If there have been increased losses through diarrhea and/or vomiting and it is not due to recent illness, change in medication, or change in formula concentration or volume, then consider changing formula type or composition.

Further evaluation is needed to determine which components of the formula are not tolerated.

• High levels of fecal fat indicate fat malabsorption. Try a formula such as Pregestimil or Alimentum with Medium Chain triglycerides. Please see section on Formula.
• Except for brief periods following illness, lactose intolerance is unlikely in infants.
• Soy formulas are not appropriate feedings for VLBW infants. Please see section on Formula.
• A trial of casein hydrolysate formulas such as Nutramagen, Alimenum, or Pregestimil may be helpful in cases of protein intolerance. Please see section on Formula.

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