Does Your Baby Need Hypoallergenic Formula?

If your baby has difficulty processing standard formula—or sometimes even breast milk—a milk protein allergy could be to blame. In those cases, a pediatrician may prescribe a hypoallergenic baby formula to help your little one get the nutrients they need. Some doctors may also recommend hypoallergenic formula for babies with a strong family history of allergies.

Unfortunately, hypoallergenic formula can be difficult to find during the baby formula shortage, creating an incredibly stressful situation for parents. That's because babies who need speciality formula for food intolerances can have negative reactions from standard formula, ranging from rashes to excessive crying to digestive issues.

We spoke with experts to answer your top questions about hypoallergenic formula, with tips for finding it during the shortage.

Does My Baby Need Hypoallergenic Formula?

If your little one has a milk protein allergy, their immune system overreacts to the proteins in milk, creating a host of symptoms. After a feeding session, you'll immediately notice clues that something's wrong, such as excessive crying, diarrhea, vomiting, bloody stool, trouble sleeping, wheezing, eczema hives, and runny nose.

Your baby might also have a sensitivity or intolerance to milk, which is more common than a full-blown allergy. Symptoms tend to be delayed, and they can include irritability, loose stools, digestive problems, and more.

Talk to your doctor before switching to a hypoallergenic formula to confirm an allergy or sensitivity is actually the problem. Food allergies are on the rise, but studies have shown that the prevalence of milk protein allergies in infants is around 2 to 3 percent. In those rare instances, hypoallergenic formula may be the only thing an infant can digest, says New York-based registered dietitian Natalie Gillett.

"Hypoallergenic formulas are absolutely necessary for infants who cannot tolerate regular formula," she says. "Without it, they will not properly absorb nutrients and will not grow."

What's in Hypoallergenic Baby Formula?

Although hypoallergenic formulas are often made with cow's milk, they're processed so that the allergy-causing protein is broken down in order to be more easily digestible for your baby. The two main types are extensively hydrolyzed formulas and amino acid-based formulas; the latter might be given to babies who can't tolerate extensively hydrolyzed formula.

You may also notice partially hydrolyzed formulas (such as Enfamil Gentlease) when you're comparing formula brands. Although some parents claim these options relieve fussiness and gas in some infants, it's important to note that they are not truly hypoallergenic, and they aren't intended for babies with confirmed allergies.

Gillett notes that parents should consider the different levels of pre-digestion in formulas, alongside the severity of the child's allergies. "Similac Alimentum and Enfamil Nutramigen contain fully broken down proteins," Gillett says. "One step further is an amino acid-based formula such as Neocate. The more broken down the proteins, the easier it is to digest, but it also comes with a higher price."

How Much Do Hypoallergenic Baby Formulas Cost?

Hypoallergenic formulas can be up to three times more expensive than standard formulas, but there may be hope for families on a budget, according to childbirth educator Genevieve Howland of Mama Natural. "Although hypoallergenic formulas can be very costly, it may be medically necessary for your baby, based on the severity of their allergy and symptoms," she says. "In some cases, health insurance may supplement—or even pay for—hypoallergenic formula if your pediatrician deems it medically necessary."

Choosing the Right Hypoallergenic Baby Formula

Your pediatrician may be able to help you choose between extensively hydrolyzed formulas (like Gerber Extensive HA, Enfamil Nutramigen, Similac Alimentum, and Enfamil Pregestimil) and amino acid-based hypoallergenic baby formulas (like Abbott Nutrition Elecare, Enfamil PurAmino, and Nutricia Neocate) based on your child's symptoms.

Still, it may also be necessary to try a few different brands before finding one that works best for your baby, says maternal child health expert Crystal Karges of Crystal Karges Nutrition. "Thankfully, there are multiple options available on the market today. If you try one recommended by your doctor that your baby doesn't seem to tolerate well, there are other brands that might work better," she says.

Karges suggests asking your doctor for formula samples to see which brand your baby tolerates best. "Once you have found a brand that works well for your baby, you can feel more confident in purchasing a larger size," she says. Karges mentions Enfamil Nutramigen and Similac Alimentum as two reliable hypoallergenic formula brands.

Howland favors European brands, including HiPP HA Combiotik, which contains only hydrolyzed proteins to help prevent allergic reactions. "Plus it has all the same great benefits of the brand's more traditional organic counterpart," she says. (Note that the Centers for Disease Control and Prevention says there's no evidence that imported formulas are better than commercial options sold in the U.S., which must be reviewed by the Food and Drug Administration).

Alternatives to Hypoallergenic Formula

The most obvious alternative to hypoallergenic formula, but still worth noting, is breast milk. The elimination of cow's milk and other dairy products from the nursing parent's diet will often ease the infant's symptoms.

Soy formulas may be another alternative to hypoallergenic formulas. Some infants with symptoms of IgE-associated cow's milk allergy have success with soy formulas—although many babies with documented cow's milk protein allergy will also be sensitive to soy. Also, some experts discourage the use of soy formula. "It's worth noting that soy-based formulas contain high levels of plant-based estrogen-like compounds," Howland says. "Studies show infants who consumed soy-based formula as newborns had differences in some reproductive-system cells and tissues, the long-term effects of which are unknown." It's important to note, however, that the concern is said to be minimal.

Howland notes that goat milk-based formula is generally well tolerated, because it contains smaller fat molecules, and rice protein-based formulas may also work for a severely allergic child.

While the options can seem dizzying, finding the right formula could transform your fussy, allergy-suffering baby into a happy, healthy child. Talk to your pediatrician about finding the right hypoallergenic baby formula or alternative for your little one.

Finding Hypoallergenic Formula During the Shortage

Parents nationwide are facing a baby formula shortage right now. You can blame supply chain issues, labor shortages, and recent voluntary recalls from Abbott Nutrition. Unfortunately, hypoallergenic formula has been hit particularly hard, leaving parents to face empty grocery store shelves and buying limits. If you're having trouble finding your speciality baby formula, here are some tips.

• Check elsewhere for supply. Look for your formula at grocery stores, pharmacies, local shops, baby supply stores, online retailers, and the manufacturer's website. Some parents have found formula through Facebook groups, food banks, and charity organizations.
• Reach out to your pediatrician or a local hospital. They might be able to point you in the right direction. Some pediatricians also have formula samples they can supply, says Parents advisor Ari Brown, M.D., author of Baby 411.
• Consider switching brands. Your baby might respond to other brands of hypoallergenic formula. Talk to your health care provider about making the switch.
• Incorporate solids. If your baby is old enough, consider supplementing their diet with solid foods.
• Avoid homemade formula and dairy products. Experts caution against homemade baby formula, which comes with a risk of nutritional imbalance and contamination. What's more, young babies shouldn't have cow's milk—especially if they have a milk protein allergy.