Oregon Academy of Nutrition and Dietetics



ProductsIndicationsContra-indicationsMain featuresBreastfeedingBreastmilkWith very few exceptions, breastfeeding is indicated for all infantsWhen extra fortification is required infant formula may be added to breastmilkMother:Illegal drug use HIV-positiveInfant:GalactosemiaProtein:Whey and casein, with a changing ratio over the duration of lactationWhey/casein ratios:Early lactation: 90/10Mature lactation: 60/40Standard Infant FormulasRoutineEnfamil InfantSimilac AdvanceSimilac SensitiveHealthy infants born >34 weeks gestational age (GA)Cow’s milk protein allergyProtein:Intact cow’s milk proteins (casein and whey)PartiallyHydrolyzedEnfamil GentleaseGood Start GentleGood Start SootheSimilac Total ComfortMarketed as intolerance formulas; not truly hypoallergenicNote:Good Start Gentle:FDA approved for use in reducing risk of atopic dermatitis in high risk infantsCow’s milk protein allergyProtein:Cow’s milk proteins partially hydrolyzed into small peptidesNote:Good Start and Similac: 100% wheyThickenedEnfamil A.R.Similac for Spit UpUncomplicated gastro esophageal reflux disease (GERD)Note:Decreased efficacy when used with proton-pump inhibitor medications (e.g. Prilosec, Prevacid)Premature infants <38 weeks GADo not concentrate above 24 kcal/ozProtein:Intact cow’s milk proteinsNote:Contains rice starch which thickens upon contact with stomach acid. Formulation maintains appropriate nutrient composition as opposed to adding cereal to formula.SoyEnfamil ProsobeeGood Start SoySimilac Soy IsomilVegan diet Family preferenceGalactosemia (Isomil and Prosobee powder only)PrematurityColicConstipationCow’s milk protein-induced enteropathyProtein:Soy protein isolatesNote:All soy formulas are lactose free-952508286750These are general guidelines; not intended for use in the treatment of a specific clinical condition or without medical supervision00These are general guidelines; not intended for use in the treatment of a specific clinical condition or without medical supervisionProductsIndicationsMain featuresSpecial Medical Infant FormulasExtensivelyHydrolyzedAlimentum(Abbott)Pregestimil(Mead Johnson)Nutramigen Enflora (Mead Johnson)General indications for use:Cow’s milk & soy protein allergyMultiple food allergiesIntractable diarrheaLactose/sucrose intoleranceProduct specific indications:Alimentum & Pregestimil:Cystic fibrosisPancreatic insufficiencyShort gutGI immaturityNutramigen Enflora & Pregestimil (powder forms only):GalactosemiaPregestimil:CeliacCholestasisProtein:Cow’s milk proteins hydrolyzed into small peptides and supplemented with amino acidsFat:Alimentum: 33% MCT oilPregestimil: 55% MCT oilNote:Nutramigen Enflora and Pregestimil: Use packed scoops for powdered formsFreeAmino AcidElecare Infant(Abbott)Neocate Infant(Nutricia)PurAmino(Mead Johnson)Cow’s milk & soy protein allergyMultiple food protein allergiesGERDShort bowel syndromeMalabsorptionEosinophlilic esophagitisGalactosemiaNote: Limited availability and expensiveProtein: Synthetic free amino acidsFat:Elecare and Neocate: 33% MCT oilNote:Mixing ratios differ from standard formulas; refer to manufacturer’s instructionsLow MineralBreastmilkSimilac PM 60/40(Abbott)Impaired renal functionNeonatal hypoglycemiaProtein: Intact cow’s milk proteins Note:Breastmilk’s efficient absorption rate results in a naturally low mineral contentSimilac PM 60/40:Iron supplementation may be neededPost-discharge PrematureEnfacare(Mead Johnson)Neosure(Abbott)Birthweight >2000 grams (4.5 lb) and <34 weeks gestational ageCan be used until 1 year corrected ageContraindications: Full term infants and failure to thrive infants due to the risk of hypervitaminosis and hypercalcemiaProtein: Intact cow’s milk proteinsNote:Provides 22 kcal/oz at standard dilution-14287518415These are general guidelines; not intended for use in the treatment of a specific clinical condition or without medical supervision00These are general guidelines; not intended for use in the treatment of a specific clinical condition or without medical supervision ................
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