Enfamil A.R. is a rice starch-thickened formula designed to reduce spit-up in babies with reflux, and several alternatives work the same way. The closest matches are store-brand “Added Rice Starch” formulas available at most major retailers, along with Similac for Spit-Up as the main name-brand competitor. Depending on why your baby spits up, a hypoallergenic formula or a European anti-reflux option may also be worth considering.
Store-Brand Formulas With Added Rice Starch
The most direct substitutes for Enfamil A.R. are generic “Added Rice Starch” formulas sold under retailer house brands. These use the same thickening approach and meet the same FDA nutritional standards as Enfamil A.R., typically at a noticeably lower price. A formula substitution guide from Children’s Hospital of Philadelphia lists the following as comparable options:
- Walmart: Parent’s Choice Added Rice Starch
- Target: Up&Up Added Rice Starch
- Amazon: Mama Bear Added Rice Starch
- Sam’s Club: Member’s Mark Added Rice Starch
- CVS: CVS Health Added Rice Starch
- Walgreens: Well Beginnings Added Rice Starch
- Kroger: Comforts Added Rice Starch
- Rite Aid: Tugaboos Added Rice Starch
All of these are milk-based formulas thickened with rice starch, so the feeding experience for your baby should be very similar to Enfamil A.R. The main differences are packaging, price, and minor flavor variations. Most parents who switch between Enfamil A.R. and a store-brand equivalent report no change in how well their baby tolerates it.
Similac for Spit-Up
Similac for Spit-Up (sometimes called Similac Spit-Up) is the other major name-brand alternative. Like Enfamil A.R., it uses added rice starch to thicken in the stomach and reduce the frequency of spit-up episodes. Enfamil claims its A.R. formula reduces spit-up by over 50% within one week, and Similac markets similar results for its version.
The two formulas are not identical, though. They differ slightly in their protein sources, fat blends, and the amounts of nutrients like DHA and ARA (fatty acids added to support brain and eye development). In practice, most babies do equally well on either one. If your baby seems gassy, fussy, or constipated on one, trying the other is a reasonable next step before moving to a completely different formula type.
How Rice Starch Formulas Work
Enfamil A.R. and its alternatives look thin in the bottle but thicken once they reach the stomach. The rice starch reacts with stomach acid and becomes heavier, making it less likely to travel back up the esophagus. This is different from simply adding cereal to a regular bottle, which thickens the formula before it’s swallowed and can create inconsistent texture or flow problems with standard nipples.
Because the thickening happens in the stomach, these formulas flow through a normal bottle nipple without much trouble, though some parents find they need to go up one nipple size. The calorie content is comparable to standard infant formula, so your baby still gets full nutrition without needing to drink more volume.
European Anti-Reflux Formulas
Some parents look beyond U.S. brands to European anti-reflux formulas, the most popular being HiPP Anti-Reflux. Instead of rice starch, HiPP uses locust bean gum (also called carob bean gum) as its thickener. Locust bean gum thickens the formula in the bottle itself rather than waiting until it hits the stomach, so it has a noticeably thicker consistency during feeding.
This difference matters for a couple of reasons. Locust bean gum thickens at a lower temperature, so it works as soon as the formula is mixed. Some babies who don’t respond well to rice starch-based formulas do better with carob-thickened ones, and vice versa. HiPP Anti-Reflux also uses organic ingredients and skips some of the additives found in U.S. formulas, which appeals to parents prioritizing organic feeding. The trade-off is higher cost and the need to order from specialty retailers, since European formulas aren’t sold in most U.S. stores.
When a Hypoallergenic Formula May Be Better
Rice starch formulas like Enfamil A.R. are designed for straightforward reflux, where the baby spits up frequently but is otherwise growing well and comfortable. They’re milk-based, so they aren’t suitable if your baby has a cow’s milk protein allergy or lactose intolerance.
If your baby has reflux along with excessive gas, diarrhea, bloody stools, or persistent fussiness, the spit-up may be driven by a food sensitivity rather than simple reflux mechanics. In that case, a hypoallergenic formula like Nutramigen or Similac Alimentum is a better fit. These formulas break milk proteins down into much smaller pieces so the baby’s immune system doesn’t react to them. Some studies suggest hypoallergenic formulas can reduce vomiting in babies whose reflux is allergy-related.
The key distinction: thickened formulas address the physical act of spit-up by making stomach contents heavier. Hypoallergenic formulas address the underlying irritation that can cause a baby to vomit in the first place. If you’re unsure which category your baby falls into, the pattern of symptoms is the best clue. Spit-up without other digestive complaints points toward a rice starch formula. Spit-up plus skin rashes, mucousy stools, or severe discomfort points toward a hypoallergenic one.
Switching Between Alternatives
You don’t need to wean your baby off one formula before starting another within the same category. Going from Enfamil A.R. to a store-brand rice starch formula, or to Similac for Spit-Up, can usually happen in one step. Some parents prefer to mix the old and new formulas in gradually increasing ratios over two to three days, but this is more about easing your baby’s taste preferences than a nutritional necessity.
If you’re switching from a rice starch formula to a completely different type, like a hypoallergenic formula, expect a brief adjustment period. The taste and texture are quite different, and some babies resist the change for a few days. Stool color and consistency may also shift temporarily as your baby’s digestive system adapts to the new protein source.