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Question
My infant was diagnosed with severe EoE. The allergist switched him over to Neocate but he refuses it. We've tried different things like adding maple syrup, sugar, and vanilla extract. Do you have any advice that would be helpful?
Answer

This can be a challenging situation. Neocate is an amino acid-based elemental formula. It can be an effective dietary treatment to manage Eosinophilic Esophagitis (EoE) in infants. This formula can have an unpleasant smell and taste. This makes it difficult for some infants to drink it.

Here are some practical tips that can be helpful in feeding this formula to your infant. Discuss these options with your allergist:

  • Try a transition period. Mix Neocate with breastmilk or their current formula. Gradually give more and more Neocate in the feedings while reducing the breastmilk or other formula. For example, start with 25% Neocate and 75% what they are currently taking. Gradually increase the amount of Neocate over 1 – 2 weeks.
  • Speak with a dietician about adding 1-2 teaspoons of pure, unpreserved vanilla without sorbate to the Neocate bottle for the first week. Then, decrease the amount over time until it is not needed. The dietician may offer other useful advice as well.
  • Mix Neocate with solid foods that your infant is eating. This can help improve adjustment to the taste.

Your allergist can recommend a dietician to work with you on all these issues.

Categories
Eosinophilic Disorders
Answered by

John M. James, MD, is a board-certified allergist. He is also President of Food Allergy Consulting and Education Services, LLC. He has worked as a medical specialist in the field of allergy, asthma, and immunology for over 30 years. Dr. James received his bachelor’s degree from the University of Arkansas and his Doctor of Medicine degree from the University of Tennessee. He is board certified by the American Board of Allergy and Immunology.

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