Neocate Parent Guide

®
Neocate
N
®
Parent Guide
AG
Guide to Understanding
Yo
Your Child’s Food Allergies
Table of Contents
Parent G
e
t
u
ca
General Information on Food Allergy - page 2
ide
Ne
o
®
What is Neocate? - page 4
Neocate Infant DHA / ARA - page 8
Frequently Asked Questions - page 10
Acknowledgement
Nutricia North America would like to thank Diana Buckley-Uhrich, RN, MS, CPNP with the
Division of Pediatric Gastroenterology and Nutrition at Massachusetts General Hospital for her
help and advice in the preparation of this resource guide.
Note
This book has been prepared as a resource guide for parents whose child has been
recommended to use Neocate.
Neocate Preparation and Nutrient Profile - page 14
The management of food allergy and intolerance can differ between individuals. As such, it is
strongly recommended that this guide be used in consultation with a healthcare professional.
All information provided in this guide is reflective of the most current and relevant
recommendations regarding the management of food allergies with Neocate Infant formula.
Neocate Parent Guide
Nutricia Family of Products - page 20
A Guide to Understanding Your Child’s Food Allergies
What is the difference between food intolerance
and food allergy?
Food intolerance is a general term used when a person has a bad
reaction to a food or food additive. Often times, food intolerance
occurs even when the affected person cannot identify the type of
food eaten.
A food allergy always involves an abnormal reaction of the immune
system to the food protein. Food intolerance, however, does not
provoke an immune response, but rather an abnormal physiological
response, such as abdominal pain and cramping or bloating and
diarrhea. Some children with severe allergies may experience both
types of reactions.
General Information on
Food Allergy
What is a food allergy?
We all have an immune system to protect us from infections.
Our immune system attacks the viruses and bacteria that can
make us sick. With a food allergy, the body’s immune system
mistakenly reacts in a similar way to certain food proteins, which
are called allergens. The immune response to the food protein
and the symptoms that come from that reaction is called an
allergic reaction.
The immune response of food allergy may occur within minutes
after a child eats or drinks, or may take several hours or days
to develop. Non-life threatening symptoms may include hives,
diarrhea, bloody stools, vomiting, poor feeding, eczema, or poor
growth. These types of reactions may take longer to develop.
Over time, this type of immune response to food may cause
inflammation of the esophagus, stomach, small intestine or large
intestine. Life threatening symptoms can include swelling of
the mouth or throat, difficulty breathing, wheezing, anaphylaxis
or shock. Such reactions usually occur within a few hours of
ingesting the food containing the allergen.
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Neocate Parent Guide
How common are food allergies?
It is estimated that 6 to 8 out of every 100 infants, and up to 3
out of 100 older children are allergic to one or more foods. The
8 most common food allergens are the proteins found in milk,
eggs, fish, shellfish, tree nuts (e.g. almonds, walnuts), peanuts,
wheat and soy. However, a child can be allergic to almost any
food protein. Most children outgrow food allergies by the age of
three (although an allergy to fish and peanuts may last a lifetime).
Why does a child become allergic
to a food?
It is not clearly understood why some
children develop an immune response
to one or more food proteins. A child
is more likely to have food allergies
when other family members have
a food allergy or when there is a
family history of asthma, hives,
hay fever, or eczema.
A Guide to Understanding Your Child’s Food Allergies
3
What is Neocate?
Neocate is a special formula designed for infants and young
children with milk protein allergy or multiple food protein
intolerance (e.g. allergies to soy protein, hydrolyzed protein in
other infant formulas, fish, eggs and nuts). Neocate provides
the necessary nutrients required for an infant’s growth and
development. Neocate has been recommended by your doctor
or dietitian because your baby has difficulty in tolerating or
digesting other infant formulas.
Neocate is described on the label as:
Hypoallergenic
The formula is less likely to cause an allergic response.
Nutritionally Complete
All of the essential nutrients needed to grow
are supplied by the formula when consumed
in adequate amounts.
Elemental
Ingredients are broken down to their simplest and
purest form so they are easier for the body
to process and digest.
Amino Acid-Based
Amino acids are the non-allergenic building blocks
for all protein.
Dairy-Free Manufacturing
Neocate is manufactured in a dairy-free environment
providing a safe and effective formula for individuals
with dairy allergies.
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Neocate Parent Guide
A Guide to Understanding Your Child’s Food Allergies
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The following table compares some of the different
infant formulas and identifies the protein source.
What makes Neocate different from other formulas?
The type of protein used in Neocate makes it different from other
infant formulas. Neocate is an amino acid-based formula in which the
proteins are broken down to their simplest and purest form, making
it easier for the body to process and digest. Additionally, because
Neocate is hypoallergenic, it is less likely to cause an allergic response
than other infant formulas consisting of more intact proteins.
REGULAR FORMULA WITH
WHOLE PROTEIN
HYDROLYZED FORMULA
Cow/soy milk protein
Majority derived from cow milk protein
NEOCATE
AMINO ACID-BASED FORMULA
Protein Source
Protein Type
Allergic Reaction
Cow Milk Protein
Goat Milk Protein
Whole protein
> Casein
> Whey
MOST
ALLERGENIC
Soy Milk
Whole soy protein & soy isolate
Extensively Hydrolyzed
Fragments of cow milk protein
> Casein hydrolysates
> Whey hydrolysates
Neocate Infant
Amino acids
> Protein in its simplest form
LEAST
ALLERGENIC
Why is the protein source so important?
Allergic reactions to food are mainly caused by
the body’s reaction to the protein present in the
food we eat (e.g. milk, soy, eggs, wheat, fish
and nuts). Infants and young children a r e
much more sensitive to these
proteins as their immune
systems are still quite
immature. Some infants
and young children may
be allergic to several food
proteins, including cow and
soy milk proteins. They can
also be allergic to the small
protein fragments contained in hydrolyzed infant formulas.
Infants and children require a certain daily amount of protein to
help support normal growth and development. For children with
protein allergies, it can be difficult for them to meet these needs
as they must avoid various types of nutritious foods that could
potentially initiate an allergic response. However, a nutritionally
complete, amino acid-based formula such as Neocate can
provide the child with the required daily nutrition.
100% non-allergenic free amino acid-based
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Neocate Parent Guide
A Guide to Understanding Your Child’s Food Allergies
7
Neocate® Infant DHA / ARA
Nucleotides and DHA / ARA
The only elemental formula that contains
nucleotides and has added DHA at a level
comparable to that found in breast milk.
Nucleotides and DHA / ARA are important
nutrients naturally found in breast milk.
DHA / ARA are important for healthy infant
growth and development. Studies have
shown a direct consumption of these key
ingredients will promote your baby’s:
• Visual development
• Brain development
DHA and ARA levels of Neocate are in line with the
recommendations of Koletzko et al. (2008),* Child Health
Foundation, ensuring beneficial amounts of DHA and ARA for
your baby.
Like all Neocate products, Neocate Infant DHA / ARA is:
• Hypoallergenic
• 100% non-allergenic free amino acids
• Nutritionally complete
• Manufactured in a milk protein-free environment
* Koletzko B, Lien E, Agostoni C, et al. The roles of long-chain polyunsaturated fatty
acids in pregnancy, lactation and infancy: review of current knowledge and consensus
recommendations. J Perinat Med. 2008;36(1):5-14.
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Neocate Parent Guide
A Guide to Understanding Your Child’s Food Allergies
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Frequently Asked
Questions
When will I see an improvement after starting
Neocate?
If your child has been experiencing negative symptoms for some
time, his or her condition may take time to improve. Severe allergies
can cause inflammation and irritation to the affected areas. This,
like a cut or burn, will take time to heal. It is important during this
time to keep your child exclusively on Neocate and not give any
other formula or foods unless otherwise directed by the doctor or
dietitian. If your child has been on solids, it is important to make sure
that those foods suspected of causing a problem are completely
eliminated from the diet. Use only those foods recommended by
your child’s doctor or dietitian.
In clinical studies an elimination diet using Neocate has been shown
to improve gastrointestinal symptoms of cow milk allergy such as
diarrhea, blood in the stools and vomiting associated with milk protein
allergies in just 3-days and improving gastroesophageal reflux and
skin irritations, such as eczema and atopic dermatitis in just 14-days.
How long will my child need Neocate?
Many, but not all children, outgrow their food allergies. This will vary
for different foods and depends on the child. Your child’s doctor will
determine how long your child may need Neocate.
Will Neocate Infant formula meet all of my child’s
nutritional needs?
Neocate Infant is formulated to meet the daily nutritional
requirements of an infant. If you are concerned that your child is
not gaining weight or growing adequately consult your doctor and/
or dietitian. They will be able to assess if nutritional needs are being
met and if dietary adjustments are necessary.
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Neocate Parent Guide
A Guide to Understanding Your Child’s Food Allergies
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Neocate tastes and appears different than other
infant formulas. Is this normal?
Yes, this is quite normal. The protein source in Neocate is different
than milk-based or hydrolyzed formulas. The free amino acids
give the formula its characteristic taste, smell and an appearance
similar to breast milk. However, our exclusive formulation gives it
superior taste, smell and texture.
My baby’s appetite has increased since starting
Neocate. Is this normal?
Your appetite can be impaired when you are generally not feeling
well and/or have gut inflammation. It may be that Neocate is the
first formula your child has taken which does not cause discomfort
and distress. As an elimination diet using Neocate improves
gut discomfort and distress, a child’s mood and health should
improve, which may help to improve appetite. Neocate has also
been shown to promote catch-up growth in children with food
allergies. As children grow, energy demands increase, as well as
their need for formula intake.
may have. For additional suggestions and helpful documents
that may assist in obtaining coverage, please contact our
Nutrition Department at 1-800-NEOCATE.
Where can I purchase Neocate?
You can order Neocate directly from Nutricia North America at
www.Neocate.com or by calling 1-800-NEOCATE. Neocate is
also available to order through your local pharmacy.
Why is Neocate only available through the
pharmacy and not on my grocery store shelf?
Neocate falls under an exempt infant formula classification.
Such formulas typically are prescribed by a physician and must
be requested from a pharmacist. Exempt infant formulas are
generally represented and labeled solely to provide dietary
management for specific diseases or conditions that must be
used under medical supervision.
Always consult your doctor or dietitian if you have
questions or concerns regarding your child’s health.
My baby has had a change in stools since
starting on Neocate. Is this normal?
Yes, this is perfectly normal! Stools can change in consistency
and color when a child is introduced to an elemental formula
such as Neocate. This is because Neocate is a low residue
formula. Low residue formulas lower the number of bacteria
in the gut leading to reduced breakdown of bile. More bile is
present in the stool making it darker in color.
Will my insurance company cover the cost of
Neocate?
Insurance coverage will depend on your plan, as well as the
state in which you reside. There are several states that mandate
Neocate coverage, for an up-to-date listing of these states visit
www.Neocate.com. Hints and tips for successful reimbursement
are also available online. Consult with your doctor and/or
insurance company to assist you with any specific questions you
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Neocate Parent Guide
A Guide to Understanding Your Child’s Food Allergies
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Neocate Preparation
and Nutrient Profile
How do I prepare Neocate Infant?
To make a standard dilution (20 cal/fl oz), add 1 unpacked level
scoop (4.6 g) of powder to each fluid ounce of water. Only use
the scoop provided. Use a gram scale for the most accurate
results. Do not boil formula or use a microwave to prepare or
warm formula.
1. Wash hands thoroughly and clean the preparation area.
2.Pour the required amount of cooled, boiled water into a
sterilized feeding bottle*.
3.Add the prescribed amount of scoops of Neocate Infant
DHA/ARA to the water.
4.Place the cap on the bottle and shake until the powder
dissolves.
Important Preparation Information
Freshly prepared formula is best. Formula prepared in advance
must be cooled rapidly, stored in the refrigerator and used
within 24 hours of preparation. Formula remaining in the bottle
after one hour of feeding should be discarded. Tube feeding
hand time should not exceed 4 hours.
*Boiling is the preferred method for sterilizing water, bottles, nipples and mixing utensils.
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Neocate Parent Guide
A Guide to Understanding Your Child’s Food Allergies
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How do I make different volumes?
Amount of Water Amount of Neocate Infant
Powder to Add Approximate Final Volume
3 fl oz
3 scoops or 13.8 g
3.3 fl oz
5 fl oz
5 scoops or 23 g
5.5 fl oz
8 fl oz
8 scoops or 37 g
9 fl oz
Nutricia North America recommends using a gram scale for greatest accuracy.
How can Neocate be stored?
• Prepared formula can be stored in a refrigerator for up to 24 hours
• Once a bottle is introduced to your infant’s mouth, all formula
remaining in the bottle should be discarded after one hour
• Opened cans of Neocate with plastic lid securely fastened
should be stored in a cool, dry place and used within one month
• Sealed cans of Neocate should be stored in a cool, dry place
and used by the expiration date, which is located on the bottom
of each can
What is the best way for me to warm the Neocate
once it has been prepared?
As with any other infant formula, a microwave oven should not
be used to reheat Neocate, as this can lead to “hot spots” in the
formula. It is recommended to place the prepared bottle either
under warm, running water, or in a container filled with warm water.
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Neocate Parent Guide
A Guide to Understanding Your Child’s Food Allergies
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Nutrient Profile
Nutrients Calories Protein Equivalent, g
Fat, g
Carbohydrate, g
Linoleic Acid, mg
Vitamins
Vitamin A, IU (mcg RE)
Vitamin D3, IU (mcg)
Vitamin E, IU (mg T.E.)
Vitamin K, mcg
Thiamin, mcg Riboflavin, mcg
Vitamin B6, mcg
Vitamin B12, mcg
Niacin, mcg
Folic Acid, mcg
Pantothenic Acid, mcg
Biotin, mcg Vitamin C, mg
Choline, mg
Inositol, mg
Minerals
Calcium, mg
Phosphorus, mg
Magnesium, mg
Iron, mg
Zinc, mg
Manganese, mcg
Copper, mcg
Iodine, mcg
Molybdenum, mcg
Chromium, mcg
Selenium, mcg
Sodium, mg
Potassium, mg
Chloride, mg
Per 100 calories ( 5 fl oz)
100
2.8
5.1
10.8
738
280 (84.1)
72.9 (1.8)
1.4 (0.94)
8.8
140
110
112
0.27
1014
13.3
600
3.9
10.7
19.8
22.4
Ingredients:
Corn Syrup Solids (54%), Refined Vegetable Oil (Medium Chain
Triglycerides (8%), High Oleic Sunflower Oil (6%), Sunflower Oil
(5%), Canola Oil (4%)), Calcium Phosphate Dibasic (2%), and less
than 2% of each of the following: L-Arginine L-Aspartate, L-Leucine,
Tripotassium Citrate, L-Lysine Acetate, L-Glutamine, L-Proline, CAEM (an
emulsifier), L-Valine, Glycine, L-Isoleucine, L-Threonine, L-Phenylalanine,
L-Tyrosine, L-Serine, L-Histidine, L-Alanine, Sodium Chloride,
L-Cystine, Magnesium Chloride, L-Tryptophan, Choline Bitartrate,
L-Methionine, Tricalcium Citrate, Magnesium L-Aspartate, M. Alpina Oil*,
C. Cohnii Oil**, M-Inositol, L-Ascorbic Acid, Taurine, Ferrous Sulfate,
Zinc Sulfate, L-Carnitine, Uridine 5’-Monophosphate Disodium Salt,
Cytidine 5’-Monophosphate, Niacinamide, Inosine 5’-Monophosphate
Disodium Salt, Adenosine 5’-Monophosphate, Calcium D-Pantothenate,
Guanosine 5’-Monophosphate Disodium Salt, DL-Alpha Tocopheryl
Acetate, Ascorbyl Palmitate, Manganese Sulfate, Thiamine Chloride
Hydrochloride, Pyridoxine Hydrochloride, Cupric Sulfate, Riboflavin,
Vitamin A Acetate, DL-Alpha-Tocopherol, Potassium Iodide, Mixed
Tocopherols, Folic Acid, Chromium Chloride, Phylloquinone, Sodium
Selenite, Sodium Molybdate, D-Biotin, Vitamin D3, Cyanocobalamin.
* A source of Arachidonic Acid (ARA),
**A source of Docosahexaenoic Acid (DHA)
116
82.2
10.6
1.5
1.1
41.4
84.9
20.7
2.3
2.2
3
39.1
109
79.7
* Standard dilution = 20 calories/fl oz
Osmolality (standard dilution): 340 mOsm/kg
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Neocate Parent Guide
A Guide to Understanding Your Child’s Food Allergies
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Neocate Choices: Tailored nutrition as children grow
®
Neocate Infant
DHA / ARA
0-12 months
Neocate Nutra
(semi-solid)
6 months +
Neocate Junior
(unflavored, tropical,
chocolate)
1 year +
Neocate Junior
with prebiotics
(unflavored, vanilla)
Neocate E028 Splash
(tropical fruit, grape,
orange-pineapple)
1 year +
1 year +
Notes
Neocate provides age-appropriate hypoallergenic
elemental nutrition choices.
Proven effective in the nutritional management of:
• Multiple food protein intolerance
• Cow and soy milk allergy
• Food allergy associated:
• Gastrointestinal tract impairment
• Eosinophilic esophagitis
• Gastroesophageal reflux
• Malabsorption
• Short bowel syndrome
For product information or to place an order call:
1-800-NEOCATE or visit www.Neocate.com
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Neocate Parent Guide
A Guide to Understanding Your Child’s Food Allergies
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Neocate
N
®
Parent Guide
P
A Guide
G
to Understanding
Yo
Your Child’s Food Allergies
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