Why is there a formula shortage? What to know and why you shouldn't try a DIY recipe
A national shortage of baby formula has emptied shelves across the U.S., including in Arizona, where some grocery stores and pharmacies are limiting formula purchases to five items per customer.
Kaity Jacobsen, a first-time mom in Tempe, said she's driven around all day looking for formula for her 3-month-old son.
She found luck using Instacart, the grocery delivery app, but said it was scary worrying how she would feed her son.
"I wish people would stop comparing this to the toilet paper shortage. It minimizes the severity of this problem that moms are facing. It’s not wiping your booty; it’s feeding your baby. And for most babies under the age of 6 months, it’s the only thing they can have," Jacobsen said.
Dr. Gary Kirkilas, a pediatrician at Phoenix Children's Hospital, says he's been fielding questions about the problem since February, when formula became more difficult to find because of a combination of a voluntary product recall and supply chain problems. So far, the shortage has persisted and supplies in retail outlets remain extremely low.
Kirkilas, who is in charge of the mobile health units at Phoenix Children's Hospital, says he can't ever recall a baby formula shortage like the one facing new parents right now.
The Women, Infants and Children program at the Maricopa County Department of Public Health is getting 150 to 200 calls per day about the formula shortage, program manager Carrie Zavala said.
The program, which is funded through the U.S. Department of Agriculture, serves low-income women and children. The women it serves are pregnant, breastfeeding or their pregnancy ended in the past six months.
"It's definitely an all day, every day situation that we're helping families one after another trying to figure out what formula to give them," Zavala said.
Complicating the situation for WIC enrollees in Arizona is that the program specifies that families must get formula made by Abbott Laboratories, which is the manufacturer of the Similac formula that was recalled in February.
"Because Abbott was the (baby) formula for most of the WIC contracts, now we're giving WIC clients formula they've never purchased before," Zavala said. "And now they are competing with the rest of the consumers that aren't on WIC for these other brands."
Metro Phoenix moms leverage social media to find formula
Hundreds of Valley moms have turned to social media for help in finding formula, joining Facebook groups created to assist parents during the shortage.
"AZ Moms of formula shortage" has garnered nearly 500 members since it was created March 28.
Members posted 256 times in the past month alone, according to the group's "About" page.
Dozens of mothers in the group "Arizona Baby Formula BST" are posting multiple daily updates on where formula is and isn't in stock.
Comments on the public group of 430 members show moms sharing stories of mad dashes to stores across the Valley to secure specific brands of formula for their babies. Some say they've spent hours driving to different stores.
In some cases, moms are buying whatever formula they find in hopes to be able to trade it for the one they need online.
Others who have extra or old cans they no longer need are selling them.
The occasional post shows a mom in desperate need, noting how many bottles worth of formula she has and asking if anyone can help.
Dani May Cord, a Surprise mom of four, said she couldn't count the number of stores she'd left in tears because she couldn't find formula for her youngest.
"I’m just going to say if you are able, you should try and BF (breastfeed) as long as possible. This formula shortage is NO joke. It’s absolutely devastating in all honesty," she wrote.
"What am I supposed to do? Can't find milk anywhere this is crazy!" another person posted.
It's OK for most babies to switch formulas, but don't make your own
One common question from families is whether they can switch the type of formula they are giving their infant if their regular brand isn't available. Kirkilas reassures them that in most cases, that's fine.
"As long as their baby doesn't have any digestive issues where they have to be on a special formula, it is OK to switch formula," he said.
"Let's say you were on Similac and the store only has Enfamil, that's perfectly OK to switch the formula type. The formulas do taste differently, so sometimes we experience kids not liking the new formula. But it's OK for the short term."
But he cautions against families making their own formula at home and also against watering down their existing supply of formula to make it last longer.
And if at all possible, he advises individuals who are giving birth now or in the near future to consider breastfeeding, if that's an option for them.
"Mothers who are just giving birth now, if they haven't considered it, I would strongly consider breastfeeding," Kirkilas said. "We get a lot less issues with fussiness and spit up and constipation with children who are breastfed than we do with formula. So if the parent was open to breastfeeding, I would highly recommend it."
Here are answers to common questions about the baby formula shortage in Arizona:
Why is there a baby formula shortage in the US?
The shortage is an unfortunate combination of supply chain issues and a voluntary product recall. Hoarding and illegal activity could be at play, too.
On Feb. 17, the U.S. Food and Drug Administration warned consumers not to use certain powdered infant formula products from Abbott Nutrition’s Sturgis, Michigan, facility, and Abbott initiated a voluntary recall of certain products.
Since then, the agency has been working with Abbott and other manufacturers to bring safe formula products to the U.S. market, the federal agency said in a May 10 release.
Before the Abbott Nutrition facility recall, the FDA already was working to address supply chain issues associated with the pandemic, including those affecting the infant formula industry, federal officials say.
In a letter to Federal Trade Commission Chair Lina Khan dated Thursday, President Joe Biden asked that the commission consider using all of its available tools and authorities to "actively monitor the infant formula market" and "address any illegal conduct that may be contributing to scarcity and hoarding as well as study whether rural or smaller retailers are being put at a disadvantage."
Any price gouging due to the infant formula shortage is "unacceptable," Biden wrote. He asked the commission to thoroughly investigate any complaints of such activity.
"We know State attorneys general are also examining this issue and may be valuable partners in this effort," he wrote.
What if I'm a WIC participant and the only formula available is not covered by my benefits?
Participants in the Arizona Supplemental Nutrition Program for Women, Infants, and Children (WIC) can call WIC if they are at a store that has formula not on their benefits. Their benefits can be updated so they are able to buy it right then and there, officials with the Maricopa County Department of Public Health wrote in an email Thursday.
Health officials advise WIC recipients to call their local WIC program or the Arizona WIC Shoppers Helpline, operated by the state, at 866-927-8390.
Zavala, the Maricopa County Department of Public Health WIC manager, said since nearly every Similac product was taken off the shelves after the Abbott recall in February, the WIC program began offering flexibility to purchase other brands.
"it is difficult because their benefits are so specific," Zavala said. "When they arrive to the store, even if we've changed their benefits to something we think they'll be able to find, if what is on their exact benefit is not present in the store, then they do need to call us."
When is it not OK for my baby to switch formula?
In most cases, switching formula is fine.
"If the child does have a digestive issue where they are on a very specific formula, then it would be best to talk to the pediatrician about maintaining that special formula," Kirkilas said. "Some children have digestive issues like lactose intolerance. ... But in general, kids can switch to a different type of formula."
If the only formula that's available is gluten-free and your baby is not gluten intolerant, the gluten-free formula would be fine for a while, Kirkilas said.
The American Academy of Pediatrics says it's OK for most babies to switch formulas unless the baby is on a specific, extensively hydrolyzed or amino acid-based formula such as Elecare.
Do food banks have baby formula available?
Food banks don't typically stock baby formula as a regular item, said Angie Rodgers, president and CEO of the Arizona Food Bank Network, although some may occasionally have a donated supply.
"There are a couple of locations, such as food banks that are attached to health centers, that tend to stock it more regularly," Rodgers said.
But food banks in Arizona are looking at options for purchasing some baby formula product to address the current formula shortage, she added.
"We're just mindful of the need that is there, and we're looking at our options," she said. "I'm talking with WIC and our partners that predominantly serve pregnant women and young infants to see what options we have available for them."
Should I grab all of the formula that's available if I see it in the store?
If you find formula, buy what you need and don’t panic buy, officials with the Maricopa County Department of Public Health said. Buying large amounts will make it harder for other families to get what they need.
Where else can I get formula if it's not at my local store?
"I've had parents say the place they normally go to doesn't have it," said Kirkilas, the Phoenix Children's Hospital pediatrician. "If parents are savvy with the internet, they can purchase their formula on the internet."
On Thursday, for example, Amazon, Walmart and Fry's all had infant formula for purchase online, according to a search conducted at midday.
Arizonans enrolled in SNAP — the Supplemental Nutrition Assistance Program, which used to be known as food stamps — can use those benefits to purchase formula, and they are able to do that online through an authorized retailer, said Rodgers of the Arizona Food Bank Network.
WIC benefits can't be used to purchase formula online.
What about homemade baby formula recipes?
The American Academy of Pediatrics has safety tips that advise against making homemade formula, which could cause electrolyte imbalances and other issues in babies, health experts say.
Recipes for homemade formulas circulating on the internet may seem healthy or less expensive, but they are not safe and do not meet your baby's nutritional needs, according to the group's safety tips, authored by pediatrician Dr. Steven Abrams, a professor of pediatrics at the University of Texas at Austin.
"Infant deaths have been reported from use of some homemade formulas," he wrote.
Kirkilas said, "It has been done in the past where people would make their own formulas ... the mixing has to be done very precisely. Too much salt, too much protein, would bother the kidneys in an infant.
"Not enough salt or not enough iron could bother other systems. You see kids who will have seizures if they don't have the right amount of salt in the formula. So it's very risky to make your own."
Should I water down my baby's formula to make it last longer?
Like trying to make formula at home, watering it down could dangerously alter the content of important components such as salt, sugars, fats and protein, Kirkilas said.
"I would definitely recommend continuing mixing the formula as prescribed. Usually it's two ounces of water to put in the bottle first, and then you add the formula afterwards. Adding more water or less formula would disrupt that. ... It could cause problems."
Can I give cow's milk to my baby?
"We only recommend cow's milk after one year of age. You are formula-fed or breastfed until you are one and then after one you switch over to cow's milk," Kirkilas said.
"If you are less than one, we definitely do not recommend cow's milk, but in this sort of situation where we don't have access to formula, if they are six months to one year, they can use cow's milk for a short time. ... But I would not recommend them taking cow's milk before six months."
What if I have unopened (unexpired) formula that I don't need?
Consider donating it to a food bank. Rodgers, of the Arizona Food Bank Network, suggests going to her organization's website at https://azfoodbanks.org/ to find a food bank near you.
What about donated breast milk?
Shell Luttrell, a midwife clinic manager in Arizona who founded a global human-to-human breast milk sharing network called Eats on Feet, said she's seen a surge in the demand for breast milk donations.
The network, which provides education on how to safely store and share breast milk, operates Facebook pages for all 50 U.S. states, as well as other locations across the world. The pages serve as a meeting ground for milk donors and recipients, though the network does not accept or distribute breast milk itself.
"I would say there's been at least a 35% increase, maybe 40%, on some (Facebook) pages of folks looking for breast milk," Luttrell told The Arizona Republic.
Though difficult to pinpoint what's led to the increase in milk sharing since those seeking breast milk don't always share the reason, Luttrell said the increase has coincided with the formula shortage.
Luttrell said she's happy to see people find more ways to feed their children but worries that infants may be at risk if families don't properly educate themselves on best practices.
Failure to comply with breast milk storage practices can taint the milk and affect a baby's health, according to the U.S. Centers for Disease Control and Prevention. The CDC provides safe breast milk storage guidelines on its website.
Milk-sharing can also pose a risk because it may expose an infant to an infectious disease like HIV. Exposure to hepatitis B and C may be possible if, for example, the expressed milk came from cracked nipples where blood was present, the CDC says.
However, "it is very unlikely that a child would be at risk for hepatitis B or C by receiving another mother’s breast milk," the CDC says.
Families seeking breast milk for their infants from donors should make an effort to meet person-to-person and learn about the donor's health history and milk storage practices, Luttrell said.
Is the formula shortage ever going to end?
The FDA says it will continue to dedicate "all available resources to help ensure that infant formula products remain available for use in the U.S. and will keep the public informed of progress updates."
Zavala said she's starting to hear from WIC clients who recently noticed Similac formula on the shelves.
“Ensuring the availability of safe, sole-source nutrition products like infant formula is of the utmost importance to the FDA," FDA Commissioner Dr. Robert Califf said in a statement. "Our teams have been working tirelessly to address and alleviate supply issues and will continue doing everything within our authority to ensure the production of safe infant formula products.”
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