Is Neocate Formula Right For My Baby?

What is Neocate?

Neocate is a specialty brand of formula manufactured by Nutricia. It is a hypoallergenic formula that contains no milk proteins --- and that is completely free of all cow's milk ingredients. 

Neocate is specially designed for babies who have milk allergies, and who can't tolerate the milk proteins in most other infant formulas as a result of those allergies.

Unlike many baby formulas, Neocate contains amino acids instead of proteins. This makes it an elemental formula.

Amino acids are the "building blocks" of proteins, and they won't cause an allergic reaction in babies who can't tolerate certain proteins.

Neocate must be used under a doctor's supervision, because it is a "medical food."

What babies can benefit from Neocate?

A doctor may recommend Neocate for a baby with one of several conditions, which makes baby unable to tolerate most other formulas without developing symptoms.

  • An immediate-type milk allergy, which causes an allergic reaction shortly after cow's milk protein is consumed
  • Multiple food allergies including a milk allergy 
  • FPIES (food-protein induced enterocolitis syndrome): A rare food allergy that causes GI symptoms 
  • EoE (eosinophilic esophagitis): A rare food allergy that causes symptoms in the esophagus
  • Allergic colitis: Also called allergic gastroenteritis or FPIAP (food protein-induced allergic proctocolitis), this is another rare food allergy that causes GI symptoms
  • Short bowel syndrome and malabsorption: Intestinal failure that makes it difficult to absorb standard nutrients. Neocate is easier for babies with this condition to digest and absorb.
  • Other malabsorption: Sometimes, a food allergy, food intolerance, or GI condition can make it difficult to absorb standard nutrients. Neocate is easier for babies with this condition to digest and absorb.
  • GERD: Gastroesophageal reflux disease, also called acid reflux. It causes forceful, repeated spitting up and may cause failure to thrive. Half of GERD cases are caused by a milk allergy or intolerance. 
  • Any other failure to thrive, which a doctor thinks is caused by a milk allergy or significant milk intolerance

Does Neocate require a prescription?

Elemental formulas, including Neocate, are considered "medical foods." 

Given this, Neocate  must be used under medical supervision. 

Always talk to your doctor to determine whether Neocate is right for your baby, and always follow their guidance when feeding Neocate.

Although you don't need a prescription to access Neocate, it's best to have one from your doctor for insurance purposes.

Having a prescription for Neocate is necessary if you want your insurance company to reimburse you for the full cost. The prescription serves as proof that Neocate is medically necessary for baby. Several states require elemental formulas like Neocate to be covered under insurance. 

In most states, Neocate is also covered by the WIC (Women, Infants, and Children) program for families with nutritional and financial needs. But again, if you'd like to be reimbursed under WIC, you need a prescription, to prove that a physician deemed it necessary for baby's nutrition.

Learn more on what to expect after starting Neocate formula for your baby: 

Is Neocate a hydrolyzed formula?

Neocate is not a hydrolyzed formula. Elemental formulas are different from hydrolyzed formulas.

While hydrolyzed formulas contain broken down milk proteins, elemental formulas use amino acids instead of proteins.

As an elemental formula, Neocate doesn't contain milk proteins. In fact, it doesn't contain any ingredients derived from cow's milk.

So, Neocate is designed especially for babies who can’t tolerate standard or hydrolyzed formulas.

Here's a breakdown of standard vs. hydrolyzed vs. elemental formulas:

  • Standard formulas have milk proteins that are completely intact.
    • Think of the proteins in standard formula as similar to a complete pearl necklace.
    • Babies with milk allergies or milk-based GI conditions can't consume these proteins without experiencing symptoms.
  • In hydrolyzed formula, the milk proteins are broken down into very small parts. 
    • Think of the proteins in hydrolyzed formula as like strands of two or three pearls, broken off of the necklace.
    • These proteins are much easier for babies with milk allergies or intolerances to digest, because their bodies are less likely to recognize them as proteins.
    • But some babies still can't consume the broken down proteins without symptoms. Their body still "recognizes" them as proteins, like you would recognize the broken strands as broken necklace parts.
  • Elemental formulas like Neocate do not contain any cow’s milk proteins. They contain amino acids instead.
    • Elemental formulas are designed for babies with severe milk allergies or significant GI conditions.
    • These babies can’t tolerate formulas with any milk proteins, even if the proteins are broken down into the smallest parts possible (as they are in extensively hydrolyzed formulas). 
    • Even though amino acids are "building blocks" that form proteins, and provide nutritional value like proteins, the body doesn't "recognize" them as proteins.
    • The amino acids are like individual pearls that aren't joined and that don't have holes in them. You recognize them as pearls, but you know they aren't part of a necklace.

Hydrolyzed formulas and elemental formulas are both types of hypoallergenic formulas. 

But elemental formulas (like EleCare) are less likely to cause an allergic or GI response, because the amino acids replace proteins.

Hydrolyzed formulas are generally recommended for mild or moderate intolerances or allergies to cow’s milk. Meanwhile, elemental formulas like Neocate are usually recommended for babies with severe cow's milk allergies or GI conditions.

How do I know if my baby has a milk allergy?

Different types of milk allergies have different symptoms, but babies with several different kinds of milk allergies can benefit from Neocate.

If baby experiences any of the symptoms described below when consuming a cow's milk product, they may have a type of milk allergy where they could benefit from Neocate.

(Learn more details below about each allergic condition.)

Immediate-type milk allergy

  • The most common milk allergy type
  •  Causes symptoms seconds to hours after someone consumes a food containing cow’s milk
  • Most common symptoms are hives, vomiting, congestion, swelling
  • Symptoms can sometimes be severe or even life-threatening 

FPIES (milk-based)

  • A rare type of food allergy; milk is one of the most common triggers 
  • Causes symptoms in the GI tract 2-8 hours after consuming milk
  • Most commonly causes vomiting and diarrhea 
  • Could cause shock, which requires emergency attention
  • Could cause failure to thrive

EoE (milk-based)

  • A rare type of food allergy; milk is the most common trigger 
  • Causes esophagus inflammation in response to milk being consumed
  • Can cause feeding problems and hindered growth
  • Can also cause vomiting, abdominal pain and reflux-like symptoms
  • Symptoms can take hours to days to appear, but sometimes only appear weeks after consuming milk
  • Can cause food to get stuck in the esophagus (considered a medical emergency)

FPIAP (milk-based)

  • A rare type of food allergy; milk is one of the most common triggers
  • Most common in babies under 1 year of age
  • Causes inflammation in the lower intestine when baby consumes milk
  • Most commonly causes bloody,  mucousy, or otherwise abnormal stools
  • Can also cause diarrhea, anemia, vomiting, and fussiness.

How will I know if Neocate is right for my baby?

Neocate must be used under medical supervision. So, even if you suspect that baby has an allergy or GI condition, whether Neocate is right for your baby is ultimately up to your doctor.

If baby's allergy or GI condition causes baby to develop symptoms while consuming standard or hydrolyzed formula, your doctor will likely recommend Neocate or another elemental formula.

Almost all babies with cow’s milk allergies or milk-based GI conditions are able to tolerate elemental formulas like Neocate --- even if their allergy or condition is severe.

Usually, when babies show symptoms of a food allergy or intolerance while consuming standard cow’s milk-based formula, a doctor will recommend switching to an extensively hydrolyzed formula first (such as Nutramigen or Alimentum). 

Keep in mind that many babies who are thought to have milk allergies really only have milk intolerances. 

If baby experiences symptoms when consuming standard formula, but has a mild or moderate milk intolerance, hydrolyzed formula is usually enough to resolve symptoms (and Neocate won't be needed).

And many babies with different types of milk allergies (even confirmed ones) tolerate hydrolyzed formula.

But if baby's allergy or GI symptoms don’t improve after a few weeks of using hydrolyzed formula, you'll need to consult your doctor again.

In this situation, they will often recommend switching to an elemental formula like Neocate.

If baby shows severe GI symptoms (or allergy symptoms on the skin) along with poor growth, your doctor may also recommend an elemental formula like Neocate --- and in this case, they usually won't recommend a hydrolyzed formula first. 

How do I switch formulas to Neocate?

Your doctor will give you guidance on how to switch formulas to Neocate. Ask them whether  it's best to introduce the formula gradually or all at once.

If your doctor doesn’t have a preference between immediate and gradual switching, consider introducing Neocate gradually over a few days,  so baby can get used to the taste. 

To gradually switch formula, you'll mix some of baby's old formula with Neocate, and increase the percentage of Neocate in the mix each day until baby is fully switched over.

Can I switch back from Neocate to a different formula?

If baby has an immediate-type milk allergy and they can't tolerate standard or hydrolyzed formula, you won't be able to switch back to either of those formulas. Baby will likely remain on Neocate until they fully transition to solids.

If baby has a delayed-type milk allergy, consider ask your doctor if and when baby should be reintroduced to regular formula. Many babies with delayed-type milk allergies can be safely reintroduced to regular formula. But your doctor may not want baby to switch back if the allergy makes baby extremely sensitive to milk proteins, as is the case with many babies whose food source is Neocate. 

As for GI conditions and other conditions unrelated to allergies, ask your doctor if and when they recommend switching back to a different formula.

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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.  

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