We believe breast milk is the best food for infants. When in consultation with their healthcare professional, mothers and families find that optimal breastfeeding is not possible due to their infant’s medical condition, formulas for special medical purposes play a vital role in providing essential nutrients to infants. We have a global commitment to market breast-milk substitutes responsibly.

This website is about the management of cows’ milk protein allergy and nutritional solutions intended for infants. By continuing on this website, you accept that Nestlé Health Science supplies the information at your own request.

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SMA® Althéra® will soon be the only extensively hydrolysed formula (eHF)*,† made using non-porcine enzymes to better meet the needs of Muslim and Jewish infants with cows' milk allergy (CMA)1-2


eHFs traditionally use porcine (pig) pancreatic enzymes to hydrolyse protein and many caregivers may not consider this to be suitable for their child due to religious or cultural reasons. Our new clinical trial recipe tested in the clinical trial will no longer use porcine enzymes and will instead use a microbial and plant‐derived enzyme blend.2

SMA® Althéra® - Clinical Trial Recipe SMA® Althéra® - Current Recipe Aptamil Pepti® Similac Alimentum® Nutramigen with LGG®
Made without porcine-enzymes1 x x x x


The new innovative recipe has been clinically tested and was proven to be equally as effective in-vivo and in-vitro as the current SMA® Althéra® formulation for the dietary management of cows’ milk allergy.2 In another clinical trial, SMA® Althéra® demonstrated similar efficacy to an amino acid formula (Neocate LCP®).3,‡ 


We anticipate the new recipe to be made available before March 2020. All patients prescribed SMA® Althéra® at this time will be transferred to this new recipe. Please note, whilst independent halal/kosher certification of the factory may take place later in 2020, the new recipe will not contraindicate halal, kosher or strict vegetarian diets.


Research on the suitability of eHFs revealed significant differences in peptide composition, residual allergen content and sometimes batch-to-batch inconsistencies between eHF brands. “These differences in peptide composition and residual allergen content impact on the clinical efficacy and risk of allergic reactions to eHF”.2 Learn more here.

In the new clinical trial, SMA® Althéra’s® peptide and protein composition has been published in full. You can read the full publication here.



Breastfeeding is best for babies. SMA® Althéra® and SMA® Alfamino® must only be used under strict medical supervision and after full consideration of the feeding options available, including breastfeeding. The advice of a doctor, midwife, health visitor, public health nurse, dietitian or pharmacist on the need for and proper method of use of infant milks and on all matters of infant feeding should be sought. Good maternal nutrition is important for the preparation and maintenance of breastfeeding. Introducing partial bottle-feeding may have a negative effect on breastfeeding and reversing a decision not to breastfeed is difficult. Social and financial implications should be considered when selecting a method of infant feeding. Infant milk should always be prepared and used as directed. Inappropriate foods or feeding methods, or improper use of infant formula, may present a health hazard.


1. Growth in infants with cow's milk protein allergy fed an amino acid-based formula. Yvan Vandenplas, Christophe Dupont, Philippe Eigenmann, Arne Høst, Mikael Kuitunen, Carmen Ribes-Koninkx, Neil Shah, Hania Szajewska, Andrea von Berg, Rajat Mukherjee, Ralf G. Heine, Zhengyan Zhao, on behalf of the Chinese Investigator Team. Abstract presented at the annual ESPGHAN congress, June 6. JPGN Volume 68, Supplement 1, May 2019.
2. Corkins M et al. Pediatrics 2016; 10: 3–9.
3. Nowak-Wegrzyn A et al. Clin Pediatr 2015; 54(3): 264–272.