Neocate Overview

Neocate is a hypoallergenic formula designed for infants and children who are allergic to or intolerant of cows milk, soy, and other ingredients.

The product is an “elemental formula”, meaning that the proteins in the formula have been broken down into amino acids. Amino acids are the building blocks of proteins, but using amino acids allows the formula to be hypoallergenic since many allergies are a reaction to the proteins that make up certain foods.

Elemental formulas may be commonly recommended by a pediatrician for infants who are suspected to have a milk protein allergy. These children may often be fussy, cry as if in pain, have bloody stools, and fail to gain weight. Formulas like Neocate are often prescribed by a pediatrician and may not be available where consumers can buy other types of formula.

Using Infant Formula

The manufacturer gives the following tips for parents starting their child on Neocate formula, as the ingredients may take a while for a child to adapt to. They also recommend usage tips for preparing formula:

  • Powder infant formula is not sterile, so it is important to mix formula fresh and make sure that all utensils are thoroughly washed and sterilized.
  • Always use the measuring spoon that is provided in the formula tin. If the scoop slips into the container, it can be retrieved with a utensil. However, Nutricia cautions against using your hand in order to keep the product as sterile as possible.
  • Formula should be shaken or stirred immediately before feeding.
  • The formula can be heated, but not for longer than 15 minutes and not through boiling or using a microwave.
  • Excessive heating can cause nutrient loss, so Nutricia recommends not reheating the formula during feeding.
  • Formula that remains in the bottle for longer than one hour should reportedly be discarded.

Nutricia, the manufacturer of Neocate, claims that the formula provides “complete nutrition” and “fast and effective dietary management of food allergic symptoms”. However, Nutricia’s claims about Neocate may not completely reflect the risk associated with Neocate’s elemental formula.

Neocate and Bone Health

Patients have reported low phosphate levels resulting in rickets, a condition of weak bones and chronic bone breaks. In most cases, the condition was associated with hypophosphatemia (low blood phosphate levels). Although calcium is most commonly associated with bone health, phosphate has been shown to be just as important to strong bones.

Risk of Rickets

A 2018 rickets case study examined an eight month old girl who developed rickets after being fed with Neocate formula. Doctors checked her for various conditions and eventually theorized that the phosphate in the elemental formula is not sufficiently absorbed in the digestive tract. The researchers note that, while the literature supporting this theory is “limited”, this may explain the low blood phosphate levels experienced by children taking Neocate.

“This case report underlines the importance of considering nonrenal phosphate losses in the differential diagnosis for hypophosphatemic rickets and contributes to a growing body of evidence associating Neocate formula with hypophosphatemia in certain patients,” the researchers concluded.

However, “[f]urther investigation to establish the mechanism by which Neocate formula may lead to hypophosphatemic rickets is warranted.”

Luckily, the patient in the case report recovered after discontinuing the formula. This is reportedly the common experience, with infants recovering from their skeletal issues after stopping Neocate and shifting to another source of nutrition.


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