News of the dwindling supplies of baby formula has caused uneasiness and even alarm in some parents and soon-to-be parents of newborns. But while there is very much reason for concern, panic is not the way to go, as the U.S. Food and Drug Administration goes about tackling its latest challenge.
First, some background. The current shortage – labeled the severest in decades – was caused by a perfect storm of factors. First are the supply chain issues, mostly generated by the COVID-19 disruptions, that has affected some of the ingredients needed to make formula. Staff shortages throughout the supply chain have also had an effect.
The situation was further weakened when Abbott Nutrition voluntarily recalled select lots of its Similac, Alimentum and EleCare formulas. That decision came after several babies who had consumed formula made at Abbott’s Sturgis, Michigan factory became ill from bacterial infections, and two died.
Abbott ended up closing the plant in February; although that was expected to last for as little as two weeks, it remains closed. On May 16, the FDA and Abbott announced that they had finally come to an agreement on what needs to take place before it can reopen. Reportedly it will take two weeks to restart production and another six to eight weeks before its products return to stores.
What to Do While You Wait
Some parents are already struggling with finding enough formula for their newborns. Photographs and videos of half- or entirely empty store shelves permeate the news. Pregnant patients are wondering what they will do when the baby arrives, especially if they are unable or prefer not to breastfeed.
The first thing such parents should do is contact their pediatrician. They may have access to supplies that other outlets do not.
Keep in mind that, for many babies, formula is interchangeable. The baseline of all formulas, except for soy-based ones, are a cow-based protein. The formulas are sometimes changed to break down the proteins for easier digestion, lactose free for increased gassiness or reflux (even though babies are not actually lactose intolerant it aids digestion) or soy-based for similar reasons. Switching brands or types of formula is okay but might cause some temporary digestive issues as your baby adjusts.
While it is typically recommended to not start cow’s milk until a year, if your baby is 6 months old it can be used for a bottle or two a day on a very temporary basis. If your child is 10 months old you can switch to toddler formula if needed (Reminder: check with your pediatrician beforehand!) Again, only use it sparingly; all of these children are still developing and growing.
As is the case under normal circumstances, if your child is 4 months or older and is suffering from acid reflux – possibly due to the change in formula – adding a small amount of rice cereal can improve symptoms.
Any changes should be discussed with your pediatrician.
You should also keep an eye on social media. Many neighborhood/community groups have sprouted up with recommendations on where you might find a supply of formula.
What Not to Do
As with any product shortage, there is a tendency to try to hoard something when you can find it. As a community we are urging parents not to do this. The American Academy of Pediatrics (AAP) is advising to buy no more than a 10-day or a 2-week supply of formula. Most unopened liquid baby formula will last for 6 to 8 months, while unopened powdered formula can still be good for a year.
Once opened, however, the picture changes drastically: a bottle can be stored in the refrigerator for up to 48 hours, while most canisters of powdered formula can safely be used for about a month. Never use expired baby formula.
No Time to Stretch
Some parents may be tempted to add some water to their baby’s bottle to “stretch” their supply. Preparation of powdered formula involves a calibrated amount of water, but adding extra is very dangerous. Babies’ kidneys cannot tolerate free water and by changing the concentration the baby can develop electrolyte imbalances leading to vomiting, diarrhea and possibly seizures. In addition it will decrease the baby’s overall caloric intake therefore inhibiting growth. These products are called “formulas” for a reason. They are carefully calibrated in laboratories, under strict governmental guidance, to ensure a baby’s good health.
Similarly, do not try to produce your own formula. Without the right ingredients – not to mention the right, tightly controlled conditions – your efforts may have a catastrophic effect on your child. And if a generous neighbor offers you her surplus breast milk, while tempting, doing so can be dangerous as the milk has not been screened for possible contaminants.
Where to Tread Carefully
Turning directly to foreign countries for formula historically has not been a good idea because guidelines used to produce these formulas can be regulated less stringent. That being said, on May 16 the FDA announced it is adding some flexibility over the importation of some infant formula, saying it anticipates that “those products that can quickly meet safety and nutrition standards could hit U.S. stores in a matter of weeks.”
This is a very stressful time for parents as worrying about the hunger and nutrition of an infant is very scary. As we have seen in other health crises, our collective ability to pitch in and help each other out can pay huge dividends. Again, consulting – and maintaining regular contact with – your pediatrician is of paramount importance.
Dr. Samantha C. Lowe is a pediatrician at White Plains Hospital Physician Associates. For an appointment, call 914-849-7900.