Indications | Formula category and description | Examples |
Prematurity (For infants <34 weeks gestational age and/or weight <2 kg) | Premature formula: - High in protein, calcium, and phosphorus
- Includes MCT, long-chain fat, glucose polymers, and lactose
- Supplemented with additional calcium, phosphorus, vitamin A, vitamin D, folate, zinc, and iron
- Calcium:phosphorus ratio of 2:1
- Available in concentrations – 20 kcal/oz, 24 kcal/oz, 30 kcal/oz
- Low-iron formulations are available but are not generally recommended
| - Enfamil Premature (20, 24, or 30 kcal/oz)
- Similac Special Care (20, 24, or 30 kcal/oz)
- Breastmilk + Human Milk Fortifier (various types)*
|
Premature infants, post-hospital discharge¶ (For infants with birth weight <2000 g and/or laboratory evidence of metabolic bone disease) | Post-discharge formula: - Composition similar to above
- Standard concentration is 22 kcal/oz
| - Similac Neosure
- Enfamil NeuroPro Enfacare
|
Normal gastrointestinal tract | Standard infant formula: - Cow's milk protein
- Lactose
- Long-chain fat (vegetable oil blend); no MCT
| - Breast milk
- Enfamil NeuroPro
- Similac Pro-Advance
- Gerber Good Start GentlePro
|
Primary or secondary lactose intolerance | Lactose-free formula: - Milk protein isolate or soy protein isolate
- Long-chain fat
- Lactose free
| - Similac Sensitive
- Enfamil ProSobee
- Similac Soy Isomil
- Gerber Good Start Soy
|
Food protein intolerance (eg, cow's milk protein intolerance) | Hydrolysate formula: - Cow's milk protein hydrolysate
- Long-chain fat; variable MCT (0 to 55% of fat)
- Lactose free
| - Enfamil Nutramigen with Enflora LGG
- Enfamil Pregestimil
- Similac Alimentum
- Gerber HA
|
Severe protein allergy | Elemental formula: - Free amino acids
- Moderate MCT (approximately 30% of fat); remainder long-chain fat
- Lactose free
| - Neocate Infant DHA & ARA
- Neocate Infant Syneo
- Elecare Infant
- Puramino
- Alfamino Infant
|
Malabsorption Intractable diarrhea Steatorrhea | Hydrolysate formula with MCT: - Cow's milk protein hydrolysate
- Long-chain fats; moderate to high MCT (30 to 55% of fat)
- Lactose free
| - Pregestimil
- Similac Alimentum
- Gerber Extensive HA
|
Impaired fat absorption Chylous effusion Lymphatic disorder Metabolic disorders | High-MCT formula: - Intact protein
- Very high MCT (84 to 90% of fat)
| - Portagen
- Monogen
- Enfaport
- Lipistart
|
Decreased renal function | Renal formula for infants: - Cow's milk protein (60% whey/40% casein)
- Long-chain fat
- Low iron
- Lower in potassium
- Lower in calcium and phosphorus (maintaining 2:1 ratio)
| |
Galactosemia | Soy-based formula: - Soy-based protein
- Long-chain fat
- Lactose free (carbohydrate supplied by glucose polymers)
| - Enfamil ProSobee
- Similac Isomil
- Gerber Good Start Soy
|