Why Pediasure May Make Your Child’s Growth Impairment Worse

Posted by on Aug 31, 2014

glass of milk 2 jpgNeed more help than you’ve found in this post? Make an appointment to work with me here. I am not able to provide individualized care advice in this forum, but look forward to working with you. Thanks for stopping by!

Recently a parent was surprised to hear me mention that food allergies and sensitivities can create growth impairments in infants and children. Like many parents, this one had been told to turn to products like Pediasure to help his child gain and grow. But it wasn’t working.

I see this a lot in my practice. Undiagnosed and poorly managed food allergy, sensitivity, or food protein induced enterocolitis syndrome (FPIES) are probably the most common problems I encounter. But it still surprised me when a blog I posted on alternatives to Pediasure went viral. I realized that this means that Pediasure is possibly the top go-to for pediatricians nationwide, when they see an underweight child. And that is downright unfortunate.

As I explained in that Pediasure blog, if a child has a reaction to the proteins in Pediasure (milk and soy), then this product is going to do more harm than good. Besides weakening growth pattern, these reactions can cause diarrhea or constipation, rhinitis, dermatitis, or brochospasm. But, it’s routine for pediatricians to hand out Pediasure samples or coupons anyway, without checking if a protein intolerance, allergy, or other reaction is part of the problem.

If your child is experiencing symptoms described on this page, and especially a growth lag, it’s time for some lab work or professional guidance on an elimination trial. Inconvenient? Sure. But you might prevent months or even years of frustration as your child struggles with a withering growth or feeding pattern, frequent malaise, cognitive or developmental delays from low nutrition, or picky eating. This I have seen, all too often – and it’s all preventable.

Coincidentally, not long ago, I was contacted by Abbott Nutrition, the makers of Pediasure. They wondered if I would like to create webinars for them about autism and nutrition. I would have loved to, but I gently explained on the conference call that I rarely recommend dairy or soy protein sources for kids with autism, because our lab work-up usually shows these proteins to be reactive in these cases. So, no, I could not create webinars for fellow RDs or MDs that would keep this long-known piece of the autism puzzle out of the powerpoint.

That was sticky. So I threw the Abbott folks an olive branch by explaining that these kids can at times thrive with an amino acid based formula like Elecare, which Abbott also makes – and this is true. However, apparently, the Abbott people had somehow remained in the dark about all this for the last fifteen years. Needless to say, they later decided to “move the project in a different direction” – which I took to mean, find a dietitian who would help them sell Pediasure to families of kids with autism.

Hopefully that’s not you. There is so much more you can do, and do better. Solutions? If your child is already stuck in a growth or developmental rut, and showing diffuse signs like frequent colds or illnesses, fatigue, shiners at eyes, crabby or anxious affect, underweight, or funky stools, then it’s time to look for why this is happening. So far, in my fifteen years in practice, I’ve never met a kid who didn’t have a “why”. And we can usually find a solution.

Start with some thorough testing for reactions to foods. Here’s the rub: There are many kinds of reactions that the immune system or gut can contrive. If you’ve had basic allergy testing that was negative for your child, there’s probably more to the story. Here’s a strategy:

– If your child has IgE allergy symptoms like hives/vomiting/tingling of still unknown origin, complete a comprehensive IgE food antibody panel – go beyond the usual few foods tested (milk, wheat, corn, soy, peanut, egg). Great Plains Lab (GPL) and Genova Diagnostics (GDX) offer full panels, and I will request these for my patients where indicated.

– If your child does not have IgE allergy symptoms or positive results, but does have any of these: Bloating, reflux, mixed irritable stools, constipated stools, loose stools, anxiety, intermittent skin rashes, picky weak appetite, or trouble sleeping, then consider an ELISA IgG food antibody panel. GPL and GDX offer test panels to screen over 90 foods with one small blood sample. These reactions can appear often and independently of the IgE reactions, so testing both can be important.

– If you’ve done all this testing and still have no answers, consider a white blood cell antigen test with ALCAT labs. This is another option I offer in my practice. It examines yet another way that the immune system may react to a food protein, separate from antibody production. Looking at how white blood cells respond to food proteins is fraught with challenge because there can be false positives, but this test can uncover missing pieces in some cases.

– Even more detail can be scrutinized with IgG reactions to other compounds derived from food proteins in our bodies, and for cross sensitivity to our own tissue (autoimmune reactions exacerbated by food proteins) . Cyrex Labs offers these panels.

– If your child has firm or constipated stools, an extremely rigid appetite for wheat or dairy foods, and horrible behavior if he doesn’t get those foods, consider a gluten casein urine peptide test from GPL. This reaction to wheat and dairy protein is not immune-mediated. Instead, it assesses how completely the gut digests these proteins, and whether the gut wall is overly permissive in taking up poorly digested protein fragments (peptides) of gluten and casein. Not an allergy, but a reaction that can make your child miserable never the less. Peptide chains from these proteins mimic endorphins in the brain. This means they are addicting, and will not only create fierce rigidity in eating patterns, but will exert an opiate like effect on your child’s brain as well. Children with poor verbal or social skills, who have aphasia (no speech), or who have very delayed speech may be under the influence of these dietary opiates. Other features of dietary opiates are high pain tolerance, happy affect except when hungry (Jekyll/Hyde) or uncontrollable tantrums. Toddlers and young kids with an active opiate effect also tend to wake between midnight and three AM, when they may laugh, babble, want to play, or make noise, though may not be unhappy or crying for parents.

– If you already know that gluten is a problem, but aren’t sure what other grains are safe, several labs offer an array of tests to review this very question.

– If you’re still wondering if gluten is the problem, visit my blog on gluten free diets to learn about that testing.

There is no shortage of options for lab testing on food reactions. The trick is in picking the right ones based on your child’s history and presentation, and this is precisely what I do for my patients. Many of these tests are not in your pediatrician’s repertoire, or even your pediatric allergist’s repertoire (if they were, they would have offered them already). Once we have some results in hand, we interpret them in the context of your child, and can create a plan for what to eat.

Transitioning to new foods for a youngster isn’t as hard on them as it is on mom and dad. It means parents have to learn new shopping, cooking, and kitchen routines, and this can be disruptive at first. Balancing this with siblings is a challenge too. But for many families who have watched a child wilt into growth regression, weakness, developmental delays, or frequent infections, it’s worth it.

If Pediasure helped your child, fabulous. If it hasn’t worked in your family’s case, rest assured – there are many options, many answers. If you’d like help with your child’s feeding and growth, schedule an appointment – I look forward to hearing from you!


  1. Hi Judy,

    Please help!
    My 18 month old son has milk allergy and he is underweight.
    My pediatrician has recommended giving him 16 ounces of pediasure a day.
    I dont like giving him pediasure.
    Also he is a very very picky eater.
    Your help will be greatly appreciated.


    • Hi Sudha, If your son has a milk allergy, Pediasure is contraindicated, as it has both milk and soy protein in it. Have a look at the recipes in this blog for alternatives. If you’d like more guidance, let’s set up an appointment to get your son on his way to feeling and growing better! Pediasure will definitely not help him do that, if he has milk allergy and low weight.

  2. Gosh I wish I could just take you along to all my appointments for my twin girls. Delayed (working autism diagnosis for both), one never gains much weight and the other still won’t speak at 16 months. Reflux was terrible as infants. Tried every formula out there and now as toddlers they get enfagrow next step but the pedi just changed it to pediasure. Diarrhea and TERRIBLE rashes have ensued. I’m so lost. I want to try a new diet to see if it improves speech. They are in feeding/speech/occupational therapy with few results. I’m just exhausted.

    • I’m so sorry to hear this Jamie, it is exhausting for parents in this situation. It boggles my mind how little our pediatricians are trained to truly help these children with nutrition. Obviously the Pediasure is not working for your twins if diarrhea and rashes have ensued, and the solution is not to medicate those away with more drugs. I’d be happy to work with you, contact me if you like. Take a look at Special Needs Kids Eat Right book or Special Needs Kids Go Pharm Free. These can help you get started.

    • My 22 month old is 20 lbs. always been below 0% on the growth chart. And just recently got more picky about what he eats. He’s been to a GI doc and all she did was put him on medicine for a few months to gain weight. He’s also not talking. Hearing is good. He loves his milk. I’ve added ovaltine to it for added nutrition and just recently tried PediaSure. He’s had dierria since. I thought maybe a vial infection but now I think it’s the PediaSure. I don’t want him on medicine again and I don’t know what else to try

      • Cecilia, I’d suggest you download a copy of my e book on milk addicted kids. Pediasure and Ovaltine are milk source proteins, so, same problems will occur – stunted language, constipation, weak growth, poor appetite. Here’s the link: https://www.amazon.com/Milk-Addicted-Kids-Brain-Dairy-ebook/dp/B01IIUZ7R4 Download that and get started today with how to turn this around. If you need more guidance, I’m happy to work with you, just set up an appointment on line anytime and we can work via phone, Skype, or in person.

  3. My daughter(18 months old) is on Elecare Jr(vanilla flavored). I’m wondering if there are any health risks associated with the use of this formula. She is allergic to milk, soy, and peanuts. Those allergies were confirmed with skin testing but almond, tomato, avocado, and beef were either missed or are not ige allergies. She also has reflux and some aversions/pickiness to food. Thank you!

    • Elecare is an elemental formula with a protein source that is not actually whole protein from any food – it’s an assemblage of amino acids that are absorbed without needing any digestive breakdown. That is a big help for kids like your daughter, whose guts react to several proteins. I do use these formulas in some circumstances in my practice, and used judiciously, they can be healing and effective. Caveats: The carbohydrate source is genetically modified corn, which harms beneficial bacteria in the gut, and may have other negative health effects (EU countries do not allow GMO ingredients in baby foods). This is a problem because beneficial gut bacteria help repair the gut wall so inflammatory reactions from food proteins can self-correct. Elemental formulas tend to shift gut bacteria away from the healthy strains that do this, and that help digest and absorb food. Using a good multi-strain probiotic while on Elecare is important for my patients. Meanwhile your daughter may have active IgG food sensitivities (non-allergy reactions but inflammatory nevertheless) that worsen reflux and pickiness. Without knowing what these are, it may be slower for her to progress.

  4. Hello,
    My main concern here is my 5 year old. He’s very active, yet doesn’t like to eat Much
    I have not turned to pediasure due to all the bad reviews about it. I doc whatsoever give them flinstones vitamins with iron it works great on my 4 year old he’s gained a good few lbs. My oldest is still the one struggling to eat! If you can give me or recommend me something he can use I need him to grow and gain some weight as well. I would greatly appreciate it!

    • Hi Gabriela, unfortunately I can’t make specific nutrition care recommendations in this forum – your best bet is to make an appointment with me. Usually there are underlying reasons why appetites in kids get stalled. These need professional assessment and intervention that’s individualized to your kid. In the meantime, peruse other blog posts here on picky eating and recipe ideas; you can also pick up my books for even deeper strategizing.

  5. Hello.
    I’m concerned with my 33 months old daughters weight gain and bowel movements which for the past few months have be en every 2 to 3 days. She’s otherwise very active . I give her pediasure once a day. She has a history of skin allergies and allergic bronchial asthma till she was two. Doctors said it is the kuwait weather Now she gets periodic colds which I’m quick to act as I’m worried she might suffer from chest congestion immediately. She’s not a fan of milk. Please help.

    • Hi Julia, if no one has checked IgG and IgE reactions to milk and soy proteins for your daughter (Pediasure has both) then this is something to consider screening. Obviously if your doctors thought this was important they probably would have done it already, but I find this simple solution is often overlooked. These reactions can be the cause of skin and bronchial irritations, or may underlie the frequent colds. Both proteins can also be constipating for some kids. Once you know what the triggers are, you can build a better diet from there. As always, I am available for phone or Skype consults – happy to help if you like.

  6. Hi my 10 months old daughter weighs approximately 16 lbs, and she’s 89th percentile in height. She’s underweight. She throws up a lot on and off especially when she was younger. Although doc says maybe she’s too full. I really want her to grow chubbier before her 1st birthday in January 2016. She takes cereal, fruits, Similac spit up and the normal one too, she likes yogurt too,blended with blue berry and whole grains.
    What can I do?

    Worried Mom


    • My first suspect here is milk protein intolerance. If so, then both her formula and any yogurt, cheese, or other dairy foods will disrupt her growth and gain. Soy based formula is not a great option for several reasons, so I wouldn’t jump to that. To really get her nourished and replenished without triggering more of the same poor growth pattern, vomiting, and so on, I can help you if you make an appointment – can’t do that over the web on my blog, but an appointment or two would probably clear this up. I look forward to hearing from you!

  7. Hi Judy,

    My daughter is 3yrs old. She is on enfagrow 3 times a day. She gags at the sight of food and gags during eating. She used to projectile vomit her food n milk but she has gotten over the vomiting stage . But her appetite is very bad? Having said that, she is chubby . Do u think I should change into another brand of milk? Feeding her is a chore now:(

    • This is another milk protein based formula with GMO sources for corn and dairy. There is no reason to give her this artificial formula instead of real food – plus, the symptoms of gagging and vomiting history indicate a milk protein intolerance. Transitioning will take some time and probably will necessitate some targeted support (supplements, herbs, probiotics) for her digestion and gut health. Let’s talk soon if you’d like help with this, you can contact me here to set up an appointment.

  8. My son is 30 months old has been on Pediasure for a couple months now and now has been throwing up the past couple days after drinking it and acting normal during the day with diarrhea . From 1 years old he would have really bad diaper rash after drinking cows 2% and 1% milk but not with Whole milk. My doctor thought I was weird for thinking this but once he was strictly on whole milk he seemed to be fine. He has been little his whole life weighing 20 lbs now at 30months. He has not been gaining weight on the Pediasure, he has been intaking 3 bottles a day. Should I be pushing for some tests to be done? Don’t know if its relevant, also he has a younger brother 18 months at 17 lbs, that was throwing up with any dairy and is on Elecare Jr vanilla, thinking he has a milk protein allergy (never tested) and tested for having gastric slow to emptying and now has a G tube to hope it will fix it and he will gain weight. His older sister is little as well at 5th percentile now as well and had the same problem with pediasure as her brother and so we took her off it and she can only handle a little milk at a time with other foods or she throws up and/or gets stomach aches. Am I crazy for thinking they all have some common denominator of a allergy?

    • The only crazy I see here is with your GI doc! I’m sorry to hear this was permitted by any doctor to go so far as to result in a G tube, underweight, vomiting, and growth concerns sprinkled across all three kids. I agree with you that there is probably milk protein intolerance or allergy afoot here. Pediasure is milk and soy based. If your son has not gained on this after two months then it’s time for a new strategy. You can try Elecare for him too, and/or you can use several alternate proteins in other foods and blended drinks. Elecare does shift gut bacteria away from what is most healthy, while food will support healthier bacteria and thus better digestion and better immune function. Check my blog on Pediasure alternatives for ideas.

      • Thank-you for responding to me. It was been a rough battle with all my kids and their eating and I feel like I have not gotten any answers. At the children hospital in CO springs they pushed the G tube on us as the only way to help my 17moth old with his stomach slow to emptying, after staying at the hospital for 3 weeks trying to figure him out, but so far he has not been tolerating his feedings and been throwing up and hasn’t really gained any weight at home. It’s just been super frustrating. Then I found your site.Hoping maybe I could find some answers for all 3 of my kids. If you think you might be able to help us then I could try and afford set up an appointment, right now we are on Medicaid.

  9. My son was born 9 weeks premature (3lbs 12 oz). He was started on Simulac Neosure for extra calories, but had a hard time with constipation and spit up. He was then put on Simulac total comfort. He did well on the for a couple of weeks but then went back to the constant spitting up. My husband and I decided to go to the extreme and just go to the Alumentum. My son did great on that and stayed on it till he was 18 months or so. At that point we put him on the Grow and Go. He has done well on that too. He still has issues with constipation and hard stools. He was on Miralax since he was born till he turned 2. He was also on Prilosec from 12-24 months.
    He is now 28 months he is about 23.5 lbs and around 24″ tall. We tried giving him whole milk a few times and he would throw it up with in 15 min of drinking it. The docs say he is small and should be put on pediasure with prebiotic fiber. I feel like my son has some sort of allergy, but he is fine drinking his grow and go (milk based) and is fine eating yogurt and cheese. He also loves his ranch dressing. He just seems off and I don’t if I am seeing something that isn’t there.

    • What you describe is a classic scenario in my practice. These stories just make my head spin, because I wonder how our medical providers do this to kids but don’t notice that it isn’t working! Your son has had clear signs of milk protein intolernace/allergy from birth. Milk protein should have been withdrawn and replaced entirely at that time – there are elemental formulas available that may have worked nicely, or he may even have done well on pumped breast milk, or a goat milk infant formula. Instead, your son has been given milk protein or hydrolyzed milk protein formulas, and managed with Miralax and reflux medicine, to mask the symptoms of the milk protein’s effects on his gut. Meanwhile his gut has continued to sustain damage. This is the inexplicable, unfortunate, ineffective, and unnecessary standard of care in the US pediatrics today. Both drugs are detrimental to digestion and absorption, and neither are FDA approved for long term use in adults, much less infants. The good news is this is reversible – but it takes work and time. You have over two years of mismanaged care to reverse, so be patient. Though he is small due to his early start, he can probably grow and eat better. This won’t happen until he stops using dairy proteins entirely, even partly digested ones (as is the case with Alimentum). Though these are foods he is used to and may like, they need to go. He needs measures to withdraw the reflux medicine and Miralax, restore normal digestion and elimination (pooping), and needs careful replenishment and monitoring throughout this process, which usually takes several weeks. Once kids are on the other side of this, they eat better, accept more foods, and grow. Call for appointment if you would like help, or pick up a copy of my book Special Needs Kids Eat Right for some DIY. Your care team won’t like this, so be prepared for push back. If they had other skills or tools, they would have offered them by now. They don’t.

  10. Hello I have A 3 year old daughter That eats alot but also have to feed her my self at times because she wont eat on her own.She is very very active.I took her to a doctor appt.back in 8/2015 and was at 26 lbs.Took her to the Wic Office yesterday 01/27/16 And Did not gain a pound.I have always delt with her having a hard time for her to gain weight.So yesterday I started her on Pediasure grow/gain.Iam really worried.Need your help.Thank You

    • Hi Zayda, WIC has nutritionists on staff who can troubleshoot this for you. Request a visit specifically to review your daughter’s eating patterns. They may ask you to show what she typically eats in a day. She may do fine without Pediasure, if there is a way to up her intake of regular food. If you have time to do some cooking and have kitchen access, this isn’t hard to do, and the WIC staff are there to guide on exactly this kind of scenario. Here are some ideas on alternates to Pediasure in the meantime. They can also tell if she really needs the Pediasure or not.

  11. Hi! I have a 2.5 year old daughter who is experiencing constipation, GERD, picky eating, poor appetite, and underweight. She also has developmental delays (speech, occupational, physical). She has taken miralax, Prevacid, and Culturelle probiotics. It helped for a little while but now she is back to being constipated and vomiting about 1-2 times per month. She also has intermittent skin rashes and had eczema as an infant. She has had an upper GI, ultrasound, and EGD done. The only results that came from those tests were that she definitely has acid reflux. Her favorite food groups are grains and fruit. I have a background in nutrition so I believe in the healing power nutrition. Can u offer me any advice on what steps I should take to help her heal? Should i still try an elimination diet even though the EGD didn’t show any allergies. She hasn’t had a skin or blood allergy test. We recently moved from AR to IL so I’m currently trying to get her in to see a new pediatrician. I’m not sure if she is into integrative medicine so how would you suggest I approach her about getting the Igg Ige tests done? Any help you can offer will be greatly appreciated. Thanks, Jay.

    • This is a typical story in my practice, that you’ve been everywhere and done everything that non-integrative care offers and your child is still not growing, not thriving, and dependent on prescription drugs. Pediatricians in my experience don’t offer IgG food antibody testing, unless you’ve found an out-of-network, functional nutrition doctor who offers this a self pay option. Some mainstream peds may do initial IgE testing too, or may refer you to an allergist MD for this; in this case, it could be covered for you. Either way, unfortunately, you’ve described an entrenched pattern that needs a new functional strategy beyond just food reactions (which do need assessing as you suspect) that you’re not likely to find with mainstream pediatric care. I can absolutely offer advice on next steps, and invite you to schedule a time so I can do that. I offer Skype and phone consults, so you don’t have to travel here to receive help.

  12. Hi Judy, I wish I would have read this over a year ago. My daughter was born at 24wks and is now 3 yrs old and only 24lbs 3oz. She’s been vomiting daily as soon as I transitioned from breastmilk to pediasure. I pumped for 18 months. She has reflux and the meds seemed to help off and on. Recently in the past month she has been throwing up at least once daily and it’s not just a little spit up. It’s full on vomiting. She throws up at the taste of anything with sugar and has an exceptional palette however only eats a few bites of anything therefor need to rely on pediasure for the mere 900 calories she gets a day. On a good day she will eat an egg for breakfast then maybe a cracker or couple olives at lunch and maybe a half an avocado for dinner. She loves Greek yogurt and even asks to take her fish oil drops. She is a interesting toddler;)
    Anyway, any information would be extremely helpful. I cry lots and lots over stress and frustration especially now that she can make herself throw up whenever she doesn’t get her way or is upset. She barely has any hair and I can see all of her spine and rib cage. She is healthy though with no brain bleeds, cardiology problems, and good vision. She is also pretty smart for where she came from. Endocrine wants to start her on growth hormones and she has an ENT apt next week to determine if there is scarring from being intubated for so long. She was in the hospital for 5 months after birth and came home on oxygen for another 6 months.

    Thank you! Thank you!

    • Hi Tanya, my goodness, your daughter does sound malnourished, and there are solutions. Growth hormone injections won’t fabricate the building blocks that only food can give. Growth hormone is sort of like a software code for growth; it’s not the hardware, it’s not the material needed to build a body up. Giving these injections in a malnourished child is like throwing a blueprint on the ground and expecting the building to appear, without delivering any of the bricks, beams, or nails! That part is the food. I have met many kids offered growth hormone injections when they simply needed the right food and corrections to digestion/absorption so they can use it. With your daughter being born so early, her gut biome never developed normally, and the signs you mention (vomiting, reflux, poor gain, poor appetite) are classic signs that this is still needing restoration. I do this in practice often, let’s get to work if you are both ready! Contact me for an appointment anytime.

  13. Hi, my son is 15 months and is barely 20 pounds. At first the doc pescribed toddler formula when he was 12 months and in that time frame he has gain a pound. At his 15 month check up a different doctor took him off of the formula and pescribed pediasure. My son is a very picky eater some days he only eats one meal and refuses to eat other meals. OK so he doesn’t like drinking the pediasure so I mix it with the formula I still have left and I also mix it with his oatmeal. Every time he drinks or eat anything with the pediasure in it he immediately poops. He is not going to gain if he is constantly pooping. I could really use your advice. Thanks

    • I’m not able to deliver the support you may need in this forum, but am happy to help – check my calendar here to set up an appointment anytime.

  14. Hi. My son is 21 months. He’s autistic and put on a gluten free and dairy free diet by his doctor. I’m still giving him milk based formula. One to three bottles a night. Would this be bad for his diet?

    • Umm…. Your doctor maybe didn’t give you enough instruction or support? Your son is not on a diary free diet if he is eating milk based formula. If it is true that removing gluten and dairy are indicated in your son’s case, then he needs to lose that formula, and replace it with foods or formula of equal or better nutritional value. There are elemental formulas available that contain no gluten, dairy or soy protein but are nutritionally adequate for toddlers. A proper nutrition assessment would reveal if he needs formula at all, or if he can just work with foods (always preferable if possible). 21 months is on the young end for receiving an autism diagnosis, and it is definitely young enough for his trajectory to change for the better, if you intervene correctly. Save yourself months of mistakes and please pick up a copy of this book: Special Needs Kids Eat Right – Strategies To Help Kids On The Autism Spectrum Focus, Learn, and Thrive. This book details, step by step, how to use special diets for kids with autism features.

  15. Hi Judy
    My son is 20 months old and doc suggested to use Enfagrow since 18 months.. What I noticed is hard stools and difficulty in passing stools.. He has also not gained much weight since his 9th month and prone to cold n illness often. Should I stop using Enfagrow and switch to any other health drink, please suggest?

    • Let your doctor know that your son is not growing or gaining as expected, and has problems passing stools. Ask for a new plan. If none is offered, I am happy to help – but can’t advise on specific changes to your son’s care in this forum. If you like, click here to set up an appointment.

  16. Hi.my son 22 months old was failing to thrive at 12 months old.he has had several blood samples taken to test for allergies.it was positive for milk,nuts,soy,egg white.he had complications with his chest and eczema.due to this he was placed on pediasure.it initially helped and he gained weight but has a delay with his speech.also I have noticed that he wakes up often during the night crying or calling out for me.my instinct is telling me it might be the formula.even though the effects of sleepless nights and foul,very soft stools weren’t noticeable at first, he might have an intolerance to it now.I decided to not give him the bottle he has before sleep and coincidentally he slept through the night.I am very concerned as not giving him the correct diet could be causing him more bad than good.I am at a loss but starting to think that a plan of action is required and if it means stopping all formula then i will do so.please can you offer me any guidance?I was told to continue him on pediasure.

    • Your instinct is right: It’s the formula. If your son tested positive to allergy from milk and soy, then he should never have been placed on Pediasure. The protein sources in this are milk and soy. A better choice would have been elemental formula like Elecare or Neocate. These can trigger problems of their own but would still have been the better choice, based on what you’ve shared here. I can best help you with an appointment, please feel free to schedule anytime by following prompts to my calendar here.

  17. Hi..my son is 13 months old,.he is constipated he is hard to get passing stools..3-4 days before he can have bowel movement and i use laxative.. I try promil,hipp,nan,friso,enfa pedia recommended and now nido but still he has a problem passing stools..i hope u can help me.. What should i do..


  18. Hi Judy, I need a help with this situation. My son is 14months old and he doesn’t eat any solid food. He’s been refusing to eat ever since I introduce him solid food which was at 6month. He has eczema and MSPI. He started Neocate infant when he was 3months old and he’s been doing great with it. He started having acid reflux around 3month so he was on medication until he was 8months old. I recently switched his formula to Neocate jr. Unflavored and he loved it. But it was too expensive because he finishes up a can a day. So he went to see his GI Doctor yesterday and she told me to give him pediasure because his growing is well (70 percentile for both weight and height; it’s all because of Neocate) So I gave him pediasure yesterday and he woke up with eczema looking rash all over his back this morning. He has mucous in his stool as well now. What does this mean and what should I do? Thanks in advance.

    • It means your son is still milk protein intolerant and needs the Neocate. Your GI doctor can write a prescription for Neocate as well as a letter for medical necessity. Ask her to do that for you.

  19. Hi judy, My son is 23 months old, he is very active, playful, lovable and caring son. He used to say ma ma, pa pa, calling his grand parents, and do play hide and seek, stacking colors towers, reading playcards, animals, birds, vegatables etc. He used to see newspaper every morning with my dad and babble something after seeing pics in that. He will call me and walk through to dining table and ask snacks, water or some other toys in his play area. He used to sign me and ask what he need. He will sing and dance to songs and rhymes. He will say bye, welcoming persons with hands.So i’m still worried he is not speaking properly at this age. Whay should care for him to speak properly. My husband is saying if a baby is delaying to speak he will be very intellectual like Einstein. Tell me a solution judy please.

    • Are you saying your son had skills, then lost them? This is an ominous sign. Kids do evolve at varying paces but when a child has had a skill set which then vanishes, I do think this is cause for concern. There is no need to wait and see or worry – Go to a developmental pediatrician and get an evaluation, and be sure to describe all skills previously present that have faded. In any case, if nutrition, feeding or GI features are prominent, that is my purview. Make an appointment if you want to have an assessment for those pieces, so I can assist in creating strong support for brain and body development for your toddler.

      • Hi Judy, my toddler showing different actions everyday for example he used to keep two pencils in each hand and beat on the table as if a drummer. And next day he will climb and sit on the dinning table or climb nearly 40 steps to reach 2nd floor of my home. He is active in nature, playing differently. But my concern is he is still babble like mama, papa,bye.
        How do i improve his speaking skills? Should i consult any speech therapist? he can able to hear my voice and find me even if i hide somewhere else in my home. He will sing with some words and babble a lot .But I’m worried whether he will speak properly or not?

        • Ask your pediatrician for a referral to a developmental pediatrician. That person will be able to tell you if you toddler is tracking typically or if you ought to consider any interventions.

  20. Hi. I was just doing research on pedisure peptide and allergies. My 4 year old special needs son is currently on it. We are battling with his gi doc. He was recently diagnosed with e.o.e. but i was pretty much called a lier in terms. He said that there is no way he can be allergic to pedisure peptide. And that i wasnt giving him his antacid pills regularly. He only ever eats his pedisure and he gets his meds religiously. Can he still be allergic to the pedisure peptide? Im at a loss and dont know how ro push. He has had 2 scopes and all show the e.o.e. is not getting better. Thank you! I can provide more info if needed.

    • LOL! Of course he can be reactive to Pediasure. It contains soy and dairy protein and is not a hypoallergenic formula. Perhaps your GI doc has not read the ingredient label. Pepdite is a safer choice as it is made from hydrolyzed (partly broken down) soy protein, and contains no dairy protein. Some children with extreme soy sensitivity still react to this as well. The EOE is probably not improving because he may need elemental formula instead (Neocate or Elecare). Other measures should be offered to restore a healthy gut environment but many GI docs don’t work with these: Glutathione, pre-biotics, probiotics, correct diet, butyrate, vitamin D, and more. If you want help engaging all the good stuff, plus elemental formula (which I often work with), set up an appointment and we can dive in.

  21. Hello Judy,
    My son has had problems with reflux, vomiting, eating since he was a baby. He is prone to illnesses and seems to me has a weak immune system because of how frequently he gets sick. He has tubes in his ears due to too many ear infections, which he got when he was about 2 years old, he is now about to be 3 in two weeks. Sometimes he goes days in a row without eating much. He’s always had separation anxiety and at times was worse. He acts out a lot too but I feel that it may be because of his age. My main concern is his weight. He is in the 30th percentile for his weight, I keep asking his Pediatrician for help but she keeps saying he’s okay because he is just a little underweight. I can see his shoulder bones, spine, and ribs. I don’t think that is normal. Also one more thing, he vomits after drinking milk it happens almost every other day or every 2 to 3 days. He especially vomits after drinking PediaSure, which is how I got to this forum. He also gets a hoarse cough after drinking PediaSure too. Couple weeks ago when he was sick, he developed Croup overnight. As a baby, I had changed his formula multiple times and ended up at Nutramingen then tried cow’s milk after he turned 1 year old as the doctor said he should be fine. I thought he was okay so I never really bothered trying to change it, besides I was pregnant and had my daughter right before his 1st birthday. Do you think he might be lactose intolerant or has a milk allergy? Please help. Thank you.

    • What you’re describing is certainly common, but it isn’t normal and definitely not healthy. If your pediatrician is under 40 or 45 years old, then she may be confusing “common” with “normal”. Not the same, and pediatricians of yore did not see this as often as the younger ones do now. I can help you but not in this forum. You do need to be my client in order for me to advise, ethically and legally. Click the appointment tab on my website and place yourself on the calendar. It will auto reply with information about your first appointment, and we can get started.

  22. Hello Judy,

    My son is diagnosed FPIES To soy, dairy and oats. We are using elecare.

    He was born at the 58th percentile for height and now at 1 he is in the 2nd percentile.

    After discovering FPIES and switching from alimentum to elecare he’s gained weight very well (from 2nd to 18th) but his height is now an issue.

    Do you know anything about this? I’m concerned of course! He’s also receiving speech and feeding therapy services for food aversion, but despite not eating much he should have completely nutrition from the elecare correct?

    Please advise if you can based on this limited info.


    • Hi Jessica, if he’s gaining weight but not length then he is not getting and/or absorbing enough total protein. Yes Elecare is a “complete” medical food but without more info about his total intake and medical history I can’t offer much help. Also: What I find in my practice is that FPIES is about more than just protein intolerance. There is much more to the story, and the GI community has some catching up to do on this – it’s emerging in the literature but not fast enough in practice. There’s much more to do than feed him Elecare and hope it all resolves. See this blog post if you haven’t already. His food aversions should be resolving, and if they are not, there are solutions to this as well. I’m happy to help – schedule an appointment if that seems right for you.

  23. Hi Judy, My son is 3 years and 10 months. he weights just 26 lbs. he was born with weight of 9.259 lbs.
    He was diagnosed with
    1) Gluten and egg allergies by allergy specialist 2 years back. Six months back he had food challenge test for egg and doc suggested to offer him egg indirectly. I.e in the form of baked items like breads, cakes, that to not use more 2 eggs. Still avoiding gluten and wheat from his diet. Unfortunately, he developed with eczema. Not sure why this triggers occasionally.

    2) He fall sick every 15 days once with colds, stuffy nose, chest congestion, wheezing and fevers.
    Now he is on alburtol and besusonide for wheezing.

    3)  He is picky eater, never eats properly.
    sometimes he develops constipation.  Unfornately he was diagnosed with adenoids by his ENT specialist.
    Recently started giving him pediasure grow and gain with fiber. He started to gaining weight bout much worried about his immunity and frequent chest congestion, colds and nasal congestion.

    How to improve his immunity?
    How to avoid constipation as he is not on wheat diet.
    How to prevent wheezing , Chest congestion.
    Do I need to modify his diet, if so how?
    please help me as I’m getting depressed .
    Thanks in advance.

    • Your son clearly had unresolved nutrition concerns despite all the specialist visits. Pediasure is likely a non-starter for him with the symptoms you are describing, but there are likely other underlying issues as well. Obviously I can’t dispense detailed medical nutrition advice here, but am happy to help you reverse these problems if you are ready to work on that – make an appointment anytime and we can dive in.

  24. Hi Judy,

    My daughter was induced at 38 weeks due to concerns with her growth. She weighed 5 lbs 12 oz. Since birth she has struggled with eating. I tried breastfeeding, but her latch was poor and she wasn’t consuming enough. So I started pumping and giving her bottles. She still didn’t eat enough. During this time she had a bout of really bad bowel movements that were bright green, frothy and mucousy. I was told by my doctor to remove all dairy and soy from my diet. However I hadn’t eaten any dairy products for years and consumed very little soy, so I knew this was likely not the problem. My daughter’s weight was under the 1st percentile for a few months. Eventually we had to supplement with formula to try and get more calories in her. It seemed to make no difference to her what kind of milk was in the bottles, she did not want it. She did spit-up frequently, but I don’t think it was anything out of the ordinary. We were referred to a feeding team of a dietitian and OT where we were advised to increase the formula concentration to 26 kcal. This did help her to gain some weight, but she would only take bottles in a sleepy state. As she got older, she was no longer as sleepy, so we had to distract her with toys and videos in order for her to take her bottles. She is now 11.5 months old and in the 3rd percentile. She is not overly interested in solids either. We have just recently tried Pediasure and she seems to be more interested in it than any other type of milk we’ve offered, but I am not overly keen on it because of the dairy and sugar, but it seems to be something she’ll willingly take and has a high calorie content. To this day I am still baffled (and frustrated) as to why she has not been interested in eating. I am wondering if you may have any insight. Thanks.

    • Yes I would have insights for you, and these would become obvious in an assessment. Triggers for your daughters’ struggles may have included poor tolerance of vaccinations; any history for you for autoimmunity or chronic infections including yeast infections; antibiotic exposures for you in pregnancy, delivery, or lactation, or for her directly. I also observe that mothers vaccinated while pregnant bear babies with more GI disruption from birth, though I know this is quite an unpopular opinion to share. As for what is happening now, where she strongly prefers Pediasure, this is consistent with being addicted, literally, to the dairy and soy proteins in the Pediasure (see this e book) and to the sugar in it. These are fierce addictions that keep kids refusing other foods, and keep them in weak growth patterns for years, unless they are directly corrected with functional gut biome restoration and nutrition support. What typically follows here, when parents stick to Pediasure, is referral to a feeding clinic (behavior based) to break the rigid dependence on Pediasure; this requires months of weekly or twice weekly visits, and triggers snails’ pace improvements if any. Or, you can cut to the chase and restore normal appetite, digestion, stooling, and growth with functional nutrition intervention. This can begin to turn things around with 2-3 nutrition consults and 4-8 weeks time. Much faster, and cheaper.

  25. I hope you can help me, my daughter is 3 and she completely stopped eating food and drinking juice or water a few months ago. My pediatrician said its normal and to give her pediasure. All she consumes is two bottles a day of pediasure and whole milk. She usually poops little brown or black balls but today and yesterday her poop was a very very bright green my grandparents and I have never seen anything like it. Mind you I have no crayons in my home and she does not eat candy or drink anything with a dye in it. I’m very worried for my child do you think her poop turned green due to bile?? If so how can I get her to eat

    • I agree that this does not sound healthful, comfortable, or sustaining for a three year old. I can best help if you would like to make an appointment, visit NutritionCare.net and click Your Appointment.

  26. My child is 11 months old she started vomiting when she was 6 weeks old ,she’s drinking formula ,I have tried many formulas but the doctor told me that she has a little bit of acid reflux,she doesn’t want to eat at all but I’m forcing her to eat she is weighing 14kg the doctor told me that I must give her pediasure ,please help frustrated mother from 6 weeks until noe

    • Your doctor should find the cause of the vomiting and food averse behavior and fix it. This can be infection in the upper small intestine or elsewhere in GI tract. I screen for these issues in my practice and your doctor can too. You can schedule an appointment to work with me on this if you like at any time.

  27. Hi Judy,
    I hope you can help me too. I have a 4yo son,underweight, a g6pd.
    Is Pediasure not good for him since he has g6pd?

    • I can’t advise on what is best regarding G6PD for your son, but there is nothing magical about Pediasure that addresses G6PD issues.

  28. Hi judy,
    I was wondering if you also accept care credit as form of payment.

  29. Hi Maren, yes, you can find all this info on my site here http://nutritioncare.net/make-your-appointment/

  30. My son has had a gut issue since birth. Transplant of pancreas, liver, and bowel. Last 4 months he has not been able to keep food down for more than a week. His MD recommended pediasure and since then he has vomitted this up and cannot tolerate it. But the same foods he has always ate irritate his bowel now too. I’m not sure what to do. I ordered the IGG and amino acid kit. Am I on the right track?

  31. Hi Judy
    My daughter Hannah is 1 yr old and she has trisomy 18. Shes been doing real good she weighs 17 pounds n is a very happy baby. The doctor orderd pediasure for her to drink well she has a feeding tube so she gets her nutrients through there..Is pediasure good for my daughter meaning will that full her tummy but most importantely give her the nutrients she need to thrive

    • Hi Patrice, that’s great your daughter is happy. I don’t know what your doctor based the formula recommendation on, as there are several options. Pediasure can fill her tummy (you can fill a tummy with anything)! Your clues that it is the right choice will be reflected in her growth pattern, her appetite, whether her skin is clear, and her stool pattern.

  32. Hi, just finished reading this article and I found facinating all the information you explain here. My son is almost 4 years old and has speech delay, as a baby he used to vomit after every feeding and the pediatricitian told me was acid reflux. He used to poop regualry when he was exclusive breastfeed but since he was 1. Years old , he pooped every other day or every two days. He is now a really picky eater and loves milk and crackers. He has a lot of the behavior you describe on the gluten casein urine peptide test. I will request that test on my next visit to his pediatrician. In the mean time , what should I do ? What kind of diet should a follow ?

    • Hi Lis, your doctor won’t know about this test as it is not a routine test. If you’d like more info on this test click here. I can request this test for you. If you need individualized diet advice for your son, I don’t offer that in this forum, but do provide that in my practice – you can schedule an appointment any time from this link. If you don’t want an individualized care plan, try starting with instructions in either this book or this one.

  33. Hi Judy,my LO is 2.5 years old .As she turned 2 her paediatrician recommended her to have PEDIASURE as she is just 23.14 pounds which is very low (underweight) for her age. Also, she is under height as well. But now after having PEDIASURE once a day with three scoops, she ends up having really bad constipation and for that every alternate month i am giving her stool softener as the poop got stuck and it was a really painful site for me as a mother. Please suggest what else i can give her for appropriate height and weight at her agE? as i am no longer giving her PEDIASURE.

    • I wouldn’t know what to recommend without working with you in more detail: What is her growth pattern since birth? Why isn’t she eating enough to maintain her growth in the first place? How much weight does she need to gain to resume her expected trajectory? What other foods and proteins does she eat? Does she have a dysbiotic gut, does that need correcting too? Has she ever been screened for food allergy or sensitivity? There are many options besides Pediasure, but picking the right one warrants some investigation. If your pediatrician doesn’t know how to do that, contact me and we can get started anytime.

  34. My grandson is a healthy 5 yr. old, active and slim. His other grandma is from the old European school in which they have to be chubby in order to be healthy. But he is a picky eater and so she has been giving him Pediasure daily as she has him after school for a few hours. He does not like it but she makes him drink it. We have all tried to tell her not to give it to him but she will not stop so now my son is considering looking for other care for him, which will cost a lot..my grandson is hyper all evening after being with her, gets to sleep late and is tired in school.. What can you suggest we tell her to convince her to stop?

    • Tell her your grandson is hyper and unable to fall asleep when he drinks it, and send him there with an alternative or recipe to mix up a healthier option.

  35. Judy, great, thought provoking article.

    My question is pretty much: What are the impacts of food allergies/sensitivities on Poop and Sleep!

    I just started my 2.5 year old son on Pediasure. He’s only taking half the bottle once or twice a day. (A week in, I fear the posts saying their kids started chronic vomiting at about week 3)

    He’s only slightly below average for height and weight, but average is small in a family of giants (his twin sister has a solid 2 inches on him).

    My issue is that he DOES NOT SLEEP! Could this be attributed to food allergies/sensitivities?

    It takes him hours to fall asleep, and he’s up throughout the night (averages 4-5 sporadic hours). Even at 2am his mood is cheerful and playful (mine is not!). He is a very active and silly/mischievous kid, doesn’t eat much (about half of what my kids typically eat, and they EAT!). Also, he prefers milk to juice, which I like, but he only get 2-3 cups a day. I now wonder if he has a milk allergy. Can he both love/tolerate and be allergic to milk?

    I don’t know if it’s a related symptom, but his BMs are VERY loose/mushy. He hasn’t had a really solid BM in months, maybe years (I don’t really document). I will say his BM this morning was certainly the most solid I’ve seen it, so maybe Pediasure is good for him?

    A sleep study last year determined his sleep patterns to be behavior (unlike my 8 year old who at 4yr had his tonsils and adenoids removed and WAS on the Autistic Spectrum, now ADHD with Anxiety).

    I have 5 kids, 8, 4, 2, 2, 10mo. They all eat the same and he’s the only one with issues – poop and sleep!

    Thanks for your insight.


    • Hi Meghan, you got issues! Yes of course allergy, sensitivity and many other nutrition related factors impact sleep. A sleep study does not look at ANY of those things whatsoever, so telling you it’s a “behavior” is a cop out. Sleep specialists aren’t tasked with assessing nutrition factors whatsoever, so they have no idea how this may factor in. But – you mention several clues: Chronic loose stool for years, history of infections and inflammation necessitating tonsils be removed, insomnia, and he’s inexplicably smaller than his siblings. There’s clearly something different going on for this one of your brood. It’s easy to find out. You can set up an appointment with me to investigate, or start with this book to sort it out.

  36. hi good afternoon i am atik i like to know my son 5 y his w 20 k last year he was also 20 k but now he is become slim i can give him Pediasure he had NAN 4 i can continue nan 4 or better to given him pediasure please help me what will be good for him (For growth)


    • Hello Atik, I don’t know if your son can succeed with those formulas. Best to check with your GI and pediatrician on this. If they are unable to help, you are welcome to make an appointment at any time, via my calendar. Click the tab for “your appointment” above and it will prompt you to my calendar.

  37. Hi Dr. Judy, my son is 5 years old. His problem started about 7 months ago he got 3 stomach virus in a lapse of 3 months and lost some weight. His appetite hasn’t been good since then, Pediatrician recommended pediasure to help him gain weight and even dough he is slowly gaining, our concern is that his behavior has changed so much he has trouble speaking, he repeats words constantly and also has repeating behavior (does things over and over) in his frustration for speak he makes loud noises too! We are so worry because before that he was a very normal child and had a normal development. Is it possible that pediasure is giving him bad side effects or in your experience he is facing a different problem? Thank you in advance for your advice, it is greatly appreciated!

    • Hi Monica, well first off, I’m not a doctor – I’m a licensed registered dietitian/nutritionist. Ok next – clearly the Pediasure is not being well tolerated if you are seeing these effects from it. I would be happy to investigate for you but can’t do that unless we are working together – you can make an appointment by clicking the appointment tab above, which brings you to my calendar. If your son is forming a casomorphin peptide from the Pediasure, which is a possibility, then yes it will interfere with speech and behavior. Urine testing is available to show if this is happening. If positive, then your son would need to avoid casein. You can read more about that on this blog post here

  38. Where can I find your book(s)?

  39. Hi, My daughter is 3 and half years old and she has been taking pediasure since 2 years. Since birth she seems to be weak she was only on powdered milk. She hardly drank mothers milk, as she was our first baby. the problem is she gets cold nearly 2 times a month, with very bad cough. we did blood test many times. and doctor said everything is normal. When i read ur article i think pediasure may be an reason. She is also underweight and have lot of fuss to eat. Please suggest? I am thinking of changing to Enfagrow.

    • I would disagree that this frequency of illness, underweight, and difficulty feeding is “normal”. I think your instincts are right! If you’d like me to review labs and make suggestions on other feeding strategies, click the appointment tab above and we can get started anytime. In the meantime you might try your daughter on an alternative like goat milk, camel milk, semi-elemental or elemental formula. Your doctor should be able to direct you to these options, and you can always ask them to if they have not offered.

Leave a Reply

Your email address will not be published. Required fields are marked *

Subscribe To Our Newsletter

I invite you to sign up for my newsletter. Every couple of weeks I will share tips on how to help your child learn, grow, and thrive through nutrition.

You have Successfully Subscribed!

%d bloggers like this: