Switching from Hydrolyzed to Regular Formula: Pediatric Concerns

What is the process of transitioning from hydrolyzed formula to regular formula?

Dear Doctor: I was originally giving my child the Gold Nan En Hydrolyzed Formula No.
3 (occasionally experiencing constipation, so I have been giving probiotics to improve it).
Since my child is almost 3 years old, I thought about trying a regular formula (the chain pharmacy often says that since he is almost 3, the hydrolyzed formula lacks nutrition and can easily cause constipation, and I don't want to use the formula they recommend).
So, I switched to Carlotani A3 Toddler Growth Milk Powder.
On the first day of the switch, the stool was looser, with 2-3 bowel movements.
In the following days, he started having pellet-like stools, which progressively worsened each day.
Eventually, he experienced severe constipation, crying due to discomfort, and there was even a bit of blood in the stool (it has been a little over a week since the switch).
Is this formula unsuitable? Or is it that I cannot switch from hydrolyzed to regular formula? My child is currently 2 years and 19 months old; can I continue to try other brands of formula after this switch failure, or should I revert to the previous hydrolyzed formula? Will trying other brands of formula affect gut health? If the measuring scoop for the formula is different in ml, how should I adjust the amount?

Lin Xinbei, 30~39 year old female. Ask Date: 2016/04/27

Dr. Zhang Yingwen reply Pediatrics

1.
For a 1.3-year-old child, the diet is now closer to that of adults rather than being primarily milk-based.
Therefore, milk is likely not the main cause of constipation.
It is advisable to check if the intake of dietary fiber and fluids is sufficient for your child.

2.
After one year of age, it may be more effective to focus on improving the environment to prevent allergies, rather than solely relying on hydrolyzed formula or milk for allergy prevention.
Thus, consuming regular formula or hydrolyzed formula is acceptable.
3.
It is recommended to consult a pediatric gastroenterologist for further assistance and advice.

Reply Date: 2016/04/27

More Info

Switching from a hydrolyzed formula to a regular formula can be a significant transition for a child, especially one who has been on a specialized formula like hydrolyzed milk for an extended period. Hydrolyzed formulas are often recommended for infants and toddlers with specific dietary needs, such as allergies or digestive issues, as they contain proteins that are broken down into smaller peptides, making them easier to digest.
In your case, it seems that your child has experienced some gastrointestinal distress following the switch to a regular formula. The initial loose stools followed by increasingly severe constipation, and even the presence of blood in the stool, are concerning symptoms that warrant careful consideration. Here are some points to consider regarding this situation:
1. Digestive Adaptation: When switching formulas, it is common for a child's digestive system to take some time to adapt. However, if the symptoms worsen, as in your case, it may indicate that the new formula is not suitable for your child. The presence of blood in the stool is particularly alarming and should be addressed by a healthcare professional immediately.

2. Hydrolyzed vs. Regular Formula: Hydrolyzed formulas are designed for easier digestion and may be more suitable for children with sensitive stomachs or those prone to constipation. If your child has a history of digestive issues, it might be best to consult with a pediatrician before making any changes. They can provide guidance on whether to continue with the hydrolyzed formula or explore other options.

3. Trying Other Formulas: If you decide to try another brand of formula, it is essential to do so cautiously. Gradually introducing the new formula over several days can help your child's digestive system adjust. Mixing the new formula with the old one can ease the transition. However, if your child continues to experience severe constipation or other gastrointestinal issues, it may be best to revert to the hydrolyzed formula.

4. Impact on Gut Health: Switching formulas can impact gut health, especially if the new formula contains different types of proteins, sugars, or fats. Some children may react poorly to certain ingredients, leading to digestive discomfort. Probiotics can be beneficial in maintaining gut health, but it is essential to ensure that they are appropriate for your child's age and health status.

5. Measuring and Mixing: If the measuring scoops for different formulas are not the same, it is crucial to follow the manufacturer's instructions for each specific formula. Over-concentration or under-concentration of formula can lead to digestive issues, so adhering to the recommended amounts is vital.

6. Consulting a Pediatrician: Given the symptoms your child is experiencing, it is advisable to consult with a pediatrician or a pediatric gastroenterologist. They can assess your child's overall health, evaluate the need for dietary changes, and provide tailored recommendations based on their specific needs.

In summary, while switching from a hydrolyzed formula to a regular formula can be done, it should be approached with caution, especially if your child has a history of digestive issues. Monitoring your child's response to the new formula and consulting with a healthcare professional is essential to ensure their health and well-being. If the symptoms persist or worsen, reverting to the hydrolyzed formula may be the best course of action until a suitable alternative is found.

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