We all know the saying “breast is best.” Yet approximately 75% of all babies are given some type of infant formula during the first year of their life. This percentage could be even higher for little ones with a milk allergy or dairy intolerance. So we’ve created this helpful guide to dairy-free infant formula and specialized milk formula. It isn’t intended as advice, but as a knowledge tool for discussions with your pediatrician.
The Dairy-Free & Specialized Infant Formula Guide
I have broken this post into three sections: milk-based infant formula options, milk-free infant formula options, and other types of formula. If you and your pediatrician decide to change your child’s formula, experts say improvements are frequently seen within a week of the switch. Some parents even say they’ve seen “immediate” results. But full adjustment to a new formula can take up to six weeks. If an adverse reaction occurs at any time, seek medical attention immediately.
Formulas available in the United States are approved by the Food and Drug Administration (FDA) and have been created through processes that cannot be duplicated at home. Regular, commercially available soymilk, goat milk, rice milk, and almond milk are not considered to be safe alternatives for infant formula.
This post is for informational purposes only and should not be construed as medical advice. Always consult your pediatrician before any change in your child’s diet or if you suspect an allergic reaction.
This post may contain affiliate links to shops we also use, like Amazon. But these are not direct recommendations for you or your child. They are provided as a resource for purchase, and help to support our site. Please note that ingredients and processes can change at any time. Always read the ingredients carefully, and contact the company if needed, to ensure products are safe for your needs.
Milk Infant Formula Options for Milk Allergy or Intolerance
Many pediatricians prefer to try infants on specialized milk-based formulas before switching them dairy-free options. All of the following are dairy-based, but have been developed to be better tolerated for certain conditions.
Hydrolyzed formulas are made from cow milk, but the proteins have been broken down to be less allergenic. Partially hydrolyzed formulas are primarily used to ease digestive discomfort in babies, and are not considered effective for babies with milk allergy. But extensively hydrolyzed formula are well tolerated by some infants with milk allergy, and are frequently recommended by doctors as a first trial. Some brands are made with whey protein hydrolysate and some with casein protein hydrolysate. Ask your pediatrician if there is a certain type they recommend for your infant. For example, if your child is allergic to casein, but not whey, they might want you to try a whey-based extensively hydrolyzed infant formula.
Did You Know? Extensively hydrolyzed formula, but not partially hyrdolyzed formula, has shown promise in the prevention of milk allergy and atopic disease.
Lactose-Free or Reduced Lactose Formula
In rare instances, babies are born with congenital lactose intolerance. In this case, a lactose-free or low lactose formula could be essential. Also, secondary lactase deficiency can occur in babies suffering from acute diarrhea. In this case, a pediatrician may recommend the temporary use of a lactose-free formula. Low lactose or lactose-free only formula is not suitable for infants with a milk allergy, protein intolerance, or galactosemia.
Did You Know? Lactose is a simple sugar that has the same chemical make up in the milk of all mammals. That means, if a baby is lactose intolerant, they won’t tolerate their mother’s milk either.
Goat Milk Formula
Some infants with cow milk protein allergy or intolerance might tolerate goat milk protein. The proteins in goat milk are slightly different from the ones in cow milk. However, studies have shown that more than 90% of infants with an IgE mediated cow milk allergy are also allergic to goat milk. Before considering goat milk formula, your pediatrician can run an allergy test for goat milk specifically. But remember, there is no difference between the lactose in cow and goat milks. Goat milk formula isn’t suitable for infants with lactose or galactose issues.
Did You Know? Milk proteins differ between mammals. All babies tolerate the protein in their mother’s milk, but they might not tolerate the protein in other mammal milks, like cow or goat.
Milk-Free & Dairy-Free Infant Formula Options
If none of the specialized dairy-based formulas discussed above are suitable, then your pediatrician might recommend one of the following dairy-free infant formula options.
Amino Acid Based Infant Formula
Hydrolyzed infant formula still contains fragments of protein, which might trigger an allergic reaction in some babies. Amino acid-based formula is made from free amino acids, the building blocks of protein. It doesn’t contain any milk protein. This type of milk-free infant formula is often recommended if extensively hydrolyzed infant formula isn’t working. Nevertheless, some pediatricians will recommend amino acid-based formula as a first trial. It’s more commonly used with a severe IgE milk allergy or a digestive condition, like eosinophilic esophagitis (EE).
Did You Know? Some insurance companies will cover hypoallergenic formula if deemed medically necessary for allergies or other health conditions. Some states actually mandate the coverage of elemental formula if prescribed for allergies and/or eosinophilic conditions.
Soy formula is made with soy protein instead of milk protein. Per FDA guidelines, soy formula is developed and fortified to offer relatively equivalent nutrition to cow milk formula. Soy formula has been around for decades, but it still has many detractors due to its high level of isoflavones. Unfortunately, there are relatively few studies comparing soy formula to cow’s milk formula in infant development, and even fewer long term health studies into adulthood. You can review some of those studies here, here, here, and here.
Did You Know? Despite soy naysayers, soy formula continues to be a popular choice among parents. According to a recent study, approximately 10% of all babies (0 to 12 months) are fed soy formula.
When Soy Formula is Avoided
Soy allergies are seen more frequently in milk allergic infants than in the general baby population. But websites that state 50% to 60% of milk allergic infants will be soy allergic are quite misleading. Even if all soy allergic infants were also milk allergic, only about 20% of the milk allergic babies would also have soy allergy. This includes both IgE and non-IgE type milk allergies.
In reality, researchers have found that only up to 10% to 14% of IgE type milk allergic babies also have a soy allergy. Some studies of IgE-mediated allergies have even found little to no correlation between milk and soy allergies. This doesn’t mean there aren’t kids with milk and soy allergies together. But it does mean children with an IgE type milk allergy have only a slightly elevated risk of soy allergy over children without a cow milk allergy.
However, there is a greater connection between some types of non-IgE mediated milk allergies, also referred to as delayed food allergies. In Food protein-induced enterocolitis (FPIES) specifically, 45% to 60% of the milk allergic also react to soy. Some other types of non-IgE mediated milk allergies appear to have a correlation with soy allergy, but the link isn’t as strong as with FPIES.
Milk and Soy Protein Intolerance (MSPI) is the one big gray area. This condition, which involves both milk and soy issues together, has similar symptoms to FPIES, but is not considered to be as severe. It’s consequently labeled as an “intolerance” rather than an “allergy.” However, there is evidence that MSPI might cause certain types of immune responses, which could be related to more severe medical issues. The definition of a food allergy is a “a damaging immune response by the body to a substance.” You do the math.
Other Dairy-Free Formula Options
Thus far, the options listed above are the only types of formula approved by the FDA that can be used for milk allergic or intolerant infants. There are options like chicken infant formula and rice infant formula in the works, but they haven’t made it to market in North America. There is rice-based formula called Bébé M out of Europe.
You can find other types of dairy-free toddler formula and specialized nutritional drinks for kids and adults. Some options include Baby’s Only Plant-Based Pea Protein Toddler Formula, Else Toddler Plant-Based Complete Nutrition, and Kate Farms Formulas (for kids and adults).