Looking for a hypoallergenic baby formula? Not all babies can digest breastmilk and formula due to milk allergies or sensitivities. If your little one has a hard time tolerating dairy, you may want to try a hypoallergenic baby formula!
Though I am most in favor of breastfeeding, I do support the philosophy that parents should do what’s best for their baby, whether that’s breastfeeding, formula feeding, or a mix of both.
So, if formula is the right choice for your baby, I always recommend choosing an organic and minimally processed formula for the highest quality nutrition. But, it might not be that simple if your little one shows symptoms of a cow’s milk protein allergy or sensitivity. While it’s one of the most common food allergies, true milk protein allergies (thankfully) only occur in 2% to 3% of children. But many more babies are sensitive or intolerant to milk proteins found in many formulas (and soy formulas), which can make the journey quite a process.
Most babies will seemingly outgrow their cow’s milk allergy during childhood. In the interim, fortunately, there are many formula options on the market that will have your baby happy and fed.
Does Your Baby Have a Milk Protein Allergy or Intolerance?
A milk protein allergy is diagnosed by examining your baby’s reaction to the presence of milk proteins. Essentially, allergic reactions occur when the immune system treats food molecules as foreign and attacks them. This response triggers allergy symptoms. That said, some babies simply have a hard time tolerating dairy because the proteins in cow’s milk are larger and more difficult to digest. In fact, breastfed babies who are sensitive to milk proteins can have a difficult time if their mother also consumes dairy.
Cow’s milk protein allergy (CMPA) and sensitivity (CMPI) can result in a multitude of uncomfortable uncomfortable symptoms and it can seem like your baby has colic-like symptoms or is overall uncomfortable. Here are some common symptoms to look out for:
- Blood or mucous in the stool
- Runny nose
- Difficulty breathing
- Skin reactions and itchiness
Milk protein allergy symptoms are likely to occur soon after feeding. You’ll see them within a few hours. Sensitivities take longer to present because they are digestion-related rather than a full-blown immune response. Depending on your baby’s symptoms, your pediatrician may perform a stool test to diagnose the allergy or refer you to an allergist for further testing.
When it comes to feeding your baby, many parents find it distressing if they can’t find a formula that’s working. Unfortunately, babies with a milk protein allergy are likely to have a reaction to even the highest-quality formulas and even some goat milk formulas. (One of the more gentle formula brands is Kabrita, by the way. As long as your baby doesn’t have a milk protein allergy, you may want to consider trying this before switching to hypoallergenic formula.)
For those babies who do have severe sensitivities or verified milk protein allergies, even the highest-quality formulas can cause a reaction because the milk proteins remain intact.
So, that’s where hypoallergenic baby formula comes into play.
What is Sensitive or Hypoallergenic Baby Formula?
Hypoallergenic formula contains broken down proteins so that your baby can better and more easily digest the formula, typically without having a reaction. Typically, hypoallergenic formula is a kind of a last resort for parents whose baby just isn’t tolerating any other formula types.
There are different formulas for babies who are having trouble with milk proteins. Your pediatrician can help determine the severity of your baby’s allergy/reaction. He or she will also be able to advise you on the best type of hypoallergenic formula for your baby.
Here are your general options, and you’ll want to consider these depending on the severity of your baby’s symptoms.
- Goat’s Milk Formula. Some parents have luck with a goat’s milk formula to combat the unpleasant symptoms caused by a suspected sensitivity to cow’s milk. Goat’s milk proteins are smaller than cow’s milk proteins, and they are closer in size to the proteins found in breastmilk. So, it’s possible that your baby may tolerate goat’s milk formula better than cow’s milk (as long as they don’t have a confirmed cow’s milk allergy). It’s unfortunately not an option for babies with a cow’s milk allergy as the proteins are still very similar. Some of the most popular goat milk formula brands include Kabrita, Kendamil, and Holle Organic. If you’d like to consider a gentle formula option like goat’s milk, please see our full guide to goat milk formulas. These are not technically hypoallergenic baby formulas.
- A2 Baby Formula. Formulas made with A2 milk are sourced from cows that produce the A2 beta-casein protein. While this is still a dairy milk, this protein is believed to be easier to digest than A1 (conventional) milk proteins. For some sensitive babies, A2 milk formula might be a gentler alternative to traditional cow’s milk formulas. You can view our A2 formula recommendations on the organic baby formula article.
- Soy, Rice, and Sensitive Formulas. Another potential option is a soy-based formula; however, this is not the optimal feeding solution. Some babies with a cow’s milk protein allergy will also have an allergic reaction to soy formula, so it isn’t suitable for babies with a confirmed allergy. There are also concerns about the long-term effects of consuming soy from a young age due to the estrogen-like compounds in the plant. Alternatively, there are rice-based formulas on the market suitable for infants who have a milk protein allergy. However, these should only be used after consulting with your pediatrician.
- Fully or Partially Hydrolyzed Baby Formula. When milk proteins have been extensively broken down, the formulas are considered to be hypoallergenic, making them unlikely to provoke an allergic response. This type of formula can be especially great for babies who are high-risk for food allergies. For example, babies with a family history of food allergies or who are presenting with eczema. This type of formula is also useful for gently introducing babies to milk proteins in their hydrolyzed form. A young immune and digestive system will then be better equipped to handle intact proteins later on. Note that you can also find many formulas that are partially hydrolyzed. This type of formula contains proteins that are smaller as they are broken down into easier-to-digest fragments. This type of formula is ideal for newborns and young babies with sensitive, inexperienced digestive systems. Although partially-hydrolyzed formulas may help to relieve symptoms such as colic, gas, and fussiness, they aren’t truly hypoallergenic and not suitable for babies with a diagnosed milk protein allergy. Examples of hydrolyzed formulas include Hipp HA and sensitive formulas, as well as Elecare and Nutramigen.
- Amino Acid Formula. For some babies with a severe allergy, even fully hydrolyzed formulas will still cause a reaction. In these cases, it may be appropriate to use an amino acid-based formula. An amino acid-based formula is also known as elemental formula such as Neocate. With this type of formula, there’s virtually no risk of reaction because the proteins are broken down into their smallest possible components, amino acids.
The Best Hypoallergenic Baby Formulas
Here are my top recommendations for the healthiest hypoallergenic formulas on the market. We’ve broken this down into three sections:
- Partially hydrolyzed baby formula
- Fully hydrolyzed baby formula
- Amino-acid based formula
When it comes to choosing a hypoallergenic baby formula that your baby can tolerate, you may find yourself switching between these different types of hypoallergenic baby formula. And even if you have the highest ingredient standards, you may need to give yourself a little grace and wiggle room when choosing a sensitive baby formula.
Partially Hydrolyzed Formulas
These formulas contain proteins that are partially broken down, and therefore are not fully hypoallergenic. They are typically still a great option to consider as you start your journey of finding the right formula for your baby
HiPP HA Combiotik Hypoallergenic
My top recommendation for a partially hydrolyzed hypoallergenic formula is HiPP HA Combiotik. Manufactured in Germany and very popular throughout Europe, this formula has quite the following in the United States. Many infants who experience digestive problems, congestion, runny nose, or skin breakouts on “normal” formula show rapid improvement after transitioning to HiPP HA.
The cow’s milk proteins in HiPP HA are extensively hydrolyzed, so they are much easier for babies to digest. Furthermore, HiPP HA contains whey protein hydrolysate and no casein. Just like all of the HiPP formulas that serve as excellent breast milk substitutes (or supplements), HiPP HA Combiotik is made with the highest-quality ingredients. You won’t find artificial nutrients, preservatives, chemicals, or flavors. This formula features organic lactose, organic vegetable oils, essential vitamins, minerals, and omega-3 and omega-6 fatty acids. HiPP HA also contains prebiotics and probiotics to strengthen your baby’s digestive system and immune responses.
HiPP HA Stage 1 and Stage 2 contain a small amount of starch that helps thicken the formula. Out of all the hypoallergenic formulas that I’ve researched, babies seem to find that HiPP HA has the most agreeable taste. The Stage 1 formula is suitable from birth to six months, while Stage 2 is suitable for babies six months and older. The stages differ only in terms of the quantities of nutrients to correspond to your baby’s dietary needs.
Similar to the stage 1 formula, stage PRE does not contain starch. Some young babies do not tolerate starch particularly well (starch is not found in breast milk). The lack of starch may help babies digest this formula more easily. It also means that Stage PRE is thinner than Stage 1. It’s mostly a matter of your baby’s preference.
HiPP Comfort helps babies who are having difficulty digesting formula. If your baby experiences colic, gassiness, bloating, or constipation (not a full-blown allergy), this might be a good option! Along with whey protein hydrolysate, HiPP Comfort has less lactose compared to other HiPP formulas, making it easier to digest. It also contains maltodextrin and starch.
HiPP Comfort features a special blend of fats similar to the fatty acids found in breast milk. It also contains prebiotics to promote a healthy gut microbiome, as well as omega-3 and omega-6 fatty acids.
This is closest to American hypoallergenic formula and has reduced
The German and UK versions of HiPP Comfort are slightly different. The German version contains prebiotics and probiotics, while the UK version contains only prebiotics.
HiPP AR Anti-Reflux
If your baby has a difficult time keeping the formula down, this formula is a good option. HiPP AR Anti-Reflux contains locust bean gum to thicken the formula. It also features prebiotics, probiotics, and long-chain polyunsaturated fatty acids to help overall digestive health.
Keep in mind that this formula contains intact milk proteins, so it’s not for infants with a milk protein allergy. Even babies with milk protein intolerance or sensitivity may have difficulty digesting the proteins in this formula.
HiPP is the only European manufacturer that makes semi-hypoallergenic baby formula. They offer a few different types of hypoallergenic formulas to try. If your baby doesn’t tolerate European hypoallergenic formula, you may need to switch to an American-made fully hydrolyzed or amino-acid formula. In that case, your pediatrician or pediatric gastroenterologist (who you should see if your baby has reflux) can help you choose which formula to use. I know many babies who did much better on an American hypoallergenic formula but these brands are not organic and the ingredients are less desirable than what you’d find in the organic baby formula brands I usually recommend.
Fully Hydrolyzed Formulas
These formulas contain highly broken down milk proteins that are easier to tolerate than traditional or partially hydrolyzed baby formulas.
Similac Alimentum is one of the popular hypoallergenic formulas in the United States, despite being made with less than ideal ingredients such as corn maltodextrin, soy oil, and safflower oil.
The proteins in Similac Alimentum are from casein and have been extensively hydrolyzed (slightly more so than those in HiPP HA), so it is hypoallergenic and tends to work well for extra sensitive babies.
It does contain corn maltodextrin and sugar as the primary carbohydrate sources rather than the organic lactose found in HiPP HA. Since babies are very unlikely to be lactose intolerant, the use of corn maltodextrin and sugar isn’t likely to solve any feeding issues. It also contains DHA and ARA and is free from artificial growth hormones and palm oil.
The regular powdered formula version contains corn maltodextrin, whereas the ready-to-feed (RTF) bottles do not contain corn and use sugar and tapioca starch as the main carbohydrates. The RTF version is popular among parents of babies with a suspected corn allergy.
Enfamil Nutramigen is another well-established U.S. formula for babies with milk protein intolerance or certain forms of milk protein allergy. The formula is lactose-free and contains extensively hydrolyzed proteins that are unlikely to cause an allergic reaction or sensitivity.
Unfortunately, the main carbohydrate source in this formula is corn syrup solids, which I am pretty adamantly against. It also contains soy oil, safflower oil, and palm olein. But it contains DHA, ARA, probiotics, and a helpful complex blend of vegetable oils, including coconut oil.
Gerber Good Start Hypoallergenic HA Formula
If you are looking for an alternative to Alimentum or Nutramigen before starting an amino acid formula, consider Gerber Good Start HA. Well-tolerated by babies with diagnosed cow’s milk protein allergies, Good Start HA is a sensitive, extensively hydrolyzed infant formula.
As with all American-made hypoallergenic formulas, the ingredients are not ideal by any means. But this seems to be a good option for a fully hydrolyzed and hypoallergenic infant formula. In fact, many parents seem to rave about Gerber Good Start HA, saying that it is the only formula their baby would tolerate (my guess is that it’s possibly because of its probiotic content, but I can’t be sure).
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Amino-Acid Based Formulas
For babies with a severe milk or soy protein allergy, an amino-acid-based (elemental) formula is the best (and maybe the only) option. It provides enough nutrition without provoking a serious allergic reaction. Amino acid formulas are also suitable for babies with various gastrointestinal conditions and disorders.
This amino-acid based, hypoallergenic baby formula is one of two options to consider if your baby is extremely sensitive and unable to tolerate hydrolyzed formulas. Neocate is a well-tolerated brand that is designed to be nutritionally complete for your baby. With 100% free amino acids, Neocate is made using the easiest to absorb form of proteins in their broken down form.
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In amino acid-based formulas like Elecare, the proteins have been hydrolyzed so extensively that they are in the form of free amino acids. Babies should not have an allergic reaction to this type of formula. Elecare also contains DHA and ARA, as well as an easily absorbable fat blend. Because it’s a medical product, Elecare formula is expensive but your insurance may help cover the cost. But it’s perfect for babies with severe food allergies who need proper calories and nutrition.
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Final Thoughts on Hypoallergenic Formula
It’s important that your baby eats without feeling itchy or uncomfortable. Food allergies and sensitivities differ from baby to baby, so there’s no “one size fits all” solution. The good news is that there is a range of hypoallergenic infant formulas you can explore to help. From cutting out dairy and soy from your diet if you are breastfeeding to choosing a hypoallergenic formula, these are all worthwhile options to try.
Remember to monitor your baby and keep a record of what you feed your baby, the times you feed your baby, and your baby’s responses. This will help both you and your baby’s pediatrician decide on the best feeding plan.
Whatever you choose, I wish you and your baby all the best! Food allergies can be a nightmare, but you’re well on your way to finding a solution that works for your baby!
FAQs About Hypoallergenic Infant Formula
More questions about hypoallergenic formula? Read on!
I’m thinking of switching to a hypoallergenic baby formula. How do I do it?
If you’re ready to make the switch to hypoallergenic baby formula, it’s important to do so gradually. Your baby’s digestive system may need time to adapt to the new formula. Usually, I recommend doing this over a period of a week or so.
The best way to transition to any new formula is to prepare a bottle containing 75% of the old formula and 25% of the new formula. Mix the formula powders together before adding hot water. After a few days, you can balance out the proportions so that the bottle is made with 50% new formula and 50% old formula powder. A few days after this, you can move on to 75% new formula and 25% old formula. And when your baby seems adjusted, you can feed your baby a bottle made only with the new, hypoallergenic formula.
It may take two weeks or more for your baby to adjust to the new formula, so feel free to make the change even more gradually, if needed. Every baby is different, and in some cases, babies might benefit from an immediate switch to a hypoallergenic formula.
How quickly does hypoallergenic formula work?
It depends if your baby is truly allergic to milk proteins or not. Generally speaking, most babies start to feel better soon after switching over to a hypoallergenic formula. But it can take anywhere from two to four weeks to see improvement in allergy symptoms. And if it’s a severe allergy, your baby may take up to six weeks to see full improvement. Of course, always contact your child’s pediatrician if you’re concerned with his response to the baby formula.
How long does it take for a formula allergy/sensitivity to appear?
Allergy symptoms can show up suddenly or over a period of time. A rapid onset reaction is rare, but if it does occur, a baby will display symptoms very quickly after eating. Otherwise, most babies may have a slower onset reaction that occurs even days after consuming formula/breastmilk. Some babies may not be diagnosed with an allergy for a month or two, depending on their reaction. It can be difficult to diagnose an allergy if the symptoms are mild.
Also, note that rapid onset and slow onset reaction symptoms tend to be different. Slow onset symptoms include colic, trouble gaining weight, mucus in bowel movements, diarrhea, and vomiting. Sudden onset reactions can be more severe like hives, swelling, bloody diarrhea, and wheezing.
Unless there is visible blood in the stool, your baby’s pediatrician will likely test your baby’s stool for microscopic blood that indicates whether they are reacting to their formula (or breast milk if you are breastfeeding).
How do you know if the formula doesn’t agree with baby?
A baby doesn’t have to be allergic to ingredients in the formula for it to not agree with your little one’s belly! In fact, sometimes you have to try a few formulas before you find one that agrees with your baby. Babies’ bodies may display a few common symptoms that indicate a negative reaction to the formula:
- Loose stools. This doesn’t have to be diarrhea. If you see an increase in loose stools, take note that this may be a formula reaction.
- Difficulty passing gas. All babies have gas, but if your baby is super irritable and visibly having trouble passing gas, it can be a sign that your baby doesn’t like the formula.
- Fussier. If your baby is more fussy than usual, take note of when it occurs. If it happens after feeding, it could be the formula.
- Skin reactions. This is more typical if your baby has an allergy to the formula, but some baby’s with a sensitivity may also have itchy skin that looks red and irritated. Some babies also get eczema.
Once my baby starts on hypoallergenic formula, what can I expect?
Eventually your baby will feel a lot better. Skin reactions will subside, he will likely sleep better, and become more settled and content. However, full recovery can take up to six or eight weeks while milk proteins and any other allergens fully leave your baby’s system. When you start your baby on a hypoallergenic formula, you can expect a few things:
- Stool changes. Your baby is eating something new that likely agrees with him, so you can expect that your baby’s stool might also change and improve in appearance and texture. While some babies may experience loose stools as they transition to a hypoallergenic formula, generally, a baby will have fewer loose stools and have less frequent bowel movements over time. However, hydrolyzed formula can also cause green stools and possibly even smelly stools, so keep this in mind as you monitor your baby’s diapers.
- Formula smell. The taste and smell of hypoallergenic formula will be different than other types of formula. It might actually smell a little unpleasant, but that’s normal.
- Texture and color. Your baby will be too young to notice, but the consistency of the formula will be much thinner than conventional formula. And the color of it will likely be much more clear. Don’t be alarmed by these differences and be assured that the formula still contains the right nutritional values for your baby!
- Baby’s refusal. Sometimes, particularly if your baby is a little older, he may associate eating with feeling uncomfortable. Don’t be surprised if it takes a little time for your baby to get used to the formula.
Is European formula better than US hypoallergenic formula?
There’s no question that the formulas made by European brands such as HiPP, Holle, and Lebenswert are better than American formulas. Organic European formulas like HiPP are certified to EU organic standards for chemical-free agriculture, which are stricter than those found in the United States. For the most part, European formulas typically do not include:
- GMO ingredients
- Toxic additives
- Harsh chemicals
- Artificial nutrients
- Corn syrup, glucose syrup, brown rice syrup, or sucrose (In fact, the European Union strictly limits how much processed sugar can be included in the baby formula).
However, while the ingredients are typically cleaner than US formulas, you should work with your pediatrician to determine if these are right for your baby. If you go this route, it’s typically best to import your formula directly from Europe. Unfortunately, when shopping for hypoallergenic infant formula, your options are more limited.
What hypoallergenic baby formula did you choose? I’d love to know!