Missouri’s Nutritional Enteral Product Guide

12/07/00, Revised 07/15/02

REFERENCE OF
AVAILABLE FORMULAS AND PRODUCTS
FOR
SPECIFIC DISORDERS*
This is a reference for WIC professionals to use when approving formula prescriptions and
discussing formula needs with the physician. The WIC staff should not use this reference for
diagnosis or for recommending formulas. (Refer to Product List to see if product is WIC
approved and for additional information.)

I. Infant Disorders of Carbohydrate Digestion and Absorption:

A. Primary and secondary lactase deficiency

1. Milk-free. Contains glucose polymers or sucrose.
a. Soy Protein Isolate
Alsoy (Carnation)
Enfamil ProSobee (Mead Johnson)
Follow-Up Soy (Carnation)
Isomil (Ross)
Store Brand-Soy (Wyeth)
b. Casein Hydrolysate
Alimentum with Iron (Ross)
Enfamil Pregestimil (Mead Johnson)
Enfamil Nutramigen (Mead Johnson)

2. Milk-based, lactose-free.
Enfamil LactoFree (Mead Johnson)
Similac Lactose Free (Ross)
Please refer to discussion paper on lactose intolerance.

B. Sucrase deficiency
Sucrose- and lactose-free. Contains glucose polymers.
1. Soy Protein Isolate
Enfamil ProSobee (Mead Johnson)
Isomil SF (Ross)

2. Milk-Based
Enfamil LactoFree (Mead Johnson)

*Adapted from the Colorado WIC Program. Revisions made to include formula
and product updates for infants and children.
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B. Sucrase deficiency (continued)
Sucrose- and lactose-free. Contains glucose polymers
3. Casein Hydrolysate
Enfamil Nutramigen (Mead Johnson)
Enfamil Pregestimil (Mead Johnson)

C. Sucrase-isomaltose deficiency
1. Sucrose- and starch-free. Contains lactose.
Milk-Based
Enfamil (low iron, Mead Johnson)
Enfamil with Iron (Mead Johnson)
Similac with Iron 24
Similac with Iron & Low Iron (Ross)
Store Brand-Milk (Wyeth)

2. Carbohydrate-free
3232A: Mono- and Disaccharide-Free Powder (Mead Johnson)
RCF: Ross Carbohydrate Free (Ross)

D. Congenital glucose-galactose malabsorption

RCF (Ross) with select carbohydrate added
3232A: Mono- and Disaccharide-Free Powder (Mead Johnson)
with select carbohydrate added

E. Galactosemia
1. Soy Protein Isolate – Primary Choice
Alsoy (Carnation)
Enfamil ProSobee (Mead Johnson)
Isomil (Ross)
Next Step Toddler Soy (Mead Johnson)
Store Brand-Soy (Wyeth)

2. Casein Hydrolysate
Enfamil Nutramigen (Mead Johnson)
Enfamil Pregestimil (Mead Johnson)
Alimentum with Iron (Ross)

3. Milk-based, lactose-free
Enfamil LactoFree (Mead Johnson)
-contaims trace amounts of galactose, ~20 mg/liter

*Adapted from the Colorado WIC Program. Revisions made to include formula
and product updates for infants and children.
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I. Infant Disorders of Protein Digestion and Absorption

A. Milk protein intolerance

Cow's milk protein-free
1. Soy Protein Isolate
Alsoy (Carnation)
Enfamil ProSobee (Mead Johnson)
Follow-Up Soy (Carnation)
Isomil (Ross)
Store Brand-Soy (Wyeth)

2. Casein Hydrolysate
Alimentum with Iron (Ross)
Enfamil Nutramigen (Mead Johnson)
Enfamil Pregestimil (Mead Johnson)

B. Combined cow's milk and soy protein intolerance

1. Casein Hydrolysate
Alimentum with Iron (Ross)
Enfamil Nutramigen (Mead Johnson)
Enfamil Pregestimil (Mead Johnson)

2. Elemental Products
Neocate (SHS)

III. Infant Disorders of Fat Digestion and Absorption

Abetalipoproteinemia and hypobetalipoproteinemia

Specialized fat-containing formula not requiring micellar and chylomicron formation.
Alimentum with Iron (Ross)
Enfamil Pregestimil (Mead Johnson)
Portagen (Mead Johnson)
ProViMin: carbohydrate and fat free formula (Ross)

IV. Special Infant Medical Problems

A. Biliary atresia
Enfamil Pregestimil (55% MCT fat calories, Mead Johnson)
Portagen (85% MCT fat calories, Mead Johnson)

B. Bronchopulmonary dysplasia
Standard infant formula with increased concentration (>20 kcal/oz)

C. Congenital heart disease

*Adapted from the Colorado WIC Program. Revisions made to include formula
and product updates for infants and children.
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Low-sodium formula
Similac PM 60/40 (Ross)
Product used depends on medical status of congenital heart disease.

D. Diarrhea
Product used depends on the cause of diarrhea. Refer to I, II, and III above.
Also Isomil DF (mild to severe diarrhea; short term use only, for infants over 6
months old and toddlers)

E. Electrolyte Replacement
Short term use only
Enfalyte (Mead Johnson)
Pedialyte (Ross)
Rehydralyte (Ross)

F. Gastroesophageal reflux
Feeding guidelines per physicians instructions may include: positioning- prone
with head elevated at 30° angle, and small and frequent feedings. Please refer to
Glossary for more detailed discussion.
Enfamil AR (Mead Johnson, not recommended for use in premature infants)
Please refer to discussion paper on Gastroesophageal Reflux.

G. Hypercalcemia or Williams Syndrome

Calcilo XD (Ross)

H. Hypocalcemia
Formula with lowered calcium and other minerals
Similac PM 60/40 (Ross)

I. Immune deficiency syndromes

Product requiring minimal digestion, easily absorbed
1. Casein Hydrolysate
Alimentum with Iron (Ross)
Enfamil Pregestimil (Mead Johnson)
Enfamil Nutramigen (Mead Johnson)

2. Elemental
Neocate (SHS)

*Adapted from the Colorado WIC Program. Revisions made to include formula
and product updates for infants and children.
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J. Prematurity and Low Birth Weight

1. Human Milk Fortifier; short term use only
Enfamil Human Milk Fortifier (Mead Johnson)
Similac Natural Care (Ross)
Similac Human Milk Fortifier (Ross)

2. Premature Infant Formulas; short term use only

Available in 20 and 24 kcal/oz, with and without iron
EPF - Enfamil Premature Formula (Mead Johnson)
SSC - Similac Special Care (Ross)

3. Full year formula for preemies

Enfamil EnfaCare (Mead Johnson)
Similac NeoSure (Ross)

K. Renal insufficiency
Formula with low electrolyte and mineral levels
Similac PM 60/40 (Ross)

V. Infant and Children Metabolic Disorders

A. Glutaric Aciduria Type I

Glutarex - 1 (infant/toddler), Glutarex - 2 (child/adult/pregnancy) (Ross)
XLYS TRY Analog (Infant) (SHS)
XLYS TRY Maxamaid (1-8 years) (SHS)
XLYS TRY Maxamum (over 8 years) (SHS)

B. Histidinemia
HIST 1 (infant), HIST 2 (child) (Mead Johnson)

C. Homocystinuria
HCY 2 (child/adult) (Mead Johnson)
HOM 1 (infant), HOM 2 (child/adult) (Mead Johnson)
Hominex - 1 (infant/toddler), Hominex - 2 (child/adult/pregnancy) (Ross)
XMET Analog (infant) (SHS)
XMET Maxamaid (1-8 years) (SHS)
XMET Maxamum (over 8 years) (SHS)

D. Hyperlysinemia
LYS 1 (infant), LYS 2 (child) (Mead Johnson)
Product 80056: Protein-Free Diet Powder (Mead Johnson)

*Adapted from the Colorado WIC Program. Revisions made to include formula
and product updates for infants and children.
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E. Hyperphenylalaninemia/Phenylketonuria (PKU)
Phenyl-Free 1 (infant/child) (Mead Johnson)
Periflex (over 1 year) (SHS)
Phenex - 1 (infant), Phenex - 2 (child/adult) (Ross)
Phenylade (Applied Nutrition)
Phenyl-Free (Mead Johnson)- available through 2001, Phenyl-Free 2 replaces it.
Phenyl-Free 2 (child/adult) (Mead Johnson)
Phenyl-Free 2 HP (child/adult/pregnancy) -higher protein for pregnancy (Mead
Johnson)
Phlexy-10 (child/adult) (SHS)
PKU 1 (infant), PKU 2 (child), PKU 3 (adolescent/maternal) (Mead Johnson)
XP Analog (infant) (SHS)
XP Maxamaid (1-8 years) (SHS)
XP Maxamum (over 8 years) (SHS)

F. Isovaleric Acidemia
I-VALEX - 1 (infant/toddler), I-VALEX - 2 (child/adult/pregnancy) (Ross)
MSUD Diet Powder (infant/child) (Mead Johnson)
Product 80056: Protein-Free Diet Powder (Mead Johnson)
XLEU Analog (infant) (SHS)
XLEU Maxamaid (1-8 years) (SHS)
XLEU Maxamum (over 8 years) (SHS)

G. Maple Syrup Urine Disease (MSUD)

Acerflex (child) (SHS)
Complex MSUD Drink Mix (child/adult/pregnancy) (Applied Nutrition)
Ketonex-1 (infant/toddler) (Ross)
Ketonex-2 (child/adult/pregnancy) (Ross)
MSUD Analog (infant) (SHS)
MSUD 2 (child/adult) (Mead Johnson)
MSUD Diet Powder (infant) (Mead Johnson)
MSUD 1 (infant), MSUD 2 (child/adult) (Mead Johnson)- made by Milupa,
distributed by Mead Johnson.
MSUD Maxamaid (1-8 years) (SHS)
MSUD Maxamum (over 8 years) (SHS)
Product 80056: Protein-Free Diet Powder (Mead Johnson)

H. Methylmalonic Acidemia/Propionic Acidemia

OS1 (infant), OS2 (child/adult) (Mead Johnson)
Propimex - 1 (infant/toddler), Propimex - 2 (child/adult/pregnancy) (Ross)
Product 80056: Protein-Free Diet Powder (Mead Johnson)
XMTVI Analog (infant) (SHS)
XMTVI Maxamaid (1-8 years) (SHS)
XMTVI Maxumum (over 8 years) (SHS)

I. Tyrosinemia (Type I and II)

*Adapted from the Colorado WIC Program. Revisions made to include formula
and product updates for infants and children.
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Product 3200AB: Low PHE/TYR Diet Powder (Mead Johnson)
TYR 1 (infant), TYR 2 (child) (Mead Johnson)
Tyrex-2 (child/adult/pregnancy) (Ross)
Tyromex-1 (infant/toddler) (Ross)
Tyros 2 (child/adult) (Mead Johnson)
XPHEN TYR Analog (infant) (SHS)
XPHEN TYR Maxamaid (1-8 years) (SHS)
XPHEN TYR Maxamum (over 8 years) (SHS)
XPTM Analog (infant) (SHS)

J. Urea Cycle Disorders

Cyclinex - 1 (infant/toddler), Cyclinex - 2 (child/adult/pregnancy) (Ross)
UCD 1 (infant), UCD 2 (child/adult) (Mead Johnson)

VI. Nutritional Supplements (See Product List for additional use information)

A. Protein Supplements
Casec (Mead Johnson)
Elementra (Nestle)
Promod (Ross)
Resource Arginaid (Novartis)
Resource Instant Protein Powder (Novartis)

B. Carbohydrate Supplements
Moducal (Mead Johnson)
Polycose (Ross)

C. Fat Supplements
MCT Oil (Medium-Chain Triglycerides) (Mead Johnson)
Microlipid (Mead Johnson)

D. Protein-Vitamin-Mineral Supplements (carbohydrate- and fat-free)

Meritene (Novartis)
ProViMin (Ross)

E. Carbohydrate and Fat Supplements

ScandiCal Calorie Booster (SHS)
Super Soluble Duocal (SHS)

F. General Use High-Calorie Supplements (Children 1 year and older)

Kindercal, Kindercal with Fiber, Kindercal TF, and Kindercal TF with Fiber (Mead
Johnson)
Nutren Jr and Nutren Jr with Fiber (Nestle)
Pediasure and Pediasure with Fiber (Ross)
Resource Just For Kids, Resource Just for Kids with Fiber (Novartis)

G. Elemental Pediatric (Children 1 year and older)

*Adapted from the Colorado WIC Program. Revisions made to include formula
and product updates for infants and children.
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Elecare (children 1 year and older) (Ross)
NeoCate One Plus (children ages 1-10 years) (SHS)
Pediatric EO28 (1 year and older) (SHS)
Peptamen Jr., Peptamen Jr. with Fiber (children ages 1-10 years) (Nestle)
Vivonex Pediatric (children ages 1-10 years) (Novartis)

*Adapted from the Colorado WIC Program. Revisions made to include formula
and product updates for infants and children.
182