Nutramigen vs. Allimentum

[Anonymous]

Is there a real difference between these two? Dr. suspected MSPI or reflux at first dr. visit, so I tried Nutramagin and Evie still had terrible reflux, so we then ruled out the MSPI. However, she’s been on Prevacid for almost 10 days and it’s still constant fuss and back arching. Should I have tried Allimentum or Neocate, or is it what I am expecting–upping the Prevacid from 15 mg/day to 30???

[Anonymous]

I don’t think you can rule out MSPI just because Nutramigen didn’t help. Basically Nutramigen and Alimentum are the same, but their ingredients are not indentical, so a baby may do well on one and not so well on the other. They are both hypoallergenic formulas meaning that they have broken down proteins which are easier to digest. But some babies’ mspi is severe enough that they need an elemental formula like Neocate. Elemental formulas contain amino acids, no whole proteins.

One of the differences between Nutramigen and Alimentum is the corn content. I’ve only seen Nutramigen in powder form so I’m assuming that’s what you used. The powder has a very high corn content which some babies react to. Alimentum comes in powder and RTF. The RTF has no corn, so some babies who could cannot handle powdered Nutramigen, do fine on Alimentum RTF.

It’s crazy, isn’t it? Unfortunatley it really is trial and error with each baby.

I’m not sure what your last question was….is she already on 30 mgs of Prevacid? What formula is she on now?

[Anonymous]

Here’s a good description by Therese on the differences between the special formulas.

This is my take on things…not sure if it is right or not. A reaction to milk protein is an immune based reaction. The immune system recognised the protein as an “invader” and reacts to it. So formulas try and change the look of the protein so the immune system doesn’t react to it.

My understanding is that the difference in the formula…elemental…semi-elemental, hydrolysates is the degree that the protein is broken down. The immune reaction is actually to the protein itself (if any of you can recall science class…the protein is made up of peptides and peptides made up of amino acid). So the immune system may react to a protein but not to a peptide or amino acid as they are different.

Partially Hydrolysed formula (like goodstart) contain cow’s milk in which the milk proteins are broken down to long chains peptides. Long chain peptides are closer to the “protein” and therefore more likely reacted to.

Extensively hydrolysed formulas are predominantly made up of short chain peptides derived from cows milk. As they are broken down further they look less like the protein and therefore there is less chance of reaction. I think these are interchangeable with semi-elemental formualas (eg Peti Junior is listed as both an extensively hydrolysed formual and a “complee semi-elemental formula based on short chain peptides). Alimentum and Nutramigen fit into this category.

Elemental formulas have the protein broken down to amino acids. They look so different to proteins that the immune system hypothetically doesn’t react to them. These would be Neocate and Elecare.

So you can have a reaction to milk proteins without needing to be on an elemental formula. It depends on the severity of the reaction…or how much the immune system reacts. This might explain why some people do OK on yoghurt (the milk proteins are altered in the process) but not milk (eg I can do yoghurt and cheeds…but no milk…bowels just don’t handle it…IYNWIM).

[Anonymous]

I am breastfeeding. I try to eliminate dairy and citrus. I realize that I should probably eliminate a lot more but I haven’t been as strict about it b/c her symptoms were identical when I switched her to Nutramigen (per dr. recommendation) for over a week. She is on 15 mg/day. 7.5mg am and 7.5 mg pm prevacid solutabs.

[Anonymous]

If she’s not improving on that dose she probably needs a higher dose. My son did not improve until he was on the marci-kids dose which for him was 10mg/3 x’s daily.

Also, it can take two weeks for offending proteins to clear the body so the Nutramigen trial that you did probably wasn’t long enough, and even if she had not improved it still wouldn’t be a definitive answer because it’s not an elemental formula and it contains that high corn content which bothers some babies.

I think I’d work on getting her Prevacid increased and then maybe try TED if she was still struggling.

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