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SMA® Alfamino® FAQs

Who is SMA® Alfamino® designed for?

SMA® Alfamino®is an amino acid formula, ACBS approved for complete nutritional support from birth or supplementary feeding from 6 months and up to 3 years of age for the dietary management of severe CMA and/or multiple food protein allergies.

It is suitable for all infants with CMA however guidelines recommend it be reserved for those with severe CMA or more complex conditions only.
Is lactose intolerance similar to CMA?

SMA® Alfamino® does not contain lactose. However, lactose intolerance should not be confused with CMA. Lactose intolerance results from a decreased ability to digest and absorb lactose (the sugar present in human milk) due to a lack of the enzyme lactase. It is very rare in infants younger than 5 years,1 even in those with CMA.

What tin size is SMA® Alfamino® available in?

SMA® Alfamino® is a 400g re-sealable tin (PIP Code 385-6416)
It’s important to know that on some ordering systems Alfamino is listed as SMA Alfamino.

Does Alfamino® contain cows’ milk, soy or coconut?

SMA® Alfamino® does not contain any cows’ milk, soy or coconut.

What are the structured lipids within SMA® Alfamino®?

Their unique structure is designed to mimic the composition of human milk and is rare in standard vegetable oils typically used in other formulas. Studies show that infants fed a formula containing structured lipids* have improved bone density and calcium absorption, softer stools and reduced crying time – compared with standard infant formula5

Does Alfamino® meet the AAP hypoallergenicity criteria?

Yes. Alfamino® meets the APP hypoallergenicity criteria and can be recommended for the dietary management of CMA.6

What are the benefits of SMA® Alfamino®?

SMA® Alfamino® is an AAF for the effective dietary management of severe CMA:6–8

  • Meets the AAP hypoallergenicity criteria and shown to support severe/complex CMA symptoms6
  • SMA® Alfamino® has preferred taste vs Puramino® and Neocate LCP®9,10 which may help aid feeding acceptance and tolerance8‡
  • Contains added MCTs and has low osmolarity, to help support a compromised gut11–16
  • Supports normal growth and development7,8
  • A cost-effective AAF17,18§ to help support NHS budgets
What is CoMiss?

CoMiSS is a free, simple, fast and easy-to-use HCP awareness tool to aid with earlier diagnosis of CMA for non-IgE mediated (delayed) cows’ milk-related symptoms. A tutorial video and CoMiSS form can be downloaded or completed online at:

CoMiSS is not a diagnostic test for CMA. It does replace a food challenge and its usefulness will need to be evaluated by a prospective randomised study.



  1. Heyman MB et al. Pediatrics 2006; 118(3): 1279–86.
  2. Koletzko S et al. J Pediatr Gastroenterology Nut 2012; 55: 221–229.
  3. Francavilla R et al. Pediatr Allergy Immunol 2012; 23: 420–27.
  4. Martin C et al. Nutrients 2016; 8: 279.
  5. Luyt D et al. Clin Exp Allergy 2014; 44: 642–672.
  6. Nowak-Wegrzyn A et al. Clin Pediatr 2015; 54(3): 264–272.
  7. Corkins M et al. Medicine Insights: Pediatrics 2016; 10: 3–9.
  8. NHSc, Clinical audits and case studies. Data on file.
  9. Data on File, 2015. Alfamino® versus Puramino® competitve benchmarking test.
  10. Data on File, 2012. Alfamino® versus Neocate LCP® competitive benchmarking test.
  11. Methany N et al. Nursing Considerations 2010. 5th ed.
  12. Bach A & Babayan V. Am J Clin Nutr 1982; 36: 950–962.
  13. Blaauw R et al. S Afr J Clin Nutr 2011; 23(3): 125–127.
  14. Alfamino Data Card, NHSc. Updated January 2018.
  15. Shaw V & Lawson M. Clin Paediatr Dietetics 2007; 3rd ed. Oxford: Blackwell.
  16. Nutritional Information from product datacards: Puramino® and Neocate LCP®. August 2017.
  17. Data on file NHSc.
  18. MIMs, 2018. Available online at: (Accessed June 2019).

Footnotes and abbreviations:

*Palmitic acid is primarily located at the mid-position (SN-2) of the triglyceride.
† In the UK and suitable from birth.
‡ Independent, blind benchmark test.
§Versus leading competitors.
AAF, amino acid formula
ACBS, Advisory Committee on Borderline Substances
APP, American Academy of Pediatrics
CMA, cows’ milk allergy
MCTs, medium-chain triglycerides

What is the Careline number?
Call 0800 0 81 81 80 to speak to a product representative.

IMPORTANT NOTICE: Mothers should be encouraged to continue breastfeeding even when their babies have cows' milk protein allergy. This usually requires qualified dietary counselling to completely exclude all sources of cows' milk protein from the mothers’ diet. If a decision to use a special formula intended for infants is taken, it is important to follow the instructions on the label. Unboiled water, unboiled bottles or incorrect dilution can make babies ill. Incorrect storage, handling, preparation and feeding can eventually lead to adverse effects on the health of babies. Formula for special medical purposes intended for infants must be used under medical supervision.