Best hypoallergenic baby formulas 2024

As usual with the baby formula industry, there is a lot of confusion around what a hypoallergenic formula is and when/if a baby might actually need one. So before we dive into our top rated hypoallergenic baby formulas, let’s just quickly review what these formulas are and when you should be considering switching to one.

What is a hypoallergenic baby formula?

Hypoallergenic (HA) baby formulas, also known as extensively hydrolyzed formulas (EHF), are for babies that have been diagnosed with a cow milk protein allergy. Their little bodies aren’t able to process the larger proteins found in cow’s milk (which are quite a bit bigger than the proteins found in breast milk). The immune system essentially perceives these proteins as a threat and then attacks them. 

Luckily, there are a number of formula companies that break down the proteins so small that your baby’s body likely won’t be able to recognize these proteins as any sort of threat. That means any antibodies your baby’s immune system makes, won’t bind to the protein to elicit the allergic reaction. #sciencerules

Now that you know the actual science behind an allergic reaction to cow’s milk proteins, it’s important to note that there is no scientific definition of the term ‘hypoallergenic’ that everyone follows. That means formula companies and other websites that review baby formulas can define it however they want.

For example, you might see goat milk, soy milk, and other gentle formulas listed on other websites as a comparison for hypoallergenic formulas. We think this is only making things more confusing for parents because it’s not comparing apples to apples. We encourage parents to potentially try those types of formulas before a hypoallergenic one but it’s clearly not an apples to apples comparison because they do not go through extensive hydrolysis to break the proteins down enough to avoid an allergic reaction. 

Here at The Baby Swag, we think a hypoallergenic formula is one that has extensively hydrolyzed at least 80% of the proteins. That is why you won’t see any goat, soy, gentle formulas on our list. The source and processing of the proteins are critical when it comes to creating a truly hypoallergenic formula. 

Best hypoallergenic baby formulas

Best overall hypoallergenic formula

HiPP HA Combiotik

HiPP HA Combiotik has taken out the top spot in our list because it contains only whey proteins (no casein) and they have managed to retain lactose as the primary carb source which we love to see.

In addition, HiPP HA also contains natural probiotic lactic acid cultures originally extracted from real breast milk and prebiotics to help strengthen your baby’s intestinal wall and protect against allergens and unwanted bacteria. Lastly, they source their DHA and ARA from fermented algae vs single cell oil extracted from a fungus. 

To top it all off, HiPP’s ingredients are all organically sourced and it’s actually cheaper than all of the 3 major US brands. The only reason they cannot claim this to be an European organic formula is because of the extensive hydrolyzation process. 

Note: HiPP HA is produced in Germany and the Netherlands. They are exactly the same except the size of the product (600g German vs 800g Dutch) and the addition of starch in HiPP German HA Stage 1, which can help satisfy a hungrier baby.

BUY FROM THEMILKYBOX AND ORGANICSBEST

2nd best hypoallergenic formula (most affordable)

Store Brand Hypoallergenic 

It wasn’t until mid 2021 that parents had a more affordable hypoallergenic formula. Up until then parents only had access to the more expensive version from Europe or from the 3 major US manufacturers (Enfamily, Similac and Gerber). But thankfully, Perrigo, who has been in the formula game for nearly 30 years, released a store brand hypoallergenic formula that has been clinically studied for cow’s milk allergy. 

With non-GMO ingredients, no artificial growth hormones plus an added probiotic to help support digestive health and DHA for brain support, this formula provides complete nutrition through 12 months. This formula is also lactose-free.

Store-Brand formulas are all the same. 

One of the other great things about this formula is that you can find it at most major retailers. That is because Perrigo, the manufacturer, white labels their product to Amazon, Target, Walmart, CVS, Walgreens, and lots of regional grocery stores. They are all exactly the same formula, just a different label stuck on the front of the can. This means you can shop around to find the best deals. Plus these formulas are also eligible for SNAP.

BUY FROM AMAZON

3rd best hypoallergenic formula

Nestle Health Science Extensive HA (formerly known as Gerber Good Start Extensive HA)

If HiPP hasn’t worked for your baby, you may want to try Nestle Extensive HA (rebranded from Gerber Extensive HA). HiPP is about 86% extensively hydrolyzed while this formula is 100%. So for those babies that continue to have a reaction to HiPP, it might not be hydrolyzed enough and this would be our next test before moving to an amino-acid based formula. 

Nestle Extensive HA only uses whey proteins, is palm oil free and is the only hypoallergenic formula to feature B. lactis, a probiotic that supports digestive health that’s similar to those found in breastmilk. 

For babies that are really struggling, this formula could also help because it is also lactose-free. We would prefer your baby to have lactose which is one reason HiPP HA is on the top of the list, but for babies that have an allergy to cow’s milk proteins, their sensitive little tummies can sometimes do better on a lactose-free formula as well. 

From our in-depth research, Extensive HA formula also seems to be more widely available than the other US brands, especially since the formula shortage of 2022. 

BUY FROM AMAZON

4th best hypoallergenic formula

Enfamil Nutramigen

Nutramigen is made by Enfamil, one of the large US formula brands. It has been around a long time and is likely going to be one of the formulas your pediatrician will recommend. That doesn’t mean it’s the one you should use though, which is why we’re glad you’re here reading this guide.

Nutramigen offers parents a different recipe than our other best hypoallergenic baby formulas. This recipe is made from only casein proteins rather than whey and is about 93% extensively hydrolyzed. This is good to know because your baby could be allergic to just one of the proteins found in cow’s milk (whey or casein). So if you’ve already tried one of the whey protein formulas above, it might be worth trying this one next. 

This formula also contains a probiotic LGG which is a friendly bacteria that is found in your intestines. It is the world’s best documented probiotic strain and has been used in food and dietary supplements since 1990.

One of the benefits of Nutramigen is that it also comes in ready to feed bottles. We have heard from some parents that their baby tolerated the liquid Nutramigen better than the powder form, especially in the very early days. 

BUY FROM AMAZON 

5th best hypoallergenic formula

Similac Alimentum

Alimentum is manufactured by the other big brand you’ve likely heard of, Similac. They have also been pioneering formula research for well over 100 years. So they know what they’re doing. This will likely be the other formula your pediatrician will mention. 

Similar to Nutramigen, Alimentum is also a casein based formula which is critical to know as you experiment with different formulas to try to find one that your baby tolerates the best. This is a lactose-free formula which can be good for sensitive tummies but when a formula has no lactose (the primary carb found in breast milk), they have to replace it with corn syrup and sucrose which we would rather avoid if possible. 

Alimentum is the first and only hypoallergenic formula with 2’-FL HMO, a prebiotic found naturally in breast milk. According to Similac “about 80 percent of mothers make 2′-FL in their breast milk. Excluding water, HMOs are the third most abundant ingredient in breast milk after fat and carbohydrates.” We like to see this type of innovation in baby formulas which is why this formula made our list. 

One of the benefits of using the big brands like Similac and Enfamil is that they are the only hypoallergenic formulas also available in ready to feed bottles. 

Note: this formula is also eligible to be purchased with Supplemental Nutrition Assistance Program (SNAP) benefits in select stores.

BUY FROM AMAZON

6th best hypoallergenic formula

Nutricia Pepticate

Nutricia is one of the OGs in the formula game. The company started in the Netherlands in 1898 and has been leading research in various therapeutic food and infant formulas ever since. Their amino acid baby formula, Neocate, has been sold in the US since the 1980’s but their hypoallergenic formula, Pepticate, has only been available since 2023. And we’re glad it’s arrived. It adds another option for parents that are having to find the right hypoallergenic formula (where there are already limited options).

They are the most popular hypoallergenic formula in the UK because they offer an extensively-hydrolyzed whey protein plus other key components found in breast milk. That includes prebiotic oligosaccharides to support infant digestive health and immune system development, nucleotides to help support the immune system, and DHA and ARA to promote brain and eye development.

We also love that they have kept some lactose as a primary carbohydrate as it’s closer to breast milk and will likely make the formula taste better. 

BUY FROM AMAZON

---

Main takeaway

Extensively hydrolyzed baby formulas are truly a remarkable invention. We are so lucky to have these formulas but given these are highly specialized, and therefore expensive, formulas to manufacture, parents are left with less choice. That’s ok though because these formulas should only be used when medically necessary. 

You really can’t go wrong with any of the formulas we have mentioned above. It may take some time to find the right one, so don’t be afraid to do some trial and error with the guidance from your pediatrician. 

Our criteria for our best hypoallergenic baby formulas

With limited choice plus the extensive hydrolysis these formulas go through, we put extra weight on the formulas that tried to continue mimicking breast milk as much as possible.

• Do not include any plant based formulas 
• Provide a global view of the formula industry since there are many European and Australian brands now available in the US
• Analyze every formula based on the cost per ounce to make it easy to compare
• Consider each formula brand’s reputation, history and customer experience

What is cow’s milk protein allergy (CMPA) vs cow’s milk protein intolerance (CMPI) vs lactose intolerance?

We get questions from parents all the time about what the difference is between an allergy and an intolerance. So let’s break it down.

The symptoms are very similar across these different diagnoses, so it can be really hard to spot the difference. You have to go down to the molecular level before you can distinguish between the three… 

• Cow’s milk protein allergy (CMPA) is when your baby’s immune system has been triggered to create antibodies to protect itself from either the whey and/or casein proteins found in cow’s milk. The immune system perceives these proteins as a threat and therefore kicks into gear to protect your baby. 
• Cow’s milk protein intolerance (CMPI) is when your baby’s immune system reacts unusually to the protein found in cow’s milk but does not create antibodies. This means that symptoms are typically less severe than an allergic reaction.
• Lactose intolerance is something completely different. This is when your baby’s body is having issues digesting lactose, the primary sugar (which is a carbohydrate, not a protein) that is generally found in most routine formulas. Lactose intolerance is very rare in babies. 

We’re telling you this because these terms are sometimes used interchangeably, but the diagnosis and treatment for each can differ. 

• If you have already confirmed with your doctor that your baby either has an allergy you’re in the right place.
• If you and your doctor have made the decision to start an elimination diet to confirm an allergy, then you’re in the right place. 
• If you have not yet started the process of diagnosing an allergy with your doctor, we would recommend having that conversation with them asap if you’re worried. There are lots of things to observe and to test before switching to a hypoallergenic formula. We suggest reading our guide on how to choose the best formula for your family or our guide to the best gentle baby formulas instead. 

PSA – we’re likely over diagnosing cow’s milk allergies and intolerances

A 2022 study by the Department of Pediatrics at the University of Rochester School of Medicine found that 26.6% of formula sold in the United States is partially hydrolyzed and 5.5% is hypoallergenic, while 59% of all formula was lactose reduced. This is despite the numbers above referring to the small % of babies that actually medically need these types of formulas. 

The researchers note “the proportion of hypoallergenic formula purchased significantly exceeded the prevalence of cow’s milk protein allergy and increased over the 3-year study period from 4.9% to 7.6% of all formula sold.” Which means that pediatricians might not be providing the best advice to parents and US infants are exposed to unnecessarily high levels of non-lactose carbohydrates and hypoallergenic formula. 

Not only is the health risk but it’s also a massive financial and mental burden on the parents to support a baby that needs one of these speciality formulas. 

This is really disheartening to see because this essentially means we’re replacing a lot of the good, natural ingredients in cow’s milk, with less healthy substitutes (like sucrose, corn syrups, etc.) and marketing them to vulnerable parents. 

The reason we’re telling you this is that you should really only be considering these extensively hydrolyzed formulas if you’ve worked with your pediatrician and received a positive allergy test results with an allergist or immunologist. 

If you have not received a positive test result, you would likely be better off speaking with your doctor about goat milk or a gentle formula which is only partially hydrolyzed.

What are amino-acid (elemental) based formulas?

While researching you may have also come across amino acid-based formulas, also known as elemental formulas. These formulas don’t include whole protein molecules at all. They are broken down into the single amino acids, which are the building blocks of protein. Amino acid based formulas are put through rigorous clinical testing and proven to be completely hypoallergenic.

You should only move to this type of formula after trying one or more of the above unless your doctor has given you other instructions. 

---

Final thoughts on hypoallergenic formulas

This is a lot of information to consume but we hope you’ve learned a few things or gotten the last bit of information you needed to make a final decision on which is the best hypoallergenic formula for your family. 

Feel free to contact us or leave a comment below if we can help in any way. And best of luck on your feeding journey!

---