What Parents Should Know about the Formula Shortage

With the formula recall in February and now supply chain issues, a baby formula shortage continues to be a concern for many families across the country who rely on it for their infants, toddlers and children with special dietary needs.

Our pediatric experts weigh in on what parents and caregivers should know.

What alternatives can I give my baby? Can they have water?

Generally, for babies four months to six months of age, parents and care givers can supplement to increase calories with baby food or solid foods. “Regarding introduction of solid foods, I advise, for infants who do not have severe eczema, introducing one new single ingredient pureed food at one time daily. For instance, peas, then carrots, then peaches to best monitor for food allergies,” advised Tomitra Latimer, MD, Medical Director Lurie Children’s Pediatrics at Deming; Clinical Practice Director, Advanced General Pediatrics and Primary Care. It’s important to keep in mind that all babies develop at different rates and it’s best to talk to your child’s healthcare provider or pediatrician for what is best for your child.

For babies at least six months old, with consultation with a pediatrician, you can introduce water to their diet in addition to solid foods, breastmilk and formula. “As water does not have any calories, I generally advise offering four-six ounces of water a day for infants six months and older that are growing well,” said Dr. Latimer. Babies under six months should only drink breastmilk or formula.

What if I can’t find formula? Can I make my own formula?

Joshua Wechsler, MD, Gastroenterology, Hepatology & Nutrition and Medical Director of the  Eosinophilic Gastrointestinal Diseases Program at Lurie Children’s advises if you can’t find formula that parents and caregivers should not dilute formula or add cow’s milk to formula. It’s important to follow the mixing directions on the formula labels for the appropriate water to formula ratio. It’s also important to discuss with your pediatrician or healthcare provider the minimum ounces of formula that your infant should be taking based on their age.

Valeria Cohran, MD, Medical Director, Intestinal Rehabilitation and Transplantation, said, “When you dilute formula, you not only dilute the nutrients, you dilute the different electrolytes that are in the formula and it may cause health problems for the child. I can see how families would consider diluting it, but that can be very dangerous, particularly for a younger infant.”

As the AAP strongly advises, do not make your own formula at home. According to the AAP, “Although recipes for homemade formulas circulating on the internet may seem healthy or less expensive, they are not safe and do not meet your baby's nutritional needs. Although rare, infant deaths have been reported from use of some homemade formulas.”

Our experts recommend checking smaller stores if you have trouble finding formula as well switching to generic brands. “If an infant is taking a formula that is not a specialty formula, then it is safe to switch from Similac Advance to Enfamil NeuroPro or Parent's Choice. If Enfamil Gentlease it is ok to switch to Similac 360 or Gerber GoodStart Soothe Pro,” said Dr. Latimer. “For infants that use a specialty formula or amino acid formula, it is best to talk with your pediatrician about safe alternative choices.”  

North American Society for Pediatric Gastroenterology, Hepatology & Nutrition maintains a list of suggested formula substitutions. However, Dr. Wechsler shares, “A discussion with your pediatrician is going to be particularly important if your child has specific nutritional needs, or if the alternative formula you're considering is designed for a baby with specific needs.”

“Part of the current issue is the frenzy being whipped up by social media and the press, causing people to stock up and stash formula that they do not currently need. This is another toilet paper situation,” said Melissa Freeman, MS, RD, LDN, CNSC, Director of Clinical Nutrition. “I heard a report of a pregnant woman purchasing a year’s worth of formula to have what she thought she would need. The irony of a situation such as that is that her child could have a special nutrition need and not even be able to consume that formula, or the product could expire before she can use it. Much of the retail situation can be resolved if folks remain calm and only purchase what they need.”

Can I give my baby donor breastmilk?

Most babies without dietary concerns will tolerate switching to breastmilk if that is an option.

“Donor breast milk can be a viable option for a baby, but it depends on the rigor in which it was collected,” Wechsler said. “People have to do their due diligence.”

As we navigate this shortage, the health and safety of infants, toddlers and youth are top priority. If you have questions or concerns about what formula to give your child, don’t hesitate to reach out to your healthcare provider or pediatrician for advice and guidance. Additionally, the department of Health and Human Services (HHS) lists a number of resources to help with the shortage, https://www.hhs.gov/formula/index.html.

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