Cow's milk allergy (CMA) is diagnosed in a 6-month-old infant. Which should the nurse recommend as a substitute formula?

A) Nutramigen
B) Goat's milk
C) Similac
D) Enfamil

Treatment of CMA is elimination of cow's milk-based formula and all other dairy products. For infants fed cow's milk formula, this primarily involves changing the formula to a casein hydrolysate milk formula (Pregestimil, Nutramigen, or Alimentum). Goat's milk (raw) is not an acceptable substitute because it cross-reacts with cow's milk protein, is deficient in folic acid, has a high sodium and protein content, and is unsuitable as the only source of calories. Cow's milk protein is contained in both Enfamil and Similac.