Can Alfamino be used for ANY CMPA patient?
This product has been clinically shown to be hypoallergenic and is available for patients requiring a hypoallergenic amino acid-based formula. The suitability and use of a hypoallergenic formula should be determined by an experienced health care professional.
Why does Alfamino contain potato starch?
Potato starch is a minor contributing carbohydrate source in Alfamino and is used for its emulsification properties during manufacturing. The ingredients in Alfamino, including the potato starch, are carefully selected and screened.
Why does the Alfamino Infant formula have a 1:1 ratio of DHA/ARA, instead of a 2:1 ratio?
Scientific literature and most expert recommendations addressing DHA and ARA intake during infancy indicate infant formula should contain DHA/ARA at least 0.3% of total fat for each (Hoffman et al., 2009; Kris-Etherton et al., 2007; Koletzko et al., 2008). The levels of DHA and ARA that are provided in Alfamino are within these expert-recommended levels (0.32% for each) and ranges reported in human milk (Brenna et al, 2007).
What is the shelf life of Alfamino?
24 months from production. Look at the bottom of the can for the expiration date. However, once opened, the contents of the can should be used within 1 month.
What is HIGH 2-PALMITIC VEGETABLE OIL? And is it a structured lipid?
This ingredient is a refined vegetable fat blend, in which a proportion of the palmitic acid in the fat is esterified to the middle (sn-2) position of the glycerol molecule similar to that found in breastmilk. This is a minor component of the fat blend in Alfamino Infant. The amount of high 2-palmitic vegetable oil used in Alfamino is lower than the sn-2 lipid that is found in breastmilk, and is not at levels significant to show meaningful effects on mineral absorption as reported in the literature.
Both Alfamino Infant and Junior have significantly higher levels of MCT? How did Nestle decide which levels to choose?
We wanted this formula to be closely aligned with the other well-tolerated products in our pediatric portfolio that are designed for GI impairment: Peptamen Junior®(with 60% of fat as MCT), which has been on the market for over 20 years, and Vivonex® Pediatric (with 70% of fat as MCT), which has been on the market for almost 20 years. We know from both clinical evidence - for the Peptamen® brand, specifically - and a long history of HCP feedback that our products containing high MCT levels are well-tolerated in patients with GI dysfunction. There is no MCT-containing product on the market that has a study showing the specific amount of MCT in that product is the “optimal” amount, which is why we chose to align our formulation with our pediatric brands that already have a proven track-record of tolerance. The significantly higher levels of MCT over our competitors may provide a clinical advantage for patients with a malabsorptive condition.
Are there studies that support these levels of MCT?
The studies in the VEEVA presentation support the claims we make for the appropriate use of the product: a hypoallergenic, AA-based formula such as Alfamino is appropriate for CMPA, multiple food allergies, EoE, malabsorption and short bowel syndrome. No studies exist on any MCT-containing AA formula on the market showing that a specific amount is the optimal amount for an amino acid based formula. The studies that have been done with our product are the growth study and the hypoallergenicity study.
Alfamino contains corn syrup solids; could this create an allergic reaction or intolerance in a child allergic to corn?
The FDA does not consider corn as a major allergen; however, intolerance to corn may exist in certain individuals. Alfamino contains corn syrup solids as a source of carbohydrates. All Alfamino ingredients undergo a careful screening process. Corn syrup solids are considered a highly processed ingredient capable of removing any carryover from corn proteins. While the formula meets the clinical requirements for hypoallergenicity as defined by the AAP, the suitability of the formula for anyone with a corn allergy or intolerance should be determined by a health care professional.
What is the % of LCT and grams of long chain triglycerides per 100 k/cal for Alfamino Infant and Junior?
For Alfamino Infant, 44% of the fat is from LCT (2.24g/100 kcal). For Alfamino Junior, 26% of the fat is from LCT (1.15g/100 kcal).
What is the amount of soybean oil in grams per 100 kcal for Alfamino Infant and Junior?
For Alfamino infant, the amount of soybean oil is 1.46 g/100 kcal. For Alfamino Junior, the amount of soybean oil is 1.21 g/100 kcal.
What is the essential fatty acid (EFA) content of Alfamino Infant formula, and does it meet EFA requirements for infants?
Alfamino Infant formula contains approximately 700mg linoleic acid, and approximately 90mg alpha-linolenic acid per 100 kcal at standard dilution; this amount provides approximately 6.3% total energy (for linoleic acid) and approximately 0.8% total energy (for alpha-linolenic acid) per 100 kcal, respectively. The FDA requires infant formula to provide linoleic acid at >300mg/100kcal and >2.7% calories, and alpha-linolenic acid to provide >0.5g/d (or >10% of linoleic acid). Alfamino® Infant formula meets the EFA requirements for infant formula.
Can Alfamino Infant be used with NICU patients?
Hypoallergenic, amino acid-based formulas are not designed for use in the NICU, and these formulas are generally not used routinely in such a setting. None of the currently available products have been formulated to meet the nutritional requirements of the medically compromised premature neonate, and therefore are not indicated for use in this patient population. However, the use of such a product in a premature infant is ultimately up to the healthcare provider.
Alfamino Infant is formulated to meet the macro- and micronutrient requirements to support optimal growth and nutrition of healthy, full-term infants. Premature neonates, including medically compromised premature neonates, have unique nutrient requirements separate from healthy full-term infants and should be evaluated by a qualified healthcare professional. The use of this product in a premature infant is not recommended. The suitability of any formula, including supplementation with modulars, should be addressed by a qualified healthcare professional familiar with the case history of the patient. As with any powdered formula product, use with immune-compromised infants & children is not recommended.
How is Alfamino different than the other amino acid-based formulas already on the market?
Both Alfamino formulas contain a unique lipid blend that is designed to support tolerance: Alfamino Infant formula contains 43% of fat as MCT (10% more than competitors), and Alfamino Junior contains 65% of fat as MCT (>30% more than competitors). Because Alfamino formulas are indicated for both food protein allergies and malabsorption, the MCT content can provide a nutritional advantage for children with fat malabsorption (like short bowel syndrome).* If a customer prefers to carry only one amino acid-based formula on formulary, Alfamino may have an advantage due to the higher MCT for patients with malabsorption. Alfamino is truly a dual use product: i.e. it contains a hypoallergenic amino acid-based nitrogen source, and a high MCT content to support tolerance in children with fat-malabsorptive conditions.
*MCTs do not require traditional fat metabolism and, are therefore more easily absorbed directly into the enterocyte and are transported through the portal vein to the liver. As a result, MCTs are absorbed more rapidly than long chain triglycerides (Bach et al, 1982). Also, MCT oils are valuable in a number of clinical situations because they are digested quickly and less likely to be affected by intestinal factors that inhibit fat absorption (Krause, 2012).
Is Alfamino WIC & Medicaid approved?
Yes, Alfamino is WIC and Medicaid approved.