Both are hypoallergenic, non-dairy formulas with casein hydrolysate or smaller, broken-down milk proteins. They’re also lactose-free and soy-free. Casein is a protein found exclusively in milk and dairy products. It’s already broken down into smaller pieces in these formulas. The smaller protein components, called peptides, may no longer trigger an allergic reaction. (1) These specialized formulas can contain similar nutrients and have the same amount of iron, vitamins A and D3, copper, and iodine. While the Alimentum formula costs less ($2.02 per oz) than the Nutramigen formula ($2.32 per oz), it contains added sugars and doesn’t have probiotic cultures. Both formulas have plenty of other similarities and differences. So, which one should you choose? Continue reading to learn more.

Main Similarities & Differences

These are the similarities and differences between Enfamil Nutramigen and Similac Alimentum to help you choose which one to give your baby:

Similarities

They’re both casein hydrolysate-based formulas. The smaller proteins may be easier for your baby’s sensitive tummy to digest. (1) They’re both non-dairy and soy-free formulas, although they contain soy oil. Both also have soy oil. Although highly refined soy oil doesn’t have soy proteins which can trigger allergic reactions in some babies, you might prefer to keep this oil from your baby’s diet. (2) Both are hypoallergenic baby formulas. Both claim to offer relief from colic due to food allergies, including protein sensitivity or cow’s milk allergy. Both have DHA (docosahexaenoic acid), an omega-3 fatty acid that can promote healthy eye and brain development. They also have ARA (arachidonic acid), an omega-6 fatty acid sourced from Mortierella Alpina oil. ARA may help improve your baby’s immune system. (3) Both contain highly processed vegetable oils. Nutramigen contains corn syrup, while Alimentum has corn maltodextrin. They’re closely related, but corn syrup is at least 20% sugar, while maltodextrin is less than 20% sugar. Neither formula has artificial growth hormones. The FDA requires that infant formulas sold in the US have at least 1 mg iron per 100 calories to help prevent iron-deficiency anemia. Both formulas are fortified with iron and contain 1.8 mg of iron per 100 calories. (4)

Both also contain the same amount of the following essential nutrients:

Vitamin A Vitamin B6 Vitamin D3 Riboflavin (vitamin B2) Copper Iodine

What Is The Difference In Nutramigen And Alimentum?

Why Enfamil Nutramigen Infant Formula Is Better

According to Enfamil, the Nutramigen formula is clinically proven to reduce colic caused by cow’s milk allergy within 48 hours of use. The company also claims that this formula may help reduce future allergies, including asthma, hives, eczema, and allergic rhinitis. It has probiotic culture strain LGG (Lactobacillus rhamnosus GG) that serves as “good bacteria” for your baby’s healthier digestive system. Unlike Alimentum, it doesn’t have added sugars or sucrose.

Nutramigen has more of the following essential minerals and nutrients:

Carbohydrates Protein equivalent Vitamin C Vitamin K Thiamin (vitamin B1) Folic acid Choline Inositol Magnesium Zinc Manganese Selenium Sodium Chloride

Why Similac Alimentum Infant Formula Is Better

According to Similac, the Alimentum formula is clinically proven to reduce excessive crying because of protein sensitivity within 24 hours. It costs less ($39.99 for a 19.8 oz can or $2.02 per oz) than Nutramigen formula ($45.99 for a 19.8 oz can or $2.32 per oz). This formula features a type of fat called MCT (medium-chain triglycerides) that can be easier for your child’s digestive system to absorb. It doesn’t have palm olein, an oil found in some formulas (including Nutramigen) that can negatively affect calcium absorption. (5) It contains more calcium (105 mg) than Nutramigen (94 mg).

The Alimentum formula has more of the following nutrients and essential minerals:

Total fats Vitamin E Calcium Linoleic acid Vitamin B12 Niacin Pantothenic acid Biotin Phosphorus Potassium

Continue reading for detailed information about Nutramigen vs Alimentum.

Enfamil Nutramigen with Enflora LGG Infant Formula

Price

12.6 oz can: $34.99 19.8 oz can: $45.99 27.8 oz can: $58.99

Best Features & Safety

According to Enfamil’s website, Nutramigen formula is clinically proven to reduce colic from cow’s milk allergy within 48 hours. The brand also claims that this formula may help reduce the incidence of future allergies, such as hives, allergic rhinitis, asthma, and eczema. This is a hypoallergenic formula. It has LGG (Lactobacillus rhamnosus GG) probiotic cultures of gut-friendly bacteria for your baby’s healthy digestive system function. It contains DHA to support your baby’s brain and eye development.

Ingredients

Modified casein hydrolysate Corn syrup solids Vegetable oil (high oleic sunflower, palm olein, soy, or coconut oil) Modified corn starch Lactobacillus rhamnosus (probiotics) Mortierella alpina oil (for ARA) Schizochytrium sp. oil (for DHA)

Nutrition Facts

Each serving (5 fl oz) of this formula contains:

Calories: 100 calories Total fats: 5.3 g Total carbohydrates: 10.3 g Added sugars: 0 g Protein equivalent: 2.8 g Iron: 1.8 mg Calcium: 94 mg Vitamin A: 300 IU Vitamin B6: 60 mcg Vitamin C: 12 mg Vitamin D3: 60 IU Vitamin E: 2 IU Vitamin K: 9 mcg Linoleic acid: 780 mg Thiamin (vitamin B1): 80 mcg Riboflavin (vitamin B2): 90 mcg Vitamin B12: 0.3 mcg Niacin: 1,000 mcg Folic acid: 16 mcg Pantothenic acid: 500 mcg Biotin: 3 mcg Choline: 24 mg Inositol: 24 mg Phosphorus: 52 mg Magnesium: 8 mg Zinc: 1 mg Manganese: 25 mcg Copper: 75 mcg Iodine: 15 mcg Selenium: 2.8 mcg Sodium: 47 mg Potassium: 110 mg Chloride: 86 mg

Product Recall

Mead Johnson Nutritionals recalled the Enfamil Nutramigen formula in 2001 due to incorrect, potentially dangerous preparation instructions. (6) According to the advisory, the incorrect instructions were written in Spanish. Following these instructions may inadvertently lead to serious health conditions, possibly even death. (6) The following lot codes of the powder infant formula (16-oz) were included in the recall: (6)

BHC43 BHC44 BJC45 BJC46 BJC47 BJC48 BKC49 BKC50 BLC51 BLC52 BLC53 BMC54 BMC55 BMC56 BAM57 BAM58 BBM59 BBM60 BBM61 BCM62 BCM63 BCM64 BDM65 BDM66 BEM67 BEM68 BEM69 BEM70 BEM71 BEM72 BFM73 BFM74

These lot codes of the ready-to-use (32-oz) liquid formula were included: (6)

MBM90 MBM91 MCM92 MCM93 MCM94 MDM95 MDM96 MEM97 MFM00 MFM01

Pros & Cons

Pros

It’s lactose-free. It doesn’t have artificial growth hormones. It doesn’t contain table sugars or sucrose.

Cons

It had a recall. (6) It contains palm olein and other vegetable oils that can interfere with nutrient absorption. It also has soy oil. Even if highly refined soy oil doesn’t have soy proteins, you might still prefer to keep it from your baby’s diet. It can cost more than regular formulas.

What Customers Say

Positive Reviews “We was having so much trouble with gas and her belly hurting and we’ve been on this for about a month now and no more gas drops or crying when she uses the bathroom.” – Reviewer on Enfamil’s website. “At 5 months, our little boy started to develop a rash all over his front and back and was screaming all night long when we started supplementing with a different formula. The doctor suggested trying Nutramigen. Literally that night, he slept 8 hours straight without screaming and his rash started to disappear.” – Reviewer on Enfamil’s website. Negative Reviews “This product was chosen for us by the NICU pediatrician for food sensitivities because my newborn might have the same food allergies that I have (I have 15). From the beginning of bringing him home however, we had to endure 1-2 hours of gas, stomach pain and crying.” – Reviewer on Enfamil’s website.

Similac Alimentum Hypoallergenic Formula

Price

12.1 oz can: $28.99 19.8 oz can: $39.99 19.8 oz can, case of four: $167.99

Best Features & Safety

It’s based on casein hydrolysate or smaller, broken-down proteins. It’s clinically proven to be hypoallergenic. (7) It contains a type of fat called MCT (medium-chain triglycerides) which may be easier for your baby’s digestive system to absorb.

Ingredients

Casein hydrolysate Corn maltodextrin Sugar High oleic safflower oil Soy oil Medium-chain triglycerides Crypthecodinium cohnii oil (for DHA) Mortierella alpina oil (for ARA)

Nutrition Facts

Each 5 fl oz serving of this formula contains:

Calories: 100 calories Total fats: 5.54 g Total carbohydrates: 10.2 g Protein equivalent: 2.75 g Iron: 1.8 mg Calcium: 105 mg Vitamin A: 300 IU Vitamin B6: 60 mcg Vitamin C: 9 mg Vitamin D3: 60 IU Vitamin E: 3 IU Vitamin K: 8 mcg Linoleic acid: 800 mg Thiamin (vitamin B1): 60 mcg Riboflavin (vitamin B2): 90 mcg Vitamin B12: 0.45 mcg Niacin: 1,350 mcg Folic acid: 15 mcg Pantothenic acid: 750 mcg Biotin: 4.5 mcg Choline: 12 mg Inositol: 5 mg Phosphorus: 75 mg Magnesium: 7.5 mg Zinc: 0.75 mg Manganese: 8 mcg Copper: 75 mcg Iodine: 15 mcg Selenium: 2 mcg Sodium: 44 mg Potassium: 118 mg Chloride: 80 mg

Product Recall

There has been no recall on Similac Alimentum in powder form. But the liquid, ready-to-drink Similac Alimentum formula (in 32 oz bottles) was recalled in September 2006 because of a manufacturing defect. (8) The bottles don’t have a special layer that’s supposed to keep air out. When air enters the container, oxygen may react with the vitamin C content and cause it to decrease over time. (8) The formula itself may still be safe for consumption, but the lower vitamin C levels can lead to a nutrient deficiency. (8) According to the recall advisory, a child who continually drinks any formula with low levels of this vitamin for at least two weeks might begin showing the following signs of vitamin C deficiency: (8)

Irritability with generalized tenderness Paleness Easy bruising Fatigue

The recalled Similac Alimentum formulas have these details printed on the back of the bottles: (8)(9)

Lot 401895V Stock code 57512. Use-by date code of “1 May 2007.”

These products were distributed by Abbott Nutrition’s Ross Products division to retailers in the United States, Puerto Rico, and Guam between May 18 and September 5, 2006. (9) If you bought this product or received it as a free sample from your baby’s pediatrician, you may get free replacements by calling Ross Products Division at 800-624- 3412. (9) No medical complaints were reported concerning this recall. (9)

Pros & Cons

Pros

It’s a hypoallergenic formula. It doesn’t contain palm olein oil, a component in some formulas that can affect calcium absorption. (5)

Cons

It has added sugars, corn maltodextrin, and highly processed vegetable oils. It has soy oil. You are required to keep it in cool temperatures once the container is opened.

What Customers Say

Positive Reviews “After trying several formulas to help with fussiness and major constipation my Pediatrician recommended Alimentum. Within 24 I noticed a dramatic difference in the baby. Yes it stinks, but definitely not a reason to complain, and give a bad review. Too many positives to focus on one negative.” – Reviewer on Similac’s website. “This is the only formula either of my children could use. My daughter had a milk protein allergy and had constant stomach problems until we switched her to this formula. My son would constantly spit up and had colic until we switched him to this formula also. This formula is a life saver for my family.” – Reviewer on Target. “My daughter has both a milk protein allergy as well as a corn allergy. We are so thankful Similac came up with this formula! Our daughter would pass out from all the screaming and crying she did because of the pain. She also lost her voice, and was so horse sounding that we were afraid that she damaged her vocal cords. This formula was truly a blessing for our daughter!” – Reviewer on Similac’s website. Negative Reviews “The smell itself is putrid and my poor baby didn’t even want to drink more than an oz of this and he’s usually a 3-4oz drinker. It made him so gassy like nonstop gassy every minute he was passing gas. Burping him after this was a nightmare because it caused so much gas in his stomach that he needed to be burped every couple of minutes while drinking this. And it made him super lethargic.” – Reviewer on Target. “It is DISGUSTING and I wouldn’t feed this to anyone. It is so sour and has a horribly painful bite that lingers at the back of your throat. The bitter flavor coats your mouth and has a lingering gag-worthy aftertaste. Seriously, it is that bad.” – Reviewer on Similac’s website. “My daughter went on this formula two weeks ago due to severe allergy to soy protein and issues with milk proteins. Since the change in the powder she has become extremely gassy and at times in consolably fussy! She is flat out miserable and the only thing that changed was the difference in the powder. It’s horrible! She burps great while she’s eating but then continues to have so much gas coming out both ends even in between feedings. She’s getting belly aches constantly and is fussy all day long due to all of the gas she has.” – Reviewer on Similac’s website.

Summary & Recommendation

Enfamil Nutramigen and Similac Alimentum are two formulas that have many similarities and can be a good choice for your baby. Here are our recommendations to help you pick the most suitable formula that your baby needs: Choose Enfamil Nutramigen Infant Formula if:

You prefer a formula that’s marketed as clinically proven to reduce colic due to cow’s milk allergy in 48 hours. You want a formula that may help reduce the incidence of future allergies, including asthma and eczema. You want a formula that has probiotic cultures or “good bacteria” which can help strengthen your baby’s digestive system. You prefer a formula that doesn’t have added sugars or sucrose. You prefer a formula with more carbohydrates, protein equivalent, vitamins C and K, thiamin (vitamin B1), folic acid, choline, inositol, magnesium, zinc, manganese, selenium, sodium, and chloride.

Choose Similac Alimentum Infant Formula if:

You prefer a formula that’s marketed as a clinically proven formula that may reduce excessive crying due to protein sensitivity within 24 hours. You want a formula with better value and a lower price. The Alimentum formula costs $2.02 per oz, while the Nutramigen formula costs $2.32 per oz. You prefer a formula with MCT oil, which can be easier for your child’s digestive system to absorb. You prefer a formula without palm olein for better calcium absorption. (5) You prefer a formula with more calcium. It has 105 mg, while the Nutramigen has 94 mg. You want a formula with more total fats, vitamin E, linoleic acid, vitamin B12, niacin, pantothenic acid, biotin, phosphorus, and potassium.

Which Formula Is Best For Babies With Allergies?

Casein hydrolysate and amino acid-based formulas are specialized formulas that your pediatrician might recommend if your little one has:

Cow’s milk protein allergy Acid reflux Colic Upset stomach or gas Lactose intolerance or hypersensitivity Multiple food allergies

While their formulations may be similar, especially in terms of what nutrients they can provide for babies, many formulas differ in the types of proteins and carbohydrates they contain. In the case of casein hydrolysate and amino acid-based formulas, they differ in the types of proteins used. The proteins in the traditional formulas and breast milk are in their full size. They can be referred to as the following in the ingredients list of the packaging:

Nonfat milk Milk protein isolate Whey protein Soy protein isolate (soy formulas)

Regular milk formulas have intact or full-sized proteins, but some dairy-free formulas have hydrolyzed proteins from cow’s milk. The proteins in these formulations have been broken down into smaller pieces that may no longer trigger an allergic reaction, such as hives when taken by your little one. But make sure to consult with your pediatrician before starting any new formula. The smaller, broken-down proteins in these formulas are called “hydrolyzed proteins” or “hydrolysates.” On your formula’s can, these proteins may be listed as:

Partially hydrolyzed nonfat milk Fully hydrolyzed protein formula Hydrolyzed proteins Casein hydrolysate Whey protein hydrolysate

Further processing of these smaller peptides can break them down into individual amino acids, known as the building blocks of proteins.

Advantages Of Casein Hydrolysate-Based Formulas

These broken-down proteins are made up of peptides which are short chains of amino acids. The smaller peptides may be less allergenic and easier to digest than the whole proteins from traditional formulas. Their components are still bigger and can be more palatable than the amino acid-based formulas.

Advantages Of Amino Acid-Based Formulas

This type of formula has much smaller protein parts that may be more suitable for babies with severe symptoms of multiple food allergies, cow’s milk protein allergies, and other digestive issues. They can be easier to digest by sensitive tummies due to their much smaller size.

A major drawback of amino acid-based formulas is that they could taste or smell much different from traditional formulas.

Formula Comparisons With Similac Elecare

Enfamil Nutramigen and Similac Alimentum are both casein hydrolysate-based formulas, while Elecare is an amino acid-based formula. They’re all hypoallergenic, specialized formulas for food allergies, cow’s milk protein allergies, lactose intolerance, and other digestive problems. They have the same amounts of iron and vitamin D3. The following are their differences:

Enfamil Nutramigen vs Similac Elecare

What Makes Nutramigen Better:

It may taste better than Elecare. It contains more vitamin C, pantothenic acid, choline, inositol, iodine, selenium, sodium, and chloride. It costs less ($2.32 per oz) than Elecare ($3.19 per oz).

What Makes Elecare Better:

It has smaller components (amino acids) that may make it easier to digest. It contains nearly three times (210 mcg) the amount of thiamin in Nutramigen (80 mcg). Thiamin is a nutrient that helps your baby’s body generate energy from the nutrients it gets from formula or breast milk. (10) It has nearly twice (29.5 mcg) the amount of folic acid as Nutramigen (16 mcg). Folic acid helps your baby’s body make healthy red blood cells. (11) It has more than three times (84 mcg) manganese than Nutramigen (25 mcg). Manganese plays several important roles in your baby’s body: promoting calcium absorption, regulating blood sugar levels, and making bones, connective tissues, and blood clotting factors. (12) It has more carbohydrates, protein equivalent, calcium, linoleic acid, riboflavin, niacin, biotin, phosphorus, magnesium, zinc, copper, and potassium. It also contains more vitamins B6, B12, E, and K.

Similac Alimentum vs Similac Elecare

What Makes Alimentum Better:

The Alimentum formula costs much less ($2.02 per oz) than Elecare ($3.19 per oz). It may taste and smell better. It contains more vitamins A, E, and B12. It also has more pantothenic acid, biotin, iodine, and chloride.

What Makes Elecare Better:

Its smaller components (amino acids) may be easier to digest. It has nearly four times (210 mcg) the amount of thiamin than Alimentum (60 mcg). It also has close to twice (29.5 mcg) the folic acid than Alimentum (15 mcg). Its manganese content (84 mcg) is more than 10 times that of the Alimentum formula (8 mcg). It also contains more carbohydrates, protein equivalent, vitamins B6 and K, calcium, linoleic acid, riboflavin, niacin, inositol, phosphorus, magnesium, zinc, copper, selenium, sodium, and potassium.

Can You Switch Between Nutramigen And Alimentum? These two have similar formulations. You may switch between them or use either one as a supplement for breastfeeding. But always make sure to seek advice from your pediatrician before starting or switching formulas. Should I Give Water Between Feeds? Don’t give water between feeds for babies below six months old. You can start giving water when they’re over six months old, but always with the clear go-ahead from your pediatrician. The following are the recommended limits: (13)

6-12 months old: just around 4-8 oz (0.5 to 1 cup) per day 1-2 years old: 8-32 oz (1 to 4 cups) per day 2-5 years old: 8-40oz (1 to 5 cups) per day

REFERENCES (1) https://pubmed.ncbi.nlm.nih.gov/2007924/ (2) https://www.kidswithfoodallergies.org/soy-allergy.aspx (3) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4848685/ (4) https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfcfr/cfrsearch.cfm?fr=107.100 (5) https://pubmed.ncbi.nlm.nih.gov/8780336/ (6) https://www.nytimes.com/2001/07/10/us/national-briefing-science-and-health-recall-of-baby-formula.html (7) https://pubmed.ncbi.nlm.nih.gov/2007924/ (8) https://www.aappublications.org/content/27/9/2006229 (9) https://www.cbsnews.com/news/huge-recall-of-similac-baby-formula/ (10) https://www.mayoclinic.org/drugs-supplements-thiamin/art-20366430 (11) https://www.nhs.uk/medicines/folic-acid/ (12) https://www.mountsinai.org/health-library/supplement/manganese (13) https://www.healthychildren.org/English/healthy-living/nutrition/Pages/Recommended-Drinks-for-Young-Children-Ages-0-5.aspx


title: “Enfamil Nutramigen Vs Similac Alimentum Which Specialized Formula Is Better Motherhood Community” ShowToc: true date: “2022-12-13” author: “Rufus Whisby”


Both are hypoallergenic, non-dairy formulas with casein hydrolysate or smaller, broken-down milk proteins. They’re also lactose-free and soy-free. Casein is a protein found exclusively in milk and dairy products. It’s already broken down into smaller pieces in these formulas. The smaller protein components, called peptides, may no longer trigger an allergic reaction. (1) These specialized formulas can contain similar nutrients and have the same amount of iron, vitamins A and D3, copper, and iodine. While the Alimentum formula costs less ($2.02 per oz) than the Nutramigen formula ($2.32 per oz), it contains added sugars and doesn’t have probiotic cultures. Both formulas have plenty of other similarities and differences. So, which one should you choose? Continue reading to learn more.

Main Similarities & Differences

These are the similarities and differences between Enfamil Nutramigen and Similac Alimentum to help you choose which one to give your baby:

Similarities

They’re both casein hydrolysate-based formulas. The smaller proteins may be easier for your baby’s sensitive tummy to digest. (1) They’re both non-dairy and soy-free formulas, although they contain soy oil. Both also have soy oil. Although highly refined soy oil doesn’t have soy proteins which can trigger allergic reactions in some babies, you might prefer to keep this oil from your baby’s diet. (2) Both are hypoallergenic baby formulas. Both claim to offer relief from colic due to food allergies, including protein sensitivity or cow’s milk allergy. Both have DHA (docosahexaenoic acid), an omega-3 fatty acid that can promote healthy eye and brain development. They also have ARA (arachidonic acid), an omega-6 fatty acid sourced from Mortierella Alpina oil. ARA may help improve your baby’s immune system. (3) Both contain highly processed vegetable oils. Nutramigen contains corn syrup, while Alimentum has corn maltodextrin. They’re closely related, but corn syrup is at least 20% sugar, while maltodextrin is less than 20% sugar. Neither formula has artificial growth hormones. The FDA requires that infant formulas sold in the US have at least 1 mg iron per 100 calories to help prevent iron-deficiency anemia. Both formulas are fortified with iron and contain 1.8 mg of iron per 100 calories. (4)

Both also contain the same amount of the following essential nutrients:

Vitamin A Vitamin B6 Vitamin D3 Riboflavin (vitamin B2) Copper Iodine

What Is The Difference In Nutramigen And Alimentum?

Why Enfamil Nutramigen Infant Formula Is Better

According to Enfamil, the Nutramigen formula is clinically proven to reduce colic caused by cow’s milk allergy within 48 hours of use. The company also claims that this formula may help reduce future allergies, including asthma, hives, eczema, and allergic rhinitis. It has probiotic culture strain LGG (Lactobacillus rhamnosus GG) that serves as “good bacteria” for your baby’s healthier digestive system. Unlike Alimentum, it doesn’t have added sugars or sucrose.

Nutramigen has more of the following essential minerals and nutrients:

Carbohydrates Protein equivalent Vitamin C Vitamin K Thiamin (vitamin B1) Folic acid Choline Inositol Magnesium Zinc Manganese Selenium Sodium Chloride

Why Similac Alimentum Infant Formula Is Better

According to Similac, the Alimentum formula is clinically proven to reduce excessive crying because of protein sensitivity within 24 hours. It costs less ($39.99 for a 19.8 oz can or $2.02 per oz) than Nutramigen formula ($45.99 for a 19.8 oz can or $2.32 per oz). This formula features a type of fat called MCT (medium-chain triglycerides) that can be easier for your child’s digestive system to absorb. It doesn’t have palm olein, an oil found in some formulas (including Nutramigen) that can negatively affect calcium absorption. (5) It contains more calcium (105 mg) than Nutramigen (94 mg).

The Alimentum formula has more of the following nutrients and essential minerals:

Total fats Vitamin E Calcium Linoleic acid Vitamin B12 Niacin Pantothenic acid Biotin Phosphorus Potassium

Continue reading for detailed information about Nutramigen vs Alimentum.

Enfamil Nutramigen with Enflora LGG Infant Formula

Price

12.6 oz can: $34.99 19.8 oz can: $45.99 27.8 oz can: $58.99

Best Features & Safety

According to Enfamil’s website, Nutramigen formula is clinically proven to reduce colic from cow’s milk allergy within 48 hours. The brand also claims that this formula may help reduce the incidence of future allergies, such as hives, allergic rhinitis, asthma, and eczema. This is a hypoallergenic formula. It has LGG (Lactobacillus rhamnosus GG) probiotic cultures of gut-friendly bacteria for your baby’s healthy digestive system function. It contains DHA to support your baby’s brain and eye development.

Ingredients

Modified casein hydrolysate Corn syrup solids Vegetable oil (high oleic sunflower, palm olein, soy, or coconut oil) Modified corn starch Lactobacillus rhamnosus (probiotics) Mortierella alpina oil (for ARA) Schizochytrium sp. oil (for DHA)

Nutrition Facts

Each serving (5 fl oz) of this formula contains:

Calories: 100 calories Total fats: 5.3 g Total carbohydrates: 10.3 g Added sugars: 0 g Protein equivalent: 2.8 g Iron: 1.8 mg Calcium: 94 mg Vitamin A: 300 IU Vitamin B6: 60 mcg Vitamin C: 12 mg Vitamin D3: 60 IU Vitamin E: 2 IU Vitamin K: 9 mcg Linoleic acid: 780 mg Thiamin (vitamin B1): 80 mcg Riboflavin (vitamin B2): 90 mcg Vitamin B12: 0.3 mcg Niacin: 1,000 mcg Folic acid: 16 mcg Pantothenic acid: 500 mcg Biotin: 3 mcg Choline: 24 mg Inositol: 24 mg Phosphorus: 52 mg Magnesium: 8 mg Zinc: 1 mg Manganese: 25 mcg Copper: 75 mcg Iodine: 15 mcg Selenium: 2.8 mcg Sodium: 47 mg Potassium: 110 mg Chloride: 86 mg

Product Recall

Mead Johnson Nutritionals recalled the Enfamil Nutramigen formula in 2001 due to incorrect, potentially dangerous preparation instructions. (6) According to the advisory, the incorrect instructions were written in Spanish. Following these instructions may inadvertently lead to serious health conditions, possibly even death. (6) The following lot codes of the powder infant formula (16-oz) were included in the recall: (6)

BHC43 BHC44 BJC45 BJC46 BJC47 BJC48 BKC49 BKC50 BLC51 BLC52 BLC53 BMC54 BMC55 BMC56 BAM57 BAM58 BBM59 BBM60 BBM61 BCM62 BCM63 BCM64 BDM65 BDM66 BEM67 BEM68 BEM69 BEM70 BEM71 BEM72 BFM73 BFM74

These lot codes of the ready-to-use (32-oz) liquid formula were included: (6)

MBM90 MBM91 MCM92 MCM93 MCM94 MDM95 MDM96 MEM97 MFM00 MFM01

Pros & Cons

Pros

It’s lactose-free. It doesn’t have artificial growth hormones. It doesn’t contain table sugars or sucrose.

Cons

It had a recall. (6) It contains palm olein and other vegetable oils that can interfere with nutrient absorption. It also has soy oil. Even if highly refined soy oil doesn’t have soy proteins, you might still prefer to keep it from your baby’s diet. It can cost more than regular formulas.

What Customers Say

Positive Reviews “We was having so much trouble with gas and her belly hurting and we’ve been on this for about a month now and no more gas drops or crying when she uses the bathroom.” – Reviewer on Enfamil’s website. “At 5 months, our little boy started to develop a rash all over his front and back and was screaming all night long when we started supplementing with a different formula. The doctor suggested trying Nutramigen. Literally that night, he slept 8 hours straight without screaming and his rash started to disappear.” – Reviewer on Enfamil’s website. Negative Reviews “This product was chosen for us by the NICU pediatrician for food sensitivities because my newborn might have the same food allergies that I have (I have 15). From the beginning of bringing him home however, we had to endure 1-2 hours of gas, stomach pain and crying.” – Reviewer on Enfamil’s website.

Similac Alimentum Hypoallergenic Formula

Price

12.1 oz can: $28.99 19.8 oz can: $39.99 19.8 oz can, case of four: $167.99

Best Features & Safety

It’s based on casein hydrolysate or smaller, broken-down proteins. It’s clinically proven to be hypoallergenic. (7) It contains a type of fat called MCT (medium-chain triglycerides) which may be easier for your baby’s digestive system to absorb.

Ingredients

Casein hydrolysate Corn maltodextrin Sugar High oleic safflower oil Soy oil Medium-chain triglycerides Crypthecodinium cohnii oil (for DHA) Mortierella alpina oil (for ARA)

Nutrition Facts

Each 5 fl oz serving of this formula contains:

Calories: 100 calories Total fats: 5.54 g Total carbohydrates: 10.2 g Protein equivalent: 2.75 g Iron: 1.8 mg Calcium: 105 mg Vitamin A: 300 IU Vitamin B6: 60 mcg Vitamin C: 9 mg Vitamin D3: 60 IU Vitamin E: 3 IU Vitamin K: 8 mcg Linoleic acid: 800 mg Thiamin (vitamin B1): 60 mcg Riboflavin (vitamin B2): 90 mcg Vitamin B12: 0.45 mcg Niacin: 1,350 mcg Folic acid: 15 mcg Pantothenic acid: 750 mcg Biotin: 4.5 mcg Choline: 12 mg Inositol: 5 mg Phosphorus: 75 mg Magnesium: 7.5 mg Zinc: 0.75 mg Manganese: 8 mcg Copper: 75 mcg Iodine: 15 mcg Selenium: 2 mcg Sodium: 44 mg Potassium: 118 mg Chloride: 80 mg

Product Recall

There has been no recall on Similac Alimentum in powder form. But the liquid, ready-to-drink Similac Alimentum formula (in 32 oz bottles) was recalled in September 2006 because of a manufacturing defect. (8) The bottles don’t have a special layer that’s supposed to keep air out. When air enters the container, oxygen may react with the vitamin C content and cause it to decrease over time. (8) The formula itself may still be safe for consumption, but the lower vitamin C levels can lead to a nutrient deficiency. (8) According to the recall advisory, a child who continually drinks any formula with low levels of this vitamin for at least two weeks might begin showing the following signs of vitamin C deficiency: (8)

Irritability with generalized tenderness Paleness Easy bruising Fatigue

The recalled Similac Alimentum formulas have these details printed on the back of the bottles: (8)(9)

Lot 401895V Stock code 57512. Use-by date code of “1 May 2007.”

These products were distributed by Abbott Nutrition’s Ross Products division to retailers in the United States, Puerto Rico, and Guam between May 18 and September 5, 2006. (9) If you bought this product or received it as a free sample from your baby’s pediatrician, you may get free replacements by calling Ross Products Division at 800-624- 3412. (9) No medical complaints were reported concerning this recall. (9)

Pros & Cons

Pros

It’s a hypoallergenic formula. It doesn’t contain palm olein oil, a component in some formulas that can affect calcium absorption. (5)

Cons

It has added sugars, corn maltodextrin, and highly processed vegetable oils. It has soy oil. You are required to keep it in cool temperatures once the container is opened.

What Customers Say

Positive Reviews “After trying several formulas to help with fussiness and major constipation my Pediatrician recommended Alimentum. Within 24 I noticed a dramatic difference in the baby. Yes it stinks, but definitely not a reason to complain, and give a bad review. Too many positives to focus on one negative.” – Reviewer on Similac’s website. “This is the only formula either of my children could use. My daughter had a milk protein allergy and had constant stomach problems until we switched her to this formula. My son would constantly spit up and had colic until we switched him to this formula also. This formula is a life saver for my family.” – Reviewer on Target. “My daughter has both a milk protein allergy as well as a corn allergy. We are so thankful Similac came up with this formula! Our daughter would pass out from all the screaming and crying she did because of the pain. She also lost her voice, and was so horse sounding that we were afraid that she damaged her vocal cords. This formula was truly a blessing for our daughter!” – Reviewer on Similac’s website. Negative Reviews “The smell itself is putrid and my poor baby didn’t even want to drink more than an oz of this and he’s usually a 3-4oz drinker. It made him so gassy like nonstop gassy every minute he was passing gas. Burping him after this was a nightmare because it caused so much gas in his stomach that he needed to be burped every couple of minutes while drinking this. And it made him super lethargic.” – Reviewer on Target. “It is DISGUSTING and I wouldn’t feed this to anyone. It is so sour and has a horribly painful bite that lingers at the back of your throat. The bitter flavor coats your mouth and has a lingering gag-worthy aftertaste. Seriously, it is that bad.” – Reviewer on Similac’s website. “My daughter went on this formula two weeks ago due to severe allergy to soy protein and issues with milk proteins. Since the change in the powder she has become extremely gassy and at times in consolably fussy! She is flat out miserable and the only thing that changed was the difference in the powder. It’s horrible! She burps great while she’s eating but then continues to have so much gas coming out both ends even in between feedings. She’s getting belly aches constantly and is fussy all day long due to all of the gas she has.” – Reviewer on Similac’s website.

Summary & Recommendation

Enfamil Nutramigen and Similac Alimentum are two formulas that have many similarities and can be a good choice for your baby. Here are our recommendations to help you pick the most suitable formula that your baby needs: Choose Enfamil Nutramigen Infant Formula if:

You prefer a formula that’s marketed as clinically proven to reduce colic due to cow’s milk allergy in 48 hours. You want a formula that may help reduce the incidence of future allergies, including asthma and eczema. You want a formula that has probiotic cultures or “good bacteria” which can help strengthen your baby’s digestive system. You prefer a formula that doesn’t have added sugars or sucrose. You prefer a formula with more carbohydrates, protein equivalent, vitamins C and K, thiamin (vitamin B1), folic acid, choline, inositol, magnesium, zinc, manganese, selenium, sodium, and chloride.

Choose Similac Alimentum Infant Formula if:

You prefer a formula that’s marketed as a clinically proven formula that may reduce excessive crying due to protein sensitivity within 24 hours. You want a formula with better value and a lower price. The Alimentum formula costs $2.02 per oz, while the Nutramigen formula costs $2.32 per oz. You prefer a formula with MCT oil, which can be easier for your child’s digestive system to absorb. You prefer a formula without palm olein for better calcium absorption. (5) You prefer a formula with more calcium. It has 105 mg, while the Nutramigen has 94 mg. You want a formula with more total fats, vitamin E, linoleic acid, vitamin B12, niacin, pantothenic acid, biotin, phosphorus, and potassium.

Which Formula Is Best For Babies With Allergies?

Casein hydrolysate and amino acid-based formulas are specialized formulas that your pediatrician might recommend if your little one has:

Cow’s milk protein allergy Acid reflux Colic Upset stomach or gas Lactose intolerance or hypersensitivity Multiple food allergies

While their formulations may be similar, especially in terms of what nutrients they can provide for babies, many formulas differ in the types of proteins and carbohydrates they contain. In the case of casein hydrolysate and amino acid-based formulas, they differ in the types of proteins used. The proteins in the traditional formulas and breast milk are in their full size. They can be referred to as the following in the ingredients list of the packaging:

Nonfat milk Milk protein isolate Whey protein Soy protein isolate (soy formulas)

Regular milk formulas have intact or full-sized proteins, but some dairy-free formulas have hydrolyzed proteins from cow’s milk. The proteins in these formulations have been broken down into smaller pieces that may no longer trigger an allergic reaction, such as hives when taken by your little one. But make sure to consult with your pediatrician before starting any new formula. The smaller, broken-down proteins in these formulas are called “hydrolyzed proteins” or “hydrolysates.” On your formula’s can, these proteins may be listed as:

Partially hydrolyzed nonfat milk Fully hydrolyzed protein formula Hydrolyzed proteins Casein hydrolysate Whey protein hydrolysate

Further processing of these smaller peptides can break them down into individual amino acids, known as the building blocks of proteins.

Advantages Of Casein Hydrolysate-Based Formulas

These broken-down proteins are made up of peptides which are short chains of amino acids. The smaller peptides may be less allergenic and easier to digest than the whole proteins from traditional formulas. Their components are still bigger and can be more palatable than the amino acid-based formulas.

Advantages Of Amino Acid-Based Formulas

This type of formula has much smaller protein parts that may be more suitable for babies with severe symptoms of multiple food allergies, cow’s milk protein allergies, and other digestive issues. They can be easier to digest by sensitive tummies due to their much smaller size.

A major drawback of amino acid-based formulas is that they could taste or smell much different from traditional formulas.

Formula Comparisons With Similac Elecare

Enfamil Nutramigen and Similac Alimentum are both casein hydrolysate-based formulas, while Elecare is an amino acid-based formula. They’re all hypoallergenic, specialized formulas for food allergies, cow’s milk protein allergies, lactose intolerance, and other digestive problems. They have the same amounts of iron and vitamin D3. The following are their differences:

Enfamil Nutramigen vs Similac Elecare

What Makes Nutramigen Better:

It may taste better than Elecare. It contains more vitamin C, pantothenic acid, choline, inositol, iodine, selenium, sodium, and chloride. It costs less ($2.32 per oz) than Elecare ($3.19 per oz).

What Makes Elecare Better:

It has smaller components (amino acids) that may make it easier to digest. It contains nearly three times (210 mcg) the amount of thiamin in Nutramigen (80 mcg). Thiamin is a nutrient that helps your baby’s body generate energy from the nutrients it gets from formula or breast milk. (10) It has nearly twice (29.5 mcg) the amount of folic acid as Nutramigen (16 mcg). Folic acid helps your baby’s body make healthy red blood cells. (11) It has more than three times (84 mcg) manganese than Nutramigen (25 mcg). Manganese plays several important roles in your baby’s body: promoting calcium absorption, regulating blood sugar levels, and making bones, connective tissues, and blood clotting factors. (12) It has more carbohydrates, protein equivalent, calcium, linoleic acid, riboflavin, niacin, biotin, phosphorus, magnesium, zinc, copper, and potassium. It also contains more vitamins B6, B12, E, and K.

Similac Alimentum vs Similac Elecare

What Makes Alimentum Better:

The Alimentum formula costs much less ($2.02 per oz) than Elecare ($3.19 per oz). It may taste and smell better. It contains more vitamins A, E, and B12. It also has more pantothenic acid, biotin, iodine, and chloride.

What Makes Elecare Better:

Its smaller components (amino acids) may be easier to digest. It has nearly four times (210 mcg) the amount of thiamin than Alimentum (60 mcg). It also has close to twice (29.5 mcg) the folic acid than Alimentum (15 mcg). Its manganese content (84 mcg) is more than 10 times that of the Alimentum formula (8 mcg). It also contains more carbohydrates, protein equivalent, vitamins B6 and K, calcium, linoleic acid, riboflavin, niacin, inositol, phosphorus, magnesium, zinc, copper, selenium, sodium, and potassium.

Can You Switch Between Nutramigen And Alimentum? These two have similar formulations. You may switch between them or use either one as a supplement for breastfeeding. But always make sure to seek advice from your pediatrician before starting or switching formulas. Should I Give Water Between Feeds? Don’t give water between feeds for babies below six months old. You can start giving water when they’re over six months old, but always with the clear go-ahead from your pediatrician. The following are the recommended limits: (13)

6-12 months old: just around 4-8 oz (0.5 to 1 cup) per day 1-2 years old: 8-32 oz (1 to 4 cups) per day 2-5 years old: 8-40oz (1 to 5 cups) per day

REFERENCES (1) https://pubmed.ncbi.nlm.nih.gov/2007924/ (2) https://www.kidswithfoodallergies.org/soy-allergy.aspx (3) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4848685/ (4) https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfcfr/cfrsearch.cfm?fr=107.100 (5) https://pubmed.ncbi.nlm.nih.gov/8780336/ (6) https://www.nytimes.com/2001/07/10/us/national-briefing-science-and-health-recall-of-baby-formula.html (7) https://pubmed.ncbi.nlm.nih.gov/2007924/ (8) https://www.aappublications.org/content/27/9/2006229 (9) https://www.cbsnews.com/news/huge-recall-of-similac-baby-formula/ (10) https://www.mayoclinic.org/drugs-supplements-thiamin/art-20366430 (11) https://www.nhs.uk/medicines/folic-acid/ (12) https://www.mountsinai.org/health-library/supplement/manganese (13) https://www.healthychildren.org/English/healthy-living/nutrition/Pages/Recommended-Drinks-for-Young-Children-Ages-0-5.aspx