.
It'a also a good choice for vegans and those who want a Halal or Kosher formula.
There have been some scary stories around over the last few years that soy milk is harmful, but this is simply not the case. Soy formulas have been used successfully for over 50 years with absolutely no reports of adverse effects. They meet the full nutritional needs of babies and infants, as well as all safety standards.
Soy formula is also the perfect solution for those who don't want to give their children dairy-based formula milk because of lifestyle, cultural or religious reasons.
There are plenty of organic soy formulas to choose from too, so you can be sure that there are no pesticide contaminants, that the beans are non-GMO and have been grown ethically.
The most readily available soy formulas in the US are:
- Earth's Best Soy
- Gerber's Good Start Soy
- Parent's Choice Soy
- Similac Soy Isomil
- Enfamil ProSobee
The formula we eventually settled on for our second daughter was Earth's Best Non-GMO Soy. We chose it primarily because it was non-GMO (Genetically Modified Organism). We wanted to ensure our baby wouldn't be (potentially) affected adversely by GMO's. Plus we felt the company was the most ethical.
2. Lactose-Free or Low Lactose Formulas for Lactose Intolerance
For fussy babies that suffer from colic and possibly a mild lactose intolerance, there are several brands of lactose-free formulas that have had all the milk sugar removed and replaced with a vegetable sugar (such as corn syrup).
The lactose that gives your baby stomach issues can result in diarrhea, green poop and a lot of gas. That is why there is a special formula for these babies. It is easier for their tiny bellies to digest.
What is most interesting about babies with severe lactose intolerance is that they are often unable to breastfeed. They are more often diagnosed with failure to thrive and bloody stools. For them, this type of formula is truly a life-saver.
The formulas below are made from cow's milk with the lactose removed. Soy formulas are also lactose free so they are an option if you believe your baby has a problem with lactose.
Here is a list of widely available low lactose or lactose-free formulas:
- Earth's Best Low Lactose Organic Formula
- Baby's Only Organic LactoRelief Formula
- Similac Pro-sensitive Non-GMO
- *Enfamil Nutramigen with Enflora LGG Hypoallergenic Infant Formula
We tried a few of these low lactose/lactose free formulas before we knew that the main problem was the milk protein and not the lactose. If I was going to recommend one of these I'd go for the Earth's Best Organic Low Lactose for three reasons.
1. It's the best value option
2. It's organic so no nasty chemicals
3. It's an ethical brand
*Enfamil Nutramigen is marketed as lactose free which it is. It is also hydrolyzed (the milk proteins are broken to make them easier to digest) so you'll see this brand in the hydrolyzed formulas section below.
3. Goat’s Milk Formula
Goat milk has several benefits over cow's milk. The most important it that it is the closest milk to human milk and has been shown to be easier to digest than cow's milk. The proteins and fats are much closer to breast milk than cows milk is so this isn't surprising.
Some babies who have problems with formula's made from cow's milk can tolerate goat's milk much better.
The facts show that goat milk is as good, or even better than cow’s milk.
There are three main goats milk based formula brands to buy but they are only available as follow-on or toddler formulas in the US.
To get goat's milk infant formula suitable from 0-6 months you may have to buy it from the UK or Germany.
These are the main brands:
- Holle Organic Infant Goat Milk Formula
- Kabrita Goat Milk Formula
- Nanny Care Goat Milk Formula
Our babies couldn't tolerate goats milk formula (we did try!) but if your baby is simply gassy or colicky I'd give it a go. A lot of moms report great results and a much happier baby after making the switch.
4. Anti-reflux/Spit Up Formulas
Acid reflux is not fun for anyone. It is even more uncomfortable for babies. Even when medication is prescribed to ease the problem, it doesn’t always help the formula to stay down.
Anti-spit up formula is usually thicker than regular formula. It is sometimes prepared in a different way than standard formulas.
There is a big warning with the extra thick formulas such as the ones below. It must be prepared exactly as directed or it can make your baby sick. It is thick, but it should not be lumpy. You will also need a different type of nipple for this thicker formula.
Here are the most common Anti-spit up formulas you can get:
- Enfamil AR Infant Formula
- Similac for Spit Up
These are both available at around the same price but the Enfamil AR Formula has much better reviews from parents.
5. Partially & Fully Hydrolyzed Formulas
Hydrolyzed formulas are made from cow's milk but the proteins are broken down so that they don't cause problems such as colic, gas, spit up and allergy symptoms.
There are two types.
Partially Hydrolyzed Formulas
Partially hydrolyzed formulas have been created for fussy babies who suffer with gassiness, colic and spit up. The partially broken protein chains are easier to digest and make a huge difference to many babies.
A list of the easiest to find Partially Hydrolyzed Formulas:
- Enfamil NeuroPro Gentlease
- Similac Total Comfort
- Gerber Good Start Soothe
Of the brands above, I'd recommend Gerber Good Start Soothe. Of the three options it is the best value for money and it also has the best reviews from parents.
Fully Hydrolyzed Formulas
Fully hydrolyzed versions are for babies with dairy allergy, dairy protein intolerance or lactose intolerance and are sometimes for other intolerances such as soy and egg. You'll often see them described as pre-digested formulas, which means that the protein chains have been fully broken.
The most common brands of fully hydrolyzed formulas:
- Similac Alimentum Hypoallergenic Formula
- Efamil Nutramigen Hypoallergenic Formula With Enflora
- Gerber Extensive HA
6. Hypoallergenic Formulas
For babies who are intolerant to both dairy and soy (which is very common), or who can't tolerate other formulas for one of the many other reasons, the natural choice is a hypoallergenic formula.
Hypoallergenic formulas are non-dairy and non-soy and are usually made from a blend of amino acids, vegetable fats, corn, and the full range of vitamins and minerals you'd expect to find in any formula milk.
Amino acid-based formula is another name for hypoallergenic infant formula. The difference from other formulas is that it consists of individual amino acids rather than log protein chains.
Amino acids are the very basic building blocks of protein and are so much easier for your baby to process and digest.
The most easy to find types are:
- Nutramigen Puramino
- SMA Alfamino Hypoallergenic Infant Formula
We tried three of the formulas on the list above for our daughter with dairy and soy intolerance but the only one she would drink was the EleCare Unflavored with DHA/ARA. Fortunately, it's also slightly cheaper than Neocate or Nutramigen, especially when you buy in bulk.
To sum up...
Feeding your baby is the biggest priority of all parents. We do everything we can to make sure they are healthy and happy, so when their food is causing problems it can make you feel like it is your fault. Remember that you aren’t alone. Babies have allergies and intolerances just like we do.
Every baby is different and sometimes it can take switching formulas several times before you find the perfect one.
1. Safety of Soy Formula - https://www.niehs.nih.gov/health/topics/agents/sya-soy-formula/index.cfm
2. Study on the Digestibility of Goat's Milk Formula - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5704675/