Do’s and Don’ts During the Infant Formula Shortage

A nationwide shortage of baby formula is creating empty store shelves and raising questions among parents about how to provide babies with proper nutrition. While strides are being made to address the shortage, Shweta Namjoshi, MD, medical director of the Intestinal Rehabilitation and Nutrition Support program at Stanford Medicine Children’s Health, provides guidance to parents who may be wondering what to do in this situation.

For parents who need to use formula, where do they turn if their local stores are empty?

Shweta Namjoshi, MD: I want to acknowledge how terrifying that feels, but there are resources available to find formula to feed your baby. Families can go to their pediatricians as a great first stop. Nobody knows your community better than your pediatrician, so they can help connect you to local resources, like your local WIC clinic. Those offices have lactation support, formula supply, and other connections to smaller pharmacies. So, if you go to a large commercial retailer and you don’t see formula on the shelf, there might be a local pharmacy or local supplier that has that supply.

Your pediatrician can also check your baby and take a good history to see if their intake is enough or not. Pediatricians can help troubleshoot any immediate issues but also, in the future, help guide conversations as your baby grows: How much formula does your child need? Can they transition to solids? When can they start transitioning to toddler food? Go to your pediatrician. We want to help.

Can parents change their baby’s formula to a different kind or brand?

Namjoshi: There are four major categories of formulas, and within each category the brand is really not that important. There are term infant formulas, and within this type you can feel safe switching brands. They all mimic breast milk and use very similar fats, sugar, and protein, calcium, minerals, and vitamins.

There’s another category called hydrolyzed formulas. That’s where the milk protein is broken down into smaller parts called peptides, making it easier for babies who have a milk allergy or intolerance to digest. These have been the hardest to find during the shortage.

Elemental formulas are for kids with severe allergies and certain medical conditions. Then there are medical specialty formulas. Speak to a pediatrician about finding these formulas, because they’ll be able to get you connected to the right resources.

Should parents stock up?

Namjoshi: Get what your baby needs. Even though it seems like your baby is going to feed this way forever, they will grow and start to rely on formula less. So, I don’t recommend stockpiling formula. If you have a child with specific medical nutrition needs, those are going to be prescribed by your pediatrician or GI doctor and sent to you on a regular basis through specialty pharmacies.

How do parents know if the formula they have was recalled?

Most of the retailers that dispense the formula have sent notices to families based on specific lot numbers and other types of specifics. You can also check to see which formulas were recalled online.

Should parents try to make formula at home or dilute the formula they have?

Namjoshi: Never try to make your formula go or last longer. Never dilute or stretch formula thin without medical supervision. And don’t make your own formula at home. Formulas are created to mimic breast milk. The recipes that have been floating around on social media do not provide adequate nutrition for infants, especially for infants between 0 and 6 months, and can be dangerous. This is a critical time for brain growth, organ development, so the quality of the protein, fat, vitamins, and minerals for your baby is important. It is best to have a conversation with your pediatrician about how to find a safe alternative. For safer options, check out this list of resources from the U.S. Department of Health and Human Services.

Can parents use cow’s milk or milk alternatives?

Namjoshi: It depends on the age of the child. After about 12 to 15 months, we can transition most early-toddler-age children to some type of milk. Dairy milk has a lot of calcium and is a good source of fat and phosphorous for brain development, so we do recommend switching to cow’s milk somewhere around 12 to 15 months. At that time, you can also use dairy alternatives that have enough calcium. Those are good conversations to have with your pediatrician.

We do not recommend any dairy milk or alternative milk under the age of 10 to 12 months because it doesn’t meet your child’s nutrition needs and can lead to complications of milk protein intolerance.

If parents are desperate, can they get formula from abroad, like Canada or Europe?

Namjoshi: The Food and Drug Administration (FDA) has recently changed mechanisms for monitoring and regulating imported formula. Prior to that, most of the formula options from abroad weren’t really regulated, so we couldn’t comment on their safety or nutritional content. But moving forward, the FDA does seem to have a mechanism to help boost supply, and so we can look at the FDA website links about which formula options are available.

What can expectant mothers do to best prepare themselves for breastfeeding?

Namjoshi: The last thing you want to be doing when you bring your baby home is trying to plan for things like pumps and lactation support. Breastfeeding is something that the community, the family, and everyone in the home have to support. There are a ton of resources to help.

Get a pump before your baby is born, just in case you need it. Pumps are covered by health insurance. There are lactation consultants. There are many local community partners who want to support your breastfeeding journey.

It’s important to also set expectations for breastfeeding and know that it’s OK if it’s not perfect. It takes time. So, having that pump in your house already is super-important. The pump is a nice supplement to help your body stimulate more supply. You are enough, and there is formula to support you, if needed.

Where can parents get donated breast milk?

Namjoshi: I would encourage parents to contact their local milk bank. Some of the requirements for receiving donor breast milk vary based on supply.

Is there anything else parents should know?

Namjoshi: This is a really challenging time to be a parent, but you’re doing a fantastic job. I promise you’re doing a better job than you think you are, so hang in there. Things will get better.

Remember, your pediatrician is the best resource for the best and safest ways to feed your baby during the shortage. I can’t emphasize that enough. Your pediatrician will never shame you, will never judge you. We only want to make sure your child gets the best start in their early infant life. We can guide you on how to switch formulas, even alternative strategies that do require medical guidance. We all want to help.


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