Infant Formula Substitution Guide

The table below provides categories of formulas for premature and term infants. Formulas within each category are comparable and safe to substitute for each other, in case of shortages. Any substitution should only be done under the recommendation and supervision of a healthcare professional.

Please be aware that formula mixing instructions, including proper ratios of powder to water, can vary significantly. Follow all mixing instructions on the container. Use the specific scoop that comes with each can.

NASPGHAN does not endorse any specific formulas, nor the general use of formula over possible use of human milk as the optimal source of infant nutrition.

The information provided is intended solely for educational purposes and not as medical advice. It is not a substitute for care by a trained medical provider. NASPGHAN does not endorse any of these products and is not responsible for any omissions . For additional information please email formula@naspghan.org.


Background: The FDA announced on February 17, 2022 (FDA advisory), that they are investigating an outbreak of Cronobacter sakazakii and Salmonella Newport infections in 4 infants across 3 states (Texas, Ohio, Minnesota) that have been linked to consumption of Similac, Alimentum, or EleCare powdered formulas produced in Abbott Nutrition’s Sturgis, Michigan facility.

Currently, the FDA is advising consumers not to use Similac, Alimentum, or EleCare powdered formula if it meets all of the following criteria:

  • the first two digits of the product code (located on the bottom of the can, as shown below) are 22 through 37; and 
  • the code on the container contains K8, SH or Z2; and 
  • the expiration date is 4-1-2022 (APR 2022) or later. 

In addition, the Centers for Disease Control and Prevention (CDC) is working with the FDA to investigate Cronobacter sakazakii cases among infants who have consumed powdered infant formula in the 10 days before illness onset.(Onset dates are estimated to range from November 2020 to present date.)  Please email cronobacter@cdc.gov if you have been involved in the care of any formula-fed infants with laboratory confirmed Cronobacter sakazakii infection between November 2020 and the present date.  CDC staff will contact you to request additional information and will notify the appropriate local or state public health jurisdiction.

 

North American Society for Pediatric Gastroenterology, Hepatology and Nutrition
The Association of Pediatric Gastroenterology and Nutrition Nurses
North American Society for Pediatric Gastroenterology, Hepatology and Nutrition Foundation
The NASPGHAN Council For Pediatric Nutrition Professionals
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