Available specialised formulas Interactive MAP Guideline

The constituents vary between the different individual Extensively Hydrolysed Formulas (eHFs) available and also between the different individual Amino Acid Formulas (AAFs) available. This can sometimes influence both an infant’s clinical tolerance and the perceived palatability of that formula.

The Hypoallergenic Formulas most commonly used in the infant age group in the UK for term infants are currently:

Whey-based constituents* 

Aptamil Pepti 1 Birth onwards Danone Nutricia 400g tin/900g pack
Aptamil Pepti 2 6 months onwards Danone Nutricia 900g pack 
SMA Althéra Birth onwards SMA 450g tin            

*The whey-based eHFs contain lactose

Casein-based constituents     

Similac Alimentum Birth onwards        Abbott Nutrition 400g tin    
Nutramigen LIPIL 1 Birth onwards        Mead Johnson  400g tin       
Nutramigen LIPIL 2 6 months onwards Mead Johnson 400g tin
Neocate LCP       Birth onwards  Nutricia 400g tin
Nutramigen AA Birth onwards Mead Johnson 400g tin 

These are the specialised formulas currently available in the UK, but the range may be different in each country and is subject to change1.

Extensively Hydrolysed Formulas – eHFs

Extensively Hydrolysed Formulas – eHFs are recommended as a first choice for infants with mild to moderate presentations of CMA, e.g. colic, reflux, diarrhoea, vomiting, eczema in the absence of faltering growth.

Amino Acid Formulas – AAFs

AAFs are recommended for infants:

- With a history of anaphylaxis to cow’s milk,
- Severe gastrointestinal and/or skin presentations, particularly in association with faltering growth.

There are a number of formulas available on the market which are designed to help with mild gastrointestinal discomfort and feeding problems in infants. These formulas are not suitable for use either in the diagnosis or management of cow’s milk allergy as they contain cow’s milk protein. For advice on appropriate formulas for infants with suspected or confirmed cow’s milk allergy refer to the MAP Guideline or consult a paediatric dietitian. Examples of these unsuitable formulas include:

  • SMA Staydown
  • SMA Comfort
  • SMA LF (lactose free)
  • Enfamil AR (anti-reflux)
  • Enfamil O-lac
  • Cow & Gate Anti-Reflux
  • Cow & Gate Comfort
  • Aptamil Anti-Reflux
  • Aptamil Comfort
  • Aptamil Lactose Free

1. Venter C, Brown T, Shah N, Walsh J, Fox AT. Diagnosis and management of non-IgE-mediated cow's milk allergy in infancy – a UK primary care practical guide [Online]. Clin Transl Allergy 2013;3(1):23. Available at: http://www.ctajournal.com/content/3/1/23 [Accessed Oct 2013].