Formula Options for Kids with Food Allergies

On this page:

What can I feed my infant or toddler if they have food allergies?
What are symptoms of food allergy in infants and toddlers?
Which is better: human milk or formula?
Can my baby with food allergies drink donor human milk?
When is the best time to introduce solid foods to my baby with food allergies?
What formulas are available for infants and children with food allergies?
What can I do if I can’t afford formula?

What Can I Feed My Infant or Toddler If They Have Food Allergies?

Babies should ideally drink human milk or formula for at least the first year of life. Human (breast) milk provides optimal nutrition for an infant. Formula is designed to provide complete nutrition.

Introducing solid foods to a baby between 4-6 months may help reduce their risk of developing food allergies as it teaches their immune system to tolerate food. But human milk or formula should be their main source of nutrition.

Babies can sometimes develop food intolerances or allergies before they start eating solid food. If your baby is having symptoms like vomiting, rash, blood in stools, or any other concerning symptoms, talk with your child’s doctor to get a diagnosis and recommendations.

What Are Symptoms of Food Allergy in Infants and Toddlers?

A food allergy occurs when the body’s immune system sees a certain food as harmful and reacts by causing 1 or more symptoms. This is known as an allergic reaction.

Foods that cause allergic reactions are called allergens. Even a small amount of an allergen can cause a reaction. Allergic reactions usually occur after your child eats a food they are allergic to.

There are 2 types of food allergies: cell-mediated and IgE-mediated).

Cell-mediated

Cell-mediated reactions are considered delayed hypersensitivity. They are sometimes called “non-IgE” allergy. Symptoms from cell-mediated food allergies are usually delayed after feeding and may present as:

• Bloody, mucousy stools
• Colic, reflux, more severe spitting up
• Vomiting
• Diarrhea

Most symptoms of cell-mediated food allergies involve the digestive tract (gut). Types of cell-mediated food allergies include:

• Eosinophilic [EE-oh-sin-oh-FILL-ick] esophagitis (EoE) – an allergic swallowing disorder caused by an inflamed esophagus (part of the throat)
• Food protein-induced enterocolitis syndrome (FPIES) [eff-PIES] – inflammation in the small intestine and colon (large intestine)
• Allergic proctocolitis [prahk-toe-koh-LIE-tis] – inflammation in the lower intestine caused by an allergy to cow’s milk or soy proteins found in formula or breast milk

The symptoms of cell-mediated food allergies usually go away when the food allergen is removed from the infant’s diet.

There are other medical conditions besides food allergies that can cause symptoms in infants and toddlers. Examples include:

• Lactose intolerance – an to digest lactose, a sugar found in cow’s milk
• Celiac disease – the immune system damages the small intestine when gluten protein found in wheat, rye, or barley is eaten
• Crohn’s disease – rare in infants/toddlers but may cause diarrhea or low weight gain

IgE-Mediated

Symptoms from IgE-mediated food allergies usually occur within minutes and up to 2 hours of feeding and can present as:

• Rash
• Hives
• Vomiting
• Severe allergic reaction (anaphylaxis)

This is the “classic” type of food allergy that causes symptoms like hives and swelling. Children are more likely to outgrow certain IgE-mediated food allergies than others as they get older. When a child is diagnosed with this type of allergy, your health care provider should give you an epinephrine device  to treat anaphylaxis.

If your infant or toddler has symptoms after eating foods, it is important to see a doctor to get accurately diagnosed.

Which Is Better: Human Milk or Formula?

Human (breast) milk provides ideal nutrition for an infant. Even babies with food allergies can benefit from human milk. Very rarely, the food proteins pass through the milk and can cause symptoms in an infant or toddler. If this happens, the doctor may recommend the lactating parent avoid eating the foods their child is allergic to (sometimes known as an “elimination diet”).

Most often nursing, breastfeeding, and/or pumping can continue if the lactating parent removes the foods that trigger their child’s symptoms are removed from their diet. It is important to make sure you eat a healthy variety of foods. Seeing a registered dietitian can be helpful to plan how to replace nutrition that may be lost from avoiding specific foods.                 

If the child doesn’t have food allergy symptoms, the lactating person does not have to remove foods from their diet.

Can My Baby with Food Allergies Drink Donor Human Milk

Donor human milk may be an option for infants with intestinal (gut) disorders.¹ It is important to get the milk from an established and trusted bank that has screened the milk donors, pasteurized the milk, and stored it carefully. It must also be distributed properly.

The Food and Drug Administration (FDA) regulates donor human milk. It does not recommend giving your infant breast milk that you got directly from someone or through the internet.²

Talk with your doctor to find out if this is the best option for you and your infant. There are many milk banks across the country, including the Human Milk Banking Association of North America (HMBANA).

When Is the Best Time to Introduce Solid Foods to My Baby with Food Allergies?

Introducing foods early may help reduce a baby’s risk of developing food allergies. Babies who start eating a variety of solid foods around 4 to 6 months old may have a lower rate of food allergies later in life. This includes allergenic foods such as peanuts, milk, and eggs.

Talk with your doctor for guidance food introduction, especially if your child already has a food allergy. It is important that your child is ready to eat solid foods. After you introduce a food to your baby, continue to feed it to them on a regular basis if they don’t have an allergic reaction to it.

What Formulas Are Available for Infants and Children with Food Allergies?

If human milk isn’t an option or your formula-fed baby is showing signs of allergy or intolerance, there are different types of formula available. Infant formulas are carefully balanced to supply your child with the proper nutrition they need. These options will depend on the condition that the infant has. Speak Talk with your baby’s doctor to pick the best one for them.

Here are some different types of formula available you can discuss with your child’s doctor.

Note: This list does not include every formula available. See the full list of infant formulas approved by the FDA in the United States. Also note that the images below may not reflect the current design of each product. Product designs can change often.

This list is not an endorsement of any company or its products, nor is it a guarantee of a product’s safety. Talk with your child’s doctor about the best formula for them.

Milk-Based Formulas

Do not feed to kids with milk allergy.

Milk-based formulas offer complete nutrition for kids who do not have cow’s milk allergy.

Here are some examples of milk-based formulas:

• bobbie® Organic
• Enfamil® Infant Formula
• Enfamil® NeuroPro® (for babies with lactose sensitivity)
• Enfamil® Reguline®
• Kirkland Signature ProCare (Costco)
• Member’s Mark™ Advantage Premium™ (Sam’s Club)
• Member’s Mark™ Sensitivity Premium™ (Sam’s Club)
• Similac® Advance®
• Similac® 360 Total Care®
• Similac® 360 Total Care® Sensitive (for babies with lactose sensitivity)
• Similac® Sensitive®
• up&up™ Advantage Premium™ (Target)
• up&up™ Sensitive Premium™ (Target)
• up&up™ Infant Premium™ (Target)

Plant-Based Formulas

An option for kids with milk allergy

Do not feed soy-based to kids with soy allergy or pea-based to kids with pea allergy.

Plant-based formulas may be an option for children with milk allergy. But they are no less allergenic than cow’s milk-based formulas. Many contain soy and are not recommended for children with soy allergy. Some contain pea protein and are not recommended for children with a pea allergy.

If your child has a cow’s milk allergy, ask your child’s doctor if they recommend a plant-based formula.

If your infant has allergic proctocolitis or enterocolitis, they have a 25 to 60% chance of reacting to soy formulas. Other options below may be better for your child.

Here are some examples of plant-based formulas:

• Baby’s Only® Organic Plant Based (pea protein)
• Dr. Brown’s™ soy-ease pro™
• Earth’s Best® Organic Gentle®
• Earth’s Best® Organic Sensitivity®
• Earth’s Best® Organic Dairy®
• Enfamil® ProSobee®
• Kate Farms™ (Pea Protein nutrition for infants 1 year and older, available for drinking or tube feeding)
• Mama Bear® Soy
• Similac® Soy Isomil®
• up&up™ Soy (Target)

Partially Hydrolyzed Formulas

Do not feed to kids with milk allergy.

Partially hydrolyzed formulas take cow’s milk proteins (whey and casein) and break them into smaller pieces. This makes these formulas easier to digest and reduces discomfort such as gas, fussiness, and crying. Some formulas have a whey and casein blend that is partially hydrolyzed, while others may have 100% whey protein that is hydrolyzed. These formulas are not for babies allergic to cow’s milk.

Here are some examples of partially hydrolyzed formulas:

• bobbie® Organic Gentle
• Dr. Brown’s™ Gentle Pro™
• Dr. Brown’s™ Soothe Pro™
• Enfamil NeuroPro™ Gentlease®
• Member’s Mark™ Gentle Premium™ (Sam’s Club)
• Similac® Gentle Comfort™
• up&up™ Gentle Premium™ (Target)
• up&up Hypoallergenic (Target)

Extensively Hydrolyzed Formulas

An option for kids with milk allergy

Extensively hydrolyzed formulas offer complete nutrition for infants who are allergic to cow’s milk protein. Casein is a protein in cow’s milk that is a common cause for allergy symptoms. Extensively hydrolyzed formulas break the casein protein down into smaller pieces. This reduces the chances of an allergic reaction, while offering complete nutrition. About 90% of babies with milk allergy will tolerate these formulas.

Here are some examples of extensively hydrolyzed formulas:

• Enfamil® Nutramigen®
• Enfamil® Pregestimil®
• Nestle Extensive HA®
• Neocate® Peticate™
• Similac® Alimentum®
• up&up™ Hypoallergenic Infant Formula Powder with Iron (Target)

Amino Acid-Based Formulas

An option for kids with milk allergy, other food allergies, or children unable to tolerate extensively hydrolyzed formulas

Amino acid-based formulas are complete nutrition for children who are unable to tolerate extensively hydrolyzed formulas, or have a severe cow’s milk allergy, multiple food allergies, or inflammatory conditions like eosinophilic esophagitis (EoE) or food protein induced enterocolitis syndrome (FPIES). These formulas contain no intact proteins. Amino acids are the building blocks for proteins. All of the formulas below can be used for oral or tube feeding.

Here are some examples of amino acid-based formulas:

For infants (0-12 months)

• Alfamino®™ Infant
• EleCare® Infant Formula
• Neocate® Infant
• Neocate® Syneo Infant
• PurAmino™ DHA & ARA

For ages 1+

• Alfamino® Junior (1-13 years)
• EleCare® Jr (1-13 years)
• Neocate® Junior (1 year and older)
• Neocate® Syneo Junior (1-10 years)
• PurAmino™ DHA & ARA (0-24 months)

What Can I Do If I Can’t Afford Formula?

Formula can be costly. There are different resources and programs that can help.

Formula discount programs – Some formula companies have discount programs and coupons to help reduce the cost of formula. Check formula company websites for discounts and coupons.

• Enfamil® coupons
• Gerber® coupons
• Nutramigen® savings and support
• Similac® savings and reward program

Sample and assistance programs – Talk with your doctor, pharmacist, or a registered dietitian if you can’t afford your baby’s formula. They may be able to provide some free samples or know of local assistance programs.

Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) –  If your child is under age 5 and you qualify for WIC benefits, you may receive checks or vouchers to buy formula.

If you qualify, you may receive checks or vouchers to use to buy formula. You can apply for WIC online or contact your local office. Each state’s WIC program has a list of which formula options they cover. Check with your local WIC office for more information.

Supplemental Nutrition Assistance Program (SNAP) – SNAP is another food assistance program for eligible families. Requirements vary from state to state.

This program provides a debit card that allows you to buy food in retail food stores. SNAP benefits can be used to buy baby formula.

Temporary Assistance for Needy Families (TANF) – TANF is a program funded by the Office of Family Assistance (OAF). OAF provides grants to various states to give temporary help and services to families in need.

Check with your state’s assistance office to see if help is available.

Food banks – Many food banks give away free formula. Feeding America has many locations throughout the United States. Many food banks help with free baby food, formula, and diapers.

Local nonprofit organizations and churches in your area may have food banks or pantries as well.

United Way 211 Hotline – Call 2-1-1 on your phone to speak with a community navigator in your area.

Health insurance – Formula may be covered by your health insurance if the formula is part of a treatment plan for a health condition such as eosinophilic esophagitis. Some plans will cover taking it by mouth. Others may only cover formula delivered by G or NG tubes.

Some states have insurance mandates that require elemental formulas to be covered if your infant has a condition such as a cow’s milk food allergy or an eosinophilic disorder. This varies from state to state.

If it is covered, it is usually covered as durable medical equipment (DME). You would get a prescription from your doctor to buy it through a DME supplier that would file it with your insurance.

Your doctor would write a prescription to get it through your pharmacy or durable medical equipment (DME) supplier. Appeals and prior authorizations are common.

Registered dietitian (RD) – Although these formulas are suggested in children at least during the first year, an RD can help create a nutritionally sound diet in children over 1 year old with proper food intake and commercially available plant-based foods.