How Do I Know If My Baby Needs Enfamil Nutramigen?

Learn how to tell if your baby would benefit from Nutramigen. Plus, if you do decide to give baby Nutramigen, find out everything you need to know about making the switch.

Enfamil Nutramigen is a specialized type of baby formula, found in a tan-colored can with an orange logo. It is designed for babies who have milk allergies or intolerances, who can't consume standard cow's milk-based formula without experiencing uncomfortable symptoms.

If standard baby formula causes your baby to develop an upset stomach, congestion, acid reflux, colic, abnormal stools, or other symptoms, Nutramigen may help ease the discomfort, while still providing all the nutrients baby needs to thrive. Along with Alimentum, Nutramigen is one of the specialty formulas that doctors most commonly recommend.

Here's how to tell if your baby would benefit from Nutramigen. We'll also cover everything parents need to know about making the switch, if you do decide to give baby Nutramigen.

What is Nutramigen used for?

Nutramigen is a specialty type of formula known as a hypoallergenic formula. It's meant for babies who have difficulties digesting the standard cow's milk-based formulas, including babies with milk allergies, milk intolerances, reflux disease, and colic.

Nutramigen is still a cow's milk-based formula. But the milk proteins in the formula are broken down into small enough parts, so they are much easier for cow's milk-sensitive babies to digest. (The process of breaking down the proteins is called hydrolysis, so Nutramigen is sometimes called a hydrolyzed formula.)

The formula is also lactose-free, so it won't cause digestive symptoms in babies with lactose intolerance.

Thanks to the broken-down proteins and absence of lactose, Nutramigen won't cause stomach and GI symptoms in milk-sensitive babies like regular formula does. Nutramigen is also designed to encourage baby to develop a tolerance to cow's milk proteins.

After baby switches from traditional formula to Nutramigen, the symptoms caused by the traditional formula should go away within 48 hours.

Baby Formula Expert Dr. Bridget Young compares Nutramigen to Alimentum and two other hydrolyzed formulas:

What are the unique benefits of Nutramigen?

Nutramigen contains probiotics that other hypoallergenic formulas don't. Probiotics are "good bacteria" that build up in the GI tract, aid digestion, strengthen the immune system, and help the GI tract function properly. A healthy gut contains the proper balance of probiotics.

But babies aren’t born with all the “good bacteria” they need for a healthy gut. Their GI tract is weaker, making them more susceptible to infections and GI symptoms.

They need probiotics to build up the good bacteria needed to fight colic, reflux, other GI conditions, and infections.

Building up enough good bacteria in the gut in infancy (such as with the help of Nutramigen) helps strengthen baby's immune and digestive systems. This establishes healthy foundations that will continue to benefit baby throughout their life.

And for babies who have been experiencing symptoms in the gut because of milk sensitivities, the probiotics in Nutramigen offer another bonus, as they help heal the intestine and gut after repeated symptoms.

In addition, Nutramigen is soy-free, so it's a suitable option for babies with MSPI, or milk-soy protein intolerance, who have trouble digesting the proteins in both milk and soy. This sets Nutramigen apart from other specialty formulas like Alimentum, as Alimentum still contains soy.

Trying to decide whether you should give baby Nutramigen or Alimentum? Our comparison will help you make the best choice for your baby.

How can I tell if baby would benefit from Nutramigen?

Baby may benefit from Nutramigen if they have an allergy or intolerance to cow's milk, and that allergy or intolerance causes baby to develop symptoms while consuming standard formula. Here are the symptoms to look out for, and why the symptoms occur when baby consumes standard formula.

Milk allergy symptoms: Two types of allergies

Milk allergies always involve the immune system. The immune system is designed to defend the body against viruses, bacteria, and other harmful invaders. But a baby with a milk allergy has an immune system that mistakes milk proteins for harmful invaders. When their immune system detects milk proteins, it over-defends the body against these proteins and triggers allergic reaction symptoms.

Milk allergies can be divided into two categories, based on their potential symptoms and how long it takes someone's immune system to trigger these symptoms.

The first category is known as immediate-type milk allergy. Immediate-type milk allergies cause symptoms seconds to hours after someone consumes a cow's milk product.

In babies and young children, the most common symptoms of immediate-type milk allergies are:

  • Hives
  • Congestion
  • Swelling
  • Vomiting

(For a complete list of immediate-type food allergy symptoms, read our guide to identifying food allergy reactions in babies.)

The second category of milk allergy is much rarer, and is known as delayed-type milk allergy. This type of milk allergy causes symptoms hours to days after baby consumes a milk product. Delayed-type allergy symptoms nearly always develop in the GI tract. They may include:

  • Diarrhea
  • Vomiting
  • Loose or abnormal stools
  • Abdominal pain
  • Stomach pain
  • Colic (loud, excessive crying that you can't console)
  • Reflux-like symptoms

(For more details, please read our guide to delayed-type food allergies.)

Milk intolerance symptoms

Milk intolerances are often confused with milk allergies, but the two are different. The main difference is that milk intolerances never involve the immune system.

Rather, milk intolerances involve the digestive system, and happen when baby's digestive system can't properly break down parts of cow's milk.

Milk intolerances produce GI symptoms such as:

  • Diarrhea
  • Loose stools
  • Bloody or mucousy stools
  • Stomach aches and pains
  • Gas
  • Bloating
  • Constipation
  • Abdominal pain/cramps
  • Nausea
  • Colicky crying
  • Vomiting
  • Spitting up
  • Irritability after consuming cow's milk

Although these symptoms are similar to delayed-type milk allergy symptoms, milk intolerances are much more common than delayed-type allergies.

Some types of milk intolerances include:

  • Lactose intolerance: If baby has lactose intolerance, that's because they don't have enough of the lactase enzyme. Lactase is needed to digest lactose (the sugar in milk); without lactase, baby's digestive system struggles and GI symptoms occur.
  • Milk protein intolerance: Baby could also have an intolerance to the proteins in milk
    • They could also have milk-soy protein intolerance (MSPI) where their digestive system struggles to break down both milk and soy proteins. Nutramigen works for babies with MSPI because it does not contain soy.

If you think your baby has a milk allergy or intolerance, ask your pediatrician if you should switch baby's formula to Nutramigen.

Will Nutramigen help with reflux or colic?

Yes, Nutramigen will help relieve reflux or colic symptoms. In fact, colicky crying and reflux-like symptoms can often be caused by a milk allergy or intolerance, and Nutramigen is designed to help milk-allergic and milk-intolerant babies.

You don't need to switch to Nutramigen if baby has normal spitting up patterns (this is sometimes called reflux, but is not a cause for concern). But if baby has acid gastroesophageal reflux disease (GERD), Nutramigen will help bring relief.

(To learn how to identify if your baby has reflux disease or colic, please follow the links.)

What else to keep in mind when you choose Nutramigen?

The higher cost

A specialty formula like Nutramigen is often the only viable feeding option for babies who are sensitive to cow's milk. But Nutramigen is very expensive compared to traditional formula.

There are generic specialty formulas available that are less costly. It might be worth trying a less expensive specialty formula first, before Nutramigen.

But Nutramigen is approved for the WIC program, so be sure to look into this if you're WIC-eligible (or think you may be eligible).

Another option is to use health insurance. In some cases, your insurance will partially, or even fully, cover Nutramigen. Your pediatrician may be able to help you determine if your insurance covers the cost of the formula. If insurance will only pay for a formula if it's medically necessary, your pediatrician may also write a prescription to show that Nutramigen is medically necessary for baby, so insurance will cover the cost.

The taste

Another thing to keep in mind is that Nutramigen tastes different than traditional formula or breastmilk. Nutramigen is not nearly as sweet. So, it may take some time for baby to get used to the new taste of Nutramigen. Baby might also continue to dislike the flavor and be reluctant to take a bottle.

Can I mix Nutramigen with regular formula?

It is perfectly safe to mix Nutramigen with regular formula. In fact, you’ll need to mix the two when you first switch baby's formula to Nutramigen, to help get baby accustomed to the new formula's taste.

But once you've fully switched over to Nutramigen, things are a bit more complicated.

While Nutramigen contains milk proteins that are broken down, regular formula contains intact milk proteins. And the intact proteins in the regular formula might lessen (or cancel out) the benefits of Nutramigen if the two are mixed.

Mixing in regular formula might make it tougher to relieve baby's symptoms with Nutramigen. And with how expensive Nutramigen is, it might not be worth it to take this chance. It's probably better to stick with all Nutramigen, and wait until your doctor gives the okay to attempt weaning baby off of Nutramigen altogether.

How to switch formulas: Switching to Nutramigen

When switching formulas, remember that Nutramigen isn't as sweet as standard formula, so baby may need time to get used to the taste. If you've decided to switch to Nutramigen, introducing it gradually is the way to go.

You'll do this by mixing Nutramigen with baby's current formula for a few days.

Consider using this schedule:

  • Day One: 75% old formula, 25% Nutramigen
  • Day Two: 50% old formula, 50% Nutramigen
  • Day Three: 25% old formula, 75% Nutramigen
  • Day Four: 100% Nutramigen

If baby is still refusing the bottle as you switch formulas, our post on bottle refusal offers helpful tips for overcoming this.

Can I switch back from Nutramigen to regular formula?

Whether you can successfully switch back to regular formula after using Nutramigen depends on your doctor's recommendation and what's causing baby's symptoms.

If baby has a milk intolerance, it's safe to reintroduce regular formula to them.

Doctors typically recommend reintroducing cow's milk to babies with milk intolerance at some point. This includes reintroducing formula with intact milk proteins. So, talk to your pediatrician or allergist about when to reintroduce regular milk-based formula. The best timing to reintroduce is up to your doctor!

Usually, babies with delayed-type milk allergies can be safely reintroduced to regular formula as well. So, ask your doctor about when to switch back if your baby has a delayed milk allergy.

But babies with confirmed, immediate-type milk allergies cannot be safely introduced to regular formula. This is because even small amounts of intact milk proteins will consistently cause them to develop an allergic reaction.

Still, keep in mind that many babies with suspected milk allergies really only have milk intolerances. And it's safe to reintroduce regular formula to a baby with a milk intolerance.

To clearly determine whether baby has an immediate-type milk allergy, you will need to take them for allergy testing.

Introduce Allergens Safely and Easily with Ready. Set. Food!

All health-related content on this website is for informational purposes only and does not create a doctor-patient relationship. Always seek the advice of your own pediatrician in connection with any questions regarding your baby’s health.

These statements have not been evaluated by the Food and Drug Administration. Products are not intended to diagnose, treat, cure or prevent any disease.  If your infant has severe eczema, check with your infant’s healthcare provider before feeding foods containing ground peanuts.