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The shortage should be improving soon, but for parents who need to find baby formula now, experts offer some tips for tracking it down
A grandmother in New York who scours multiple grocery stores every day for the infant formula that her twin grandsons, born 6 weeks premature, need. In Virginia, a military mom who can no longer find formula to supplement her supply. An Illinois mother, stressed to the breaking point, who says, “This shortage is the new pandemic and has to end.”
Those are just some of the people who recently told Consumer Reports how the infant formula shortage has affected their families.
The Biden administration is taking steps to address the shortage. That includes expediting the reopening of a Michigan plant operated by Abbott Nutrition, a leading producer of infant formula, that has been closed since February after a recall because of possibly contaminated products. President Biden has also invoked the Defense Production Act to boost production, which has been slowed by widespread supply chain disruptions.
While those steps are welcome, the current crisis highlights ongoing problems at the Food and Drug Administration, says Brian Ronholm, CR’s director of food policy, who is testifying about the issues in the House of Representatives today.
“The infant formula crisis is merely one symptom of the overall problem, and it is increasingly clear that confidence in the FDA food program is eroding among consumers, industry, states, and other stakeholder groups,” he says.
While the steps taken by the Biden administration should help resolve the current crisis, “we won’t see this problem disappear immediately,” says Steven Abrams, MD, a professor of pediatrics at the University of Texas at Austin Dell Medical School. And until formula becomes more readily available, lack of access may be disproportionately affecting some families, including people of color and parents of babies with complex nutritional needs.
If you can’t find the baby formula you need online or in stores, a few strategies can help you figure out how to safely feed your infant until the shortage eases. Here are some do’s and don’ts from experts.
For babies who weren’t born prematurely and don’t have special medical needs, it’s generally safe to switch brands.
“The store brand vs. the name brand, for example, are basically the same,” says Amy B. Hair, MD, program director of neonatal nutrition at Texas Children’s Hospital. “There’s really no difference if you’re talking about standard formula for a baby born on time.” Most of these formulas are similar in safety, taste, and nutrition, she says, except for a few extra ingredients babies don’t actually need for nutrition.
“The large majority of babies will have a broad range of what they’ll tolerate,” says Abrams, who is also the former chair of the American Academy of Pediatrics Nutrition Committee.
Look for a formula that’s as similar as possible to the one that already works for your baby. Some store-brand formulas will say “most similar to brand name,” for example, says Abrams.
If an equivalent store brand isn’t available and you have to switch between two brand names like Similac and Enfamil, you may need to do more research. In many states, offices of the government-run Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) publish lists of equivalent formulas on their websites. (See, for example, this list from the Minnesota Department of Health.) When in doubt, ask your child’s doctor about the best equivalent.
If you’re switching brands and still have some of your usual formula left, Hair suggests trying to start off by doing every other feed with the new formula to ease the transition. It may take a day or two for your baby to acclimate. Abrams says that depending on how similar the new formula is to the old one, a baby may notice a subtle difference in taste or develop an upset stomach and act fussy. If the fussiness doesn’t resolve after a few days, talk to your pediatrician.
The American Academy of Pediatrics recommends asking your pediatrician’s office if there are any formula samples on hand. Some OB-GYN offices may have samples, too. This isn’t a sure thing, but it’s worth a try.
While formula reps sometimes help pediatricians find formula—and some offices may have a few extra cans if you’re in a pinch—they don’t typically stockpile them, Hair says.
Abbott Nutrition’s February formula recall included many specialized formulas, which are prescribed for some babies with certain allergies or other nutritional or medical needs.
But with shortages mounting, the FDA said in a May 10 press release that it would not object to Abbott releasing these formulas “to individuals needing urgent, life-sustaining supplies of certain specialty and metabolic formulas on a case-by-case basis.” The formulas being made available “were not included in the February recall,” according to an Abbott press release, and would generally need to be special-ordered by a pediatrician.
“The benefit of allowing caregivers, in consultation with their healthcare providers, to access these products may outweigh the potential risk of bacterial infection,” the FDA said in a statement. For those who had been relying on specialty formulas from Abbott, speak with your child’s pediatrician to see if requesting these products is a recommended option, an FDA spokesperson told CR.
In general, the first step for parents of babies who need these formulas and can’t find them should be to talk to a pediatrician about finding the safest equivalent. Unlike the most common formulas, the distribution of certain specialty formulas is mainly through pediatricians and pediatric specialists, Abrams says, so they will be your best resource in tracking down what you need.
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Some babies can start eating purées, such as oatmeal or vegetables, as early as 4 months of age. But, Hair says, feeding purées to younger infants is more about practicing feeding as they develop rather than providing nutrition.
“Replacing the majority of breast milk or formula as early as four or six months would not provide them with complete nutrition,” she says. “It’s okay for taste and maybe a little nutrition, but a lot of the nutrition is still coming from milk.”
That said, most babies can start drinking cow’s milk and eating primarily solid foods when they’re about 1 year old. If your baby is nearing a year old and generally healthy, talk to your pediatrician about switching from formula to cow’s milk, or at least swapping some servings of formula for cow’s milk, suggests Shweta S. Namjoshi, MD, a pediatric gastroenterologist and the medical director of intestinal rehabilitation and nutrition support at the Lucile Packard Children’s Hospital at Stanford.
Newborns and younger babies, however, should be drinking exclusively breast milk or formula. “Regular dairy products like cow’s milk or alternatives such as soy, hemp, or almond milk are not designed with the right amount of important nutrition sources including protein, iron, calcium, and vitamins that a baby under 6 months of age needs,” the American Academy of Pediatrics noted in a May tweet.
Typically, about 98 percent of the baby formula consumed in the U.S. is produced in the U.S., according to the FDA. In response to the shortage, the agency says it is working to hasten the review of some imported formulas, with imports already up 300 percent compared with last year.
But at least for the time being, experts—including the American Academy of Pediatrics—advise against purchasing formulas online that are imported from other countries. “Foreign formulas are not FDA approved, and we can’t always guarantee the nutritional content or food safety,” Namjoshi says.
They’re also generally very expensive, Abrams says.
Toddler drinks, often marketed as “toddler formula,” are not regulated the same way as infant formula, which must meet strict nutritional and labeling requirements set by the FDA. “There are no regulations dedicated to toddler drinks,” researchers noted in a 2019 paper published in the American Journal of Law & Medicine. “Toddler drinks are not recommended by any health entity and cost more than whole milk.”
Toddler formula is also typically more concentrated in calories than infant formulas, Namjoshi says, which may not be safe for babies younger than 6 months.
Some breast milk banks distribute pasteurized milk, but Hair says those typically cater to premature infants who can’t digest formula. Sometimes, Abrams says, they may offer limited breast milk to families in need, but it’s expensive; think a few dollars an ounce.
Hair advises against using unpasteurized, untested breast milk from another person as a formula replacement, whether you buy it online or pick it up in person. It isn’t regulated by the FDA, so there’s no way to ensure it’s safe. And there are potential risks: Breast milk can transmit infections such as HIV, for example. And “some are diluted with cow’s milk from a grocery store, which isn’t nutritionally appropriate for a newborn baby,” Hair says.
Some parents are buying more caloric formulas (like toddler drinks) and diluting them at home, but that’s not a safe option. It’s also unsafe to dilute baby formula to try to make it last longer. Both can lead to serious health problems in infants. “We have seen kids end up in the emergency room,” Namjoshi says.
First, dilution means “you’re filling up the baby’s stomach with water, not nutrition,” Abrams says. Second, excess water can cause dangerous problems such as low blood sodium, known as hyponatremia.
Ignore whatever recipes you may see circulating online: Do-it-yourself formula is never a safe option. Just last year, the Centers for Disease Control and Prevention published a report on three infants who ended up in the emergency room “for symptoms related to consumption of a nutritionally deficient homemade formula.”
According to Namjoshi, formula mimics breast milk with a specific combination of protein, sugar, and fat. It’s difficult for homemade recipes to achieve the same precise proportions necessary for your child’s health and development. Plus, homemade formula usually includes dehydrated milk, which could cause an allergic reaction in babies who are allergic to milk.
“You might think you are creating the right recipe, but it can be really unsafe,” she says. There’s also a risk of contamination, Abrams says.
Ashley Abramson is a freelance writer focused on health and psychology. In addition to Consumer Reports, she’s written for the New York Times, the Washington Post, and the Guardian. She lives in Milwaukee with her husband, two young sons, and their pair of pups. When she’s not writing, she enjoys good food, movies, and the Lake Michigan views down the street.
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