In plain words
Extensively hydrolyzed formula is infant formula made with cow's milk protein that has been broken into very small pieces. Some babies react to whole cow's milk protein with symptoms like , fussiness, rash, or blood in the stool. For some of these babies, a provider may suggest a special formula to see if symptoms ease. For breastfed babies with similar symptoms, a provider may discuss changes to the mother's own diet instead. This formula is not right for every baby, and it is often more costly than standard formula. Feeding choices are personal, and no path is the right one. A change of formula for these symptoms is usually decided together with the baby's pediatrician.
The deeper version
Extensively hydrolyzed formulas (eHF) contain protein hydrolysates broken into small peptides, which are tolerated by most infants with IgE-mediated and many with non-IgE-mediated disease. The 2018 NASPGHAN and ESPGHAN guideline on pediatric gastroesophageal reflux (Rosen et al., Journal of Pediatric Gastroenterology and Nutrition) describes a trial of eHF with thickened feeds in formula-fed infants with troublesome regurgitation. The 2012 ESPGHAN position paper on cow's milk allergy (Koletzko et al.) recommends eHF for infants with non-IgE-mediated cow's milk protein allergy when breastfeeding is not possible. Evidence for symptom improvement is stronger for allergy than for reflux alone, and some trials are industry-funded.
Where it comes up
- Dairy and other sensitivities in a breastfed babyFeeding Your Baby
- Formula feeding: choosing, preparing, and doing it wellFeeding Your Baby
- Is my baby getting enough?Feeding Your Baby
- Combo feeding: breast and formulaFeeding Your Baby
What mothers here say about extensively hydrolyzed formula
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Sources
- Rosen R et al. — Pediatric gastroesophageal reflux clinical practice guidelines, NASPGHAN and ESPGHAN, 2018
- Koletzko S et al. — Diagnosis and management of cow's milk protein allergy in infants, ESPGHAN position paper, 2012