From cars to clothes, people all over the US are struggling to get the things they need, including necessities like medicine, groceries, and fuel.¹ ² ³
Seemingly no industry is exempt from the supply chain disruptions sparked by the COVID-19 pandemic. Still, some shortages are having a more severe impact than others — the widespread lack of baby formula has reached a national crisis level.⁴
Some parents have been responding by trying to make their own formula, but, for a variety of reasons, health experts including the American Academy of Pediatrics, strongly advise against doing so.⁵ Fortunately, there are several recommendations for what to do until the shortage resolves.
If you’re wondering how the baby formula shortage escalated to such a serious problem in the US, there are multiple contributing factors, including:
The formula shortage first began when people were stockpiling formula during COVID-19 lockdowns in 2020.⁶
In response to the lower sales volumes that followed, some manufacturers cut back on formula production.⁷
Once production scaled back up, ingredient shortages, lack of proper packaging, shipment delays, and labor shortages compounded the situation.⁸
A highly significant factor is the ongoing closure of Abbott Nutrition’s Michigan production facility, which began back in February of 2022. Abbott is the largest formula manufacturer in the US and the maker of multiple infant products.⁹
On February 17, 2022, Abbott voluntarily recalled its powdered formula brands Similac, Similac Alimentum, and EleCare over contamination concerns spurred by an FDA investigation into the cause of bacterial infections in four infants (two of whom died).¹⁰ Abbott voluntarily closed its plant in Sturgis, Michigan, for months.¹¹
The infants who had consumed formula manufactured in Abbott's Sturgis plant, were infected with Cronobacter sakazakii, a bacteria which is sometimes found in dry goods, including infant formula.¹² ¹³
Chronobacter infections are relatively rare, but they can pose a serious problem for infants whose immune systems are still developing.¹⁴
On May 16, 2022, Abbott announced that the FDA and CDC investigation found no evidence linking the infant Cronobacter infections with Abbott formula.¹⁵ Abbot resumed production at their Sturgis factory on June 4, 2022. However, they were only re-opened for 11 days, when Michigan was hit by a severe storm that flooded the plant.⁹
On June 15, 2022, the company released another statement regarding the storm’s impact and the latest closure, noting:
“As a result, Abbott has stopped production of its EleCare specialty formula that was underway to assess damage caused by the storm and clean and re-sanitize the plant. We have informed FDA and will conduct comprehensive testing in conjunction with the independent third party to ensure the plant is safe to resume production. This will likely delay production and distribution of new product for a few weeks.”
According to insights from Datasembly, baby formula supply was stable in the US for the first half of 2021, with out-of-stock (OOS) rates between 2–8%.
Unfortunately, noticeable shortages appeared by July 2021.
At the start of April 2022, the OOS rate rose to 30%, hitting 40% by the end of the month.
For the week ending on May 28, 2022, Bloomberg reported that nine states — California, Arizona, Nevada, Missouri, Georgia, Tennessee, Florida, and Rhode Island — were experiencing OOS rates soaring to levels of 90% and higher.¹⁶
Anxiety levels are understandably high among those caring for babies with specialized needs due to allergies or medical conditions.
Kayzie Weedman shared her situation with her 5-month-old’s milk protein allergies in a recent interview with Good Morning America:
"We don't have an option to have any other formula on the shelf. So we can't just go and get whatever's left on the shelf," explained Weedman. "We have to have her prescription formula or the hypoallergenic formula."¹⁷
The mom of two elaborated about her infant’s health struggles with allergies:
"When she has reactions, first, she gets a really bad rash. She'll get boils on her face that turn into scabs, and it's a very severe form of eczema. She gets wheezing. She has some problem [sic] going to the bathroom. So a lot of things happen when she has that milk protein."
Fortunately, Weedman has been able to secure a three-month supply of formula for her daughter by reaching out on social media for help.
Although social media has been a useful networking tool for some during this crisis, misinformation has also spreadly rapidly.
Bloggers and influencers have been promoting dangerous do-it-yourself alternatives to infant formula, some of which have gone viral.
One recipe circulating involves raw cow milk, raw goat milk, and liver as the ingredient base.
Others have suggested equally inappropriate ingredients, such as hemp seeds, sea moss, dates, or evaporated milk.¹⁸ ¹⁹ ²⁰ ²¹
The Center for Disease Control and Prevention (CDC) has reported several cases of rickets and hypocalcemia (low calcium) and brain damage in infants who were fed alkaline-diet formulas.²²
Children’s health experts and health authorities are voicing their concerns.²³
Pediatricians and the FDA are urging parents not to take a DIY approach to formula, and explain that doing so can put an infant’s health at serious risk.
Dr. Steven Abrams, a spokesman for the American Academy of Pediatrics, recently told the NY Times, “The nutrients in homemade formulas are inadequate in terms of the critical components babies need, especially protein and minerals.”
Homemade baby formula can have long-lasting ill effects on children’s health— even when consumed for just a matter of days or weeks.²⁴ ²⁵ ²⁶ ²⁷
"The potential problems with homemade formulas include contamination and absence of or inadequate amounts of critical nutrients. These problems are very serious, and the consequences range from severe nutritional imbalances to foodborne illnesses, both of which can be life-threatening,” warned the FDA in a special statement to parents and caregivers.²⁵
Before reaching the shelf, commercial baby formula goes through a very strict regulatory process. It must meet high nutritional standards that closely approximate breast milk.
In other words, making nutritionally complete formula is nowhere near as simple as mixing dairy milk and vitamins.
Babies’ nutritional needs are extremely complicated because they go through tremendous changes in the first year of their life. Breast milk or formula is their main source of nutrition for energy, development, growth, and building a working immune system.
Food safety is another big issue with homemade baby formula because there is no way for parents to ensure the ingredients are not contaminated.
This is especially true of recipes that call for raw cow's milk, goat milk, and liver.
Unpasteurized milk and uncooked meat are far more likely to contain bacteria like salmonella or E. coli and cause infections which young immune systems will struggle to fend off.²⁸
The World Health Organization (WHO) recommends breast milk as the ideal food for infants (when possible). As such, manufactured baby formula closely mimics its nutrition profile.
Breast milk contains a combination of water, protein, carbohydrates, vitamins, minerals, antibodies, enzymes, and lipids:²⁹ ³⁰ ³¹ ³² ³³
Water Water, which is essential for hydration makes up 87% of breast milk.
Protein Together, the proteins whey and casein account for 1% of breast milk. The whey-casein ratio varies over time. It ranges from 3:7 in the early stages of lactation to 1:1 later on.
Dietary lipids Lipids make up 4% of breast milk and account for 45–55% of total energy in the first six months of life of an infant's life.³⁴ They also have a vital role in the development of the central nervous system and in sending signals between cells.
Carbohydrates (including oligosaccharides): Carbohydrates account for 7% of breast milk. Lactose is the main carbohydrate and represents approximately 40% of the energy in breast milk. Oligosaccharides are a class of indigestible carbohydrates that “feed” healthy gut bacteria.
Numerous minerals and vitamins Many important nutrients like calcium, sodium, phosphorus, potassium, vitamin B, vitamin C, vitamin A, and more are all present in breast milk.
Immunity-boosting compounds: Breast milk contains antibodies and enzymes that help protect infants from the illness.
Even cow's milk which usually forms the base ingredient of baby formula must be significantly altered by manufacturers to emulate breast milk.
One of the most significant differences relates to protein content.
While cow's milk does contain more protein (3.5%) than human milk (1%), the casein-whey ratio is not ideal for humans. It has a higher proportion of casein, which is less digestible than whey.
Human milk also has a much higher proportion of long-chain polyunsaturated fatty acids and cholesterol, which are essential for brain development.
The unique human immune cells and enzymes which protect infants from disease and infection are also missing from regular cow's milk.
Again, creating such a highly-specific mix of compounds is a complicated process — even for commercial companies.
In fact, the FDA outlines 29 essential components — some of which have specific concentrations — that must be present in baby formula for it to be sold in the US.³⁵
The balance of these individual nutrients is not readily achievable in any home environment, and too much or too little of a certain ingredient can lead to dire consequences. Even excessive water (which may sound relatively harmless) can cause seizures or even death from water intoxication.³⁶ ³⁷
It isn’t just homemade formula that pediatricians are warning against. The HHS encourages parents to avoid a few other risky practices that might be tempting as short-term solutions:
Diluting baby formula Adding more water to your baby’s diet can lead to a lack of nutrients and electrolyte imbalances.
Using baby formula past its expiration date Formula that is past its best by date could be unfit to consume and may have lost some of its nutritional value.
Buying formula through online marketplaces Doctors suggest caregivers avoid buying baby formula through online marketplaces where there is a higher risk of unregulated products being sold.
If you're having trouble buying baby formula because of the current shortage, here are some possible solutions that align with advice from the US Department of Health & Human Services (HHS):³⁸
If you’re giving your baby a mixture of formula and breast milk, you could try increasing the amount of breast milk your baby currently consumes. You might encourage more supply by expressing milk or breastfeeding your baby more frequently. (There are many reasons why breastfeeding might not possible).
If you can, try a new formula that’s nutritionally equal to your regular brand. Your baby may need some time to adjust. Ideally, start off with small amounts of the new formula mixed in with the former brand and gradually increase the amount of the new formula over time. If your baby requires specialized formula, (like a hypoallergenic formula) speak to your pediatrician before making changes.
(If your infant reacts with symptoms like vomiting, diarrhea, blood in stool, crying during feeds, gas pains, or weight loss, speak to their doctor immediately).
The US government has eased regulations to allow certain brands of baby formula from overseas to be sold and marketed in the US to help ease the current shortage.
Health authorities warn parents against getting breast milk from friends or buying it online as there is no way to guarantee that the milk is safe for consumption.
However, all breast milk donors who give to milk banks go through a health screening process and are carefully instructed on how to collect and deliver their milk safely. Milk banks also typically pasteurize the milk to ensure any bacteria present are killed off.
There has been an increase in breast milk donations during the shortage. However, much of the supply is reserved for hospitalized babies. Even if you can’t receive a steady supply from the milk bank, it is worth exploring. The Human Milk Banking Association of North America has an online directory to help you find an accredited milk bank.
If you have any doubts about your next steps for coping with the shortage, or you have trialed any alternative DIY formula recipes, reach out to your physician for support.
They may have formula samples or be able to help you coordinate with local organizations who do. Additionally, they can evaluate your infant to make sure they’ve been getting adequate nutrition.
The US government has recently intervened to ease the current shortage. President Biden has instructed suppliers to prioritize goods and resources to baby formula companies to speed up manufacturing processes.
In what is known as Operation Fly Formula, Department of Defense commercial aircraft have made 10 overseas trips to help stock shelves faster.³⁹ ⁴⁰
An estimated 13 million 8-oz. bottles of infant formula will be obtained in June.⁴¹
This incident has spotlighted an industry in which there is a near-monopoly — which is to say, a small number of companies have significant influence over the baby formula market.
Some politicians are calling for more federal action to address the lack of competition — along with a call to prevent future shortages by mandating maternity leave (to support breastfeeding).
Formula is scarce for a variety of reasons, including the closure of the largest baby formula producer in the US. While DIY recipes circulating may seem like a viable solution, they can in fact be quite dangerous for infants, even short-term. Homemade formula can’t deliver adequate nutrition. Also, safe food handling and storage can’t be guaranteed in a home kitchen.
This crisis has drawn the scrutiny of an industry in which there is a near-monopoly. A small number of companies have significant influence over the baby formula market. Some politicians are calling for more federal action to address the lack of competition — along with a call to prevent future shortages by mandating maternity leave (to support breastfeeding).
If you have been feeding your baby homemade formula, it is important to speak to your family doctor or pediatrician. They can help ensure your baby isn’t suffering any nutritional deficiencies. Infants have specific growth charts, and not meeting nutritional requirements would mean a “failure to thrive,” which is preventable and treatable.
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With the baby formula shortage, what should I do if I can't find any? | American Academy of Pediatrics
Abbott voluntarily recalls powder formulas manufactured at one plant | U.S. Food & Drug Administration
Cronobacter and powdered infant formula investigation | Centers for Disease Control and Prevention
FDA warns consumers not to use certain powdered infant formula produced in abbott nutrition’s facility in Sturgis, Michigan | U.S. Food & Drug Administration
Cronobacter infection and infants | Centers for Disease Control and Prevention
Mom whose daughter needs special baby formula speaks out on shortage | Good Morning America
Homemade infant formula recipes may contain harmful ingredients: a quantitative content analysis of blogs | Cambridge University Press
U.S. baby formula shortage leaves parents scrambling | The Washington Post
Babies fed homemade alkaline diet formula hospitalized with rickets, brain damage | Penn Live Patriot-News
Is homemade baby formula safe? | American Academy of Pediatrics
FDA advises parents and caregivers to not make or feed homemade infant formula to infants | U.S. Food & Drug Administration
Infant formula: Safety do's and don'ts | U.S. Food & Drug Administration
Don’t feed homemade formula to babies; seek help instead | American Academy of Pediatrics
Risks to your baby of home-made infant formula | Healthy WA
CFR - code of federal regulations title 21 | U.S. Food & Drug Administration
Notes from the field: Vitamin D–deficient rickets and severe hypocalcemia in infants fed homemade alkaline diet formula — three States, August 2020–February 2021 | Centers for Disease Control and Prevention
Water intoxication in infants | St. Louis Children's Hospital
Biden announces airlifts of baby formula from Europe, Australia | The Washington Post
Dawn Teh is a health writer and former psychologist who enjoys exploring topics about the mind, body, and understanding what helps humans thrive.