Cow’s Milk-Free Formula Options for Premature Infants

Many mothers cannot exclusively breastfeed their premature infants. Delayed or failed milk production, an active infection, certain medications, or past surgeries can make breastfeeding sometimes difficult or impossible. The link between cow’s milk-based formulas and increased risk for NEC is well-established. However, there are many safer alternative formulas that moms can choose from for bottle-feeding their premature infants. See a list of alternative formulas below, along with which ingredients on product labels indicate they’re made with cow’s milk.  

Formulas Made for Infants That Do Not Contain Cow’s Milk

In order to minimize NEC risks, parents of premature infants may consider using one of these cow’s milk-free formula options:

  • Soy or plant-based formulas
  • Amino acid-based formulas

Parents may also wish to consult their pediatrician regarding digestive or nutritional concerns, such as food allergies or caloric intake. In addition, they may wish to discuss other supplemental nutrition options that don’t increase the risk for NEC in premature infants. Some examples may include things like goat’s milk-based formulas, donor breast milk, or human milk fortifiers (HMFs). However, it’s unclear whether any of these options may, in fact, increase a premature baby’s risk for developing NEC.

Parenting website The Baby’s Brew highly recommend the following soy or plant-based formulas:

Parents can also ask their pediatricians about the following infant formulas that do not contain cow’s milk or soy proteins:

  • EleCare® amino acid-based infant formula with iron, DHA and ARA
  • Neocate® Infant DHA/ARA amino acid-based infant formula by Nutricia
  • PurAmino DHA & ARA™ hypoallergenic amino acid-based infant formula with iron

Cow’s Milk-based Ingredients Commonly Listed on Formula Labels

When in doubt, parents should check the list of ingredients on formulas before purchasing them to ensure they’re cow’s milk-free. The following ingredients may indicate your child’s formula contains cow’s milk-based proteins:

  • Casein/caseinates
  • Lactalbumin and/or lactalbumin phosphate
  • Lactoferrin
  • Lactose
  • Lactulose
  • Milk protein hydrolysate
  • Rennet casein
  • Whey solids

What About Hypoallergenic Formulas? Are They “Safer” for Premature Infants?

Parents might also see formulas with “hypoallergenic,” “lactose-free” or “dairy-free” labels that look potentially free of bovine-based proteins. However, that’s not strictly true. These products typically contain pre-digested, bovine-based proteins or lactose-free cow’s milk solids. You may also see terms such as “extensively hydrolyzed,” which describes the pre-digestion method for processing bovine milk-based proteins. However, be aware that these infant formulas still do contain cow’s milk-based proteins.

When in doubt, always consult your pediatrician about which cow’s milk-free formula is best for premature infants.

Which Formulas Do Premature Infants Typically Receive in Hospital NICUs?

Very low birth-weight premature infants in a hospital’s newborn intensive care unit (NICU) may sometimes receive high-calorie supplemental formula feedings. Parents concerned about the link between NEC and bovine-based formulas in premature babies should review all available options with the hospital’s pediatric care team, dietician, or NICU staff.

In some cases, NICU staffers may feed premature or low birth-weight babies high-calorie formula made with cow’s milk. If your preemie received supplemental feedings with high-calorie infant formula while in the NICU and developed NEC, consult an attorney.

If you would like to learn more about negligence and the role it plays in your case, please contact Levin, Rojas, Camassar, and Reck, LLC today.

Contact Us

Main Contact Form
Scroll to Top