Nutramigen v. Alimentum: A Guide to Specialty Formula

Not all babies can easily digest breastmilk or traditional formulas. Learn how to choose the best specialty formula for your baby that will help ease their digestion discomfort and provide all the essential nutrients for their development.

What is a Specialty or Hypoallergenic Formula?

If your baby has a milk allergy or intolerance, reflux, or colic, you may find that breastmilk or regular formula can cause a lot of discomfort. By switching to a hypoallergenic speciality formula, you can still make sure your baby is getting all the vitamins and nutrients they need, while also not continuing to cause an upset stomach.

Most regular formulas are made from modified cow's milk which contain similar vitamins and nutrients found in breastmilk. But not all babies are able to enjoy traditional formulas which is why speciality formulas are a great alternative option for parents to look into. These speciality formulas are enriched with everything your growing baby needs and hypoallergenic specialty formulas can help to build your baby's tolerance to cow's milk.

Milk Allergy in Babies

A milk allergy can develop as the immune system's defense to the milk protein, the protein will be treated like a virus or bacteria by the body. When the milk protein is detected by the body, it produces allergen antibodies which then trigger an allergic reaction. Typical symptoms of an allergic reaction will include hives, vomiting, or swelling. A milk allergy can be confirmed through a skin-prick test or blood testing which will check for the presence of immunoglobulin antibodies that become present when the body is exposed to the allergen.

A baby might develop a food allergy because their body has not developed a tolerance towards the food protein. As they grow up, they may “outgrow” their food allergy by building a tolerance to that food.

A milk intolerance, also known as lactose intolerance, is often mistaken for a milk allergy, however, the two are not related. Lactose intolerance is due to a lack of the lactase enzyme and it can cause the body to have a difficult time trying to break down and digest the lactose protein. If your child has a milk intolerance, you may notice symptoms like diarrhea, bloating, colic, or reflux happen after feeding any dairy products such as breastmilk or traditional formula.

What is Reflux?

Your baby may be experiencing infant reflux, also known as infant acid reflux, or gastroesophageal reflux (GER,) because of the milk proteins found in breastmilk or traditional formula. Infant reflux is especially common in babies under the age of 3 months. This is because at this age, most babies do not have a fully developed digestive system so food can easily travel from the stomach, back up to the esophagus. As your baby grows and develops, so will the size of their stomach, and you should notice infant reflux does not happen as often.

Normal reflux or spit-up will likely look like whatever your baby has just ingested and is made up mostly by saliva or stomach acid. You may notice a sour smell to it or a curdled texture. Infant reflux and spit-up is normal for most babies and you should expect your baby to grow out of it within the first year. If you find that your baby’s reflux worsen with age, or develops into Gastroesophageal Reflux Disease (GERD,) you should consider possibly switching to a hypoallergenic speciality formula.

baby drinking from bottle

Comparing Hypoallergenic Formulas: Nutramigen v. Alimentum

With so many hypoallergenic specialty formulas on the market, it can be hard to decide which to buy. Two popular options, recommended by most doctors, are Nutramigen and Alimentum.


Enfamil Nutramigen is a hypoallergenic formula made with iron which will help support your baby's brain and nervous system development. Nutramigen can be used to help babies who have a milk allergy, intolerance, reflux, or colic. The speciality formula is sold as either a powder, or ready-to-feed.

The formulation of Nutramigen is similar to breastmilk and provides the essential nutrients to help with your baby's growth. The formula is also soy-free so it is safe for babies who have MSPI (milk soy protein intolerance) to drink. For babies who are experiencing colic, gassiness, or other symptoms from traditional formula, you should notice an improvement within 24-48 hours after switching to Nutramigen.

The main feature that sets Nutramigen apart from other hypoallergenic formulas available is that it contains a probiotic. The probiotic will help to heal and strengthen your baby's intestine and gut.

A setback of Nutramigen, as with most specialty formulas, is that it is more expensive than traditional formulas. Similarly, most specialty formulas have a stronger taste and smell in comparison to traditional formulas. Nutramigen is known to not have a great taste and might smell a bit funny. You might notice that it could take some time for your baby to adjust to the new formula.


Similac Alimentum is another great option of hypoallergenic formula. This formula is intended to help baby's who have a milk allergy, intolerance, reflux, or colic. As with Nutramigen, Alimentum is available to purchase as either a powder or ready-to-feed product. The formula is made with iron which is considered an essential vitamin for your baby's development and growth.

Alimentum is a "predigested" formula, meaning the proteins are already broken down which will make it easier for your baby to digest. Because of this, you will notice the symptoms your baby is experiencing from breastmilk or traditional formula should go away within the first 24-48 hours.

Alimentum is significantly more expensive than traditional formulas which is one of the main downsides to the formula. Just as with Nutramigen, the formula will not have the same sweet taste that breastmilk or traditional formula has. You might find that your baby will refuse the bottle at first, however, with time, they should adjust to the new taste. If you need tips on how to overcome bottle refusal, visit our blog here.

We would recommend trying to start with Nutramigen because of the added probiotic that is included in the formula. If you find that Nutramigen does not work well with your baby, try switching to Alimentum. Overall, the benefits and drawbacks of both formula options are very similar and we recommend choosing whichever option works best for you and your baby.

Get answers to other common formula feeding FAQs from Children's Hospital of Orange County (CHOC) and KidsHealth:

How to Switch Formulas

When considering switching to a specialty formula, we recommend first talking to your doctor about your baby's symptoms or reaction. You should also work with your doctor to create a plan of how to best introduce the new formula.

As mentioned earlier, the new taste of either specialty formula might take some time for your baby to get used to. The best way to get your baby to like a new formula is by gradually introducing it to them. You can set-up a schedule to slowly introduce your baby to the new formula.

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

Here are some useful tips and tricks on overcoming bottle refusal when first switching your baby from breastmilk or traditional formula to a speciality formula.

To make sure you are using the best brand of specialty formula for your baby, you should plan on monitoring your baby for any new symptoms or reactions during the first few days of using the new formula.

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.