A shortage of baby food has added to concerns for American parents already facing the pressures of raising a child during a pandemic in a country that ranks low on family-friendly policies.
Media reports have highlighted the plight of mothers, fathers and caregivers across the US who have struggled to find scarce supplies or have traveled long distances to buy infant formula.
But what is behind the deficiency? And how to prevent it from happening again? The Conversation introduced Dr. Steven Abrams, a leading pediatric health expert at the University of Texas who has advised both the infant formula industry and the government on infant formula, these questions and what advice he could give to parents who are struggling to get adequate formula.
There are really two factors that have caused the current shortage. First, we have the supply chain problem, which has affected all types of goods since the beginning of the pandemic. It eased off a bit, but then got worse in early 2022.
Then, in February, a large US baby food factory broke down. The FDA has shut down Abbott Nutrition’s Michigan factory. The closure follows Abbott’s nationwide recall of several brands of infant formula, including Similac’s cow’s milk-based routine formulas such as Similac Advance and several specialty formulas for allergic babies, including Similac Alimentum and Similac EleCare.
The factory closure came amid an investigation into bacterial infections linked to powdered formula made at the factory and the deaths of at least two babies. The problem is that there just isn’t a lot of redundancy in US infant formula production. In other words, there aren’t enough other factories to pick up the slack if one fails. The Michigan plant is the country’s largest producer, and if it fails it will put an additional strain on the entire US formula distribution system, particularly certain formulas for babies with high-risk allergic diseases and metabolic disorders.
The shortage has worsened in recent weeks. I can’t say for sure why this happened. But I suspect there was some hoarding as parents are getting anxious. Stores may limit the amount of formula people can buy, but that doesn’t stop people from going online to buy more.
In addition, the shortage has been widely publicized in newspapers, on television and in political speeches. All of this publicity is feeding the public sense that the system is failing, leading to even more panic buying and panic buying.
The majority of parents will at some point be formula feeding babies to meet their nutritional needs, especially older infants. At birth and in the days immediately following, about 80% of babies get all of their nutrition from breast milk. But by 6 months of age, the majority of babies are on at least some formula. The proportion of one-year-old infants receiving formula is even higher. This is largely the result of social dynamics and pressures – mothers returning to work after giving birth but not receiving adequate support to produce and store adequate amounts of breast milk.
But the shortage will hit some parents more than others. Not surprisingly, the parents most affected are those on the lowest incomes. The federal feeding program for poorer women, infants and children, called WIC, provides infant formula for the majority of babies in low-income families. But costs have risen and formula has become scarcer.
I hear of some families driving two hours to find stores that sell baby formula. Obviously, this will be more difficult for poorer families to do because of the costs involved. Likewise, wealthier parents may be able to purchase more expensive so-called elite branded formulas.
The other thing to note is that the shortage affects regular infant formulas as well as specialized versions. Regular or standard formula is the type most families are familiar with, and about 95% of formula-fed babies get standard formula. Specially formulated for babies with unusual needs, due to allergies, damaged gut or special dietary needs. Before the Michigan factory closed, it made most of the specialty infant formula used in the United States. So it’s an absolute crisis for families who need this kind of formula.
For the first six months, babies should only be fed breast milk or formula – anything else they are fed is nutritionally incomplete. So there is a risk that a deficiency will result in babies not getting the nutrition they need to develop. This could lead to a range of health issues that affect their physical growth and brain development.
Then there are concerns that parents might use unsafe alternatives, like watering down their baby’s formula. People have been known to try to make their own by mixing powdered milk or vegan milk with vitamins. Not only are these alternatives not nutritionally complete, they may not be completely sterile.
After the sixth month of life it gets a little better when the child can eat solid food. But even then, formula or breast milk remains the primary source of nutrition. So there may still be a risk of nutritional deficiencies such as iron deficiency.
From six months of age, parents can only feed infants whole cow’s milk and seek iron supplements for relatively short periods of time.
It is not ideal and only applies to older babies. For children under six months, cow’s milk is a real problem. It doesn’t have the right protein mix for babies and almost no iron – very young babies are at risk of anemia. Cow’s milk also has mineral imbalances, especially for younger babies.
So what advice is there for low-income parents?
It’s a challenge and I can’t give a magical answer. But food banks and the WIC program have been a crucial lifeline. The WIC program in particular has proven to be very flexible in this scarcity. When Abbott had to recall products and then could not provide enough unrecalled formulas in states where it was the WIC provider, WIC was able to switch providers and reprogram EBT cards to accommodate low-income parents other brands could buy.
First, we must help families regain confidence in the infant formula production and delivery system. This prevents problems like hoarding or making homemade recipes.
Then we have to think about how we can ensure that the failure of one plant does not affect the entire system. The federal government cannot store formula food the same way it stores oil because formula food has a shelf life. But diversifying infant formula production is one way. This would require ensuring that multiple factories and companies are producing the formulas this country needs. This does not necessarily mean increased costs – competition could potentially push prices down.
I think America also needs to look at the country’s breastfeeding support system. Don’t get me wrong, some parents will always need formula. But if you want to breastfeed, you have to do everything you can to support them. These include better family leave arrangements and help for low-income mothers who want to pump and store milk while they work.
By Steven A. Abrams, Professor of Pediatrics, University of Texas at Austin
This article was republished by The Conversation under a Creative Commons license. Read the original article.