3 pediatricians on how to handle formula shortage

Jhe United States continues to be plagued by an unprecedented shortage of infant formula. Supply chain issues caused by the pandemic began affecting infant formula in the summer of 2021, and inventories tightened further after Abbott recalled some formula products in February (then more in March) and closed its Michigan plant.

Families faced with empty shelves worry that their children will go hungry because breast milk or formula, or a combination of the two, is the main source of nutrition for babies from birth to toddler age. about a year.

“It’s not right for families to worry about this on top of being a new parent,” says Dr. Shweta S. Namjoshi, medical director of gut rehabilitation and nutritional support at Stanford Children’s Health. “This is unacceptable.”

But pediatricians are experts in finding baby foods, and they can help families locate stores where formula is in stock, guide them safely to different brands, and support them during this stressful time. “I’m sorry this is so scary, but there’s no need to panic yet,” Namjoshi says.

Here’s what pediatricians are saying about how to safely navigate formula shortages.

Try another brand

For parents of healthy full-term infants, it is very safe to switch to different brands of infant formula, including generic versions.

“The way the formula is marketed makes parents feel fearful and pressured, like ‘Oh, I can’t switch brands’…but that’s just not true,” Namjoshi says. Even when the products say they’re formulated for certain issues, like anti-gas or anti-reflux, they’ll work just fine for most babies without diagnosed issues, she says. “Enfamil, Gerber, they’re all fundamentally the same. They use the same mixture of sugars, the same proteins, the same fats.

Kids can be a little difficult when going through an adjustment period with a new brand, but often “it’s just a kid getting used to something different,” she says.

However, children with special needs and medical conditions, such as some immunocompromised children, those with allergies or gastrointestinal problems, and premature babies, for example, may need specialized formulas, such as hypoallergenic or lactose-free. These patients should work closely with their doctor when exploring new formula options.

“For babies taking typical infant formula, they’re able to pick something up,” says Dr. Rachel Dawkins, medical director of the pediatric and adolescent medicine clinics at Johns Hopkins All Children’s Hospital. “But it’s the kids with special health care needs who might be on specialist formula – they’re really struggling.”

Because each type of formula is now so hard to find, some parents of healthy infants buy specialty formulas, which are often the only options left on the shelves. Infants without medical problems can safely use them, doctors say, but they should only do so if they are the only option left, as some babies can only use these specialized formulas.

Take advantage of government options

Families receiving formula from WIC — the National Nutrition Program for Low-Income Women, Infants and Children that serves nearly half of all infants in the United States — now have additional options. On May 21, President Joe Biden signed the Baby Formula Access Act of 2022 into law so that WIC could offer more types and sizes of formula boxes for emergencies like this.

The United States now also imports formula from other countries, and the United States Food and Drug Administration (FDA) is considering changing its rules allowing international shipments of formula in the event of a shortage.

Several international companies are “requesting urgent approval for these types of formulas,” says Dr. Steven Abrams, professor of pediatrics at the University of Texas at Austin Dell Medical School and former chair of the nutrition committee of the American Academy of Pediatrics ( PAA). . He expects the FDA to grant rapid approval for international brands “within the next week or two.”

“People are starting to realize that the system didn’t have enough security points,” says Abrams. “We need a lot more backup,” he says, and a system that doesn’t just rely on a few companies to make almost all of the country’s formula.

Do not hesitate to ask your pediatrician for help

If you can’t find formula or are nervous about running out, or if your baby is fussy about trying different brands, your pediatrician can help you through this stressful time.

Pediatricians can access stockpiles of formula – children’s hospitals always have formula, for example, even though it shouldn’t be anyone’s first stop – and they’re also very careful about where formula is in stock. Physicians can also offer advice and referrals to lactation support for families looking to start breastfeeding or increase supply.

“Your baby will be fine,” Namjoshi said. “No pediatrician will ever let your child go hungry. We have backups.

Do not substitute formula or dilute it

Cow’s milk and plant-based milk substitutes are not acceptable substitutes for breast milk or formula. These liquids lack essential nutrients that babies need for proper nutrition and could cause health problems for infants. The US Centers for Disease Control and Prevention (CDC) recommends introducing whole cow’s milk around the first birthday. If infants drink too much before, they could develop intestinal bleeding, kidney problems and dairy allergies.

Parents should also not dilute the formula so that the cans last longer. This can cause hyponatremia, a condition that occurs when sodium levels drop too low, which can lead to seizures. Not getting enough nutrients can also lead to stunted growth.

Making your own homemade formula is another bad idea, experts say. “There are many old wives’ recipes and stories out there, but they’re not sure,” Dawkins said. “They don’t provide the nutrients babies need and can cause electrolyte problems and nutritional deficiencies.”

Be careful when getting formula or breastmilk that is not from a store

“It’s fine to crowdsource in your local communities or on different moms groups online, but I would just make sure the boxes of formula aren’t expired and unopened,” says Dawkins. . “Sometimes people have an extra, and I think it’s great to be able to help your neighbor.”

But beware of sharing breast milk from a freezer supply. “What we would prefer is for people who have extra milk to donate it to their milk banks,” Abrams says. Banks select milk donors based on their health status, pasteurize the milk and distribute it to babies who need it most, often those in neonatal intensive care units.

Informal milk-sharing networks are not regulated in the same way as milk banks, and the milk could be adulterated or unsafe. “We have to be careful about directly sharing milk or breastfeeding, and especially careful about anything that comes from a donor you don’t know personally,” says Abrams.

Don’t Panic, Buy

It may be tempting to stock your pantry with formula if you find it, but it’s important to leave some on the shelves for other families who need it.

“Don’t worry too much if you have a lot of supply,” Dawkins says. “Let’s hope the end is in sight for the shortage of formulas.”

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