PRESS RELEASE

By Rebekah Hall
U of A System Division of Agriculture 

Fast Facts:

• Infant formula shortage is due to FDA guidelines and recall, over-buying during pandemic

• Don’t dilute formula, ‘DIY’ it, or purchase more than 2-3 weeks’ worth at a time

• Formula is critical source of nutrition for newborns; breastmilk not always an option

LITTLE ROCK — A nationwide shortage of infant formula is impacting families across the United States. For mothers who rely on formula to provide critical nutrition for their newborns, it’s important to proceed with caution for their child’s health and safety.

Bryan Mader, extension professor and health specialist for the University of Arkansas System Division of Agriculture, said there are three primary reasons for the formula shortage: A recall of several brands of infant formula by the U.S. Food and Drug Administration, over-buying of formula during the COVID-19 pandemic and strict FDA policy.

How it started
Starting in February, the FDA recalled several brands of infant formula due to potential contamination from a foodborne pathogen called Cronobacter, which can be deadly to newborns.

“This pathogen was the catalyst for the recall, and a particular formula production facility in Michigan was temporarily shut down while the FDA investigated the contaminated product,” Mader said. “This facility was one of the largest manufacturers of formula in the country, so this halt in production immediately reduced the amount of available formula across the United States.”

Mader also said families over-buying infant formula in the early days of the COVID-19 pandemic affected supply chains. By purchasing much more formula than they could use at one time, families triggered a perceived lull in demand once their shelves were stocked — causing manufacturers to reduce their output in response.

“It’s a classic supply and demand scenario,” Mader said.

Retail stores have now placed limits on the amount of infant formula customers can purchase at one time.

A third important reason for the shortage is the FDA’s “extremely strict policy when it comes to infant formula, primarily due to health and safety concerns for children,” Mader said. Because this policy is so strict, it also prohibits the import of infant formulas from other countries that do not meet the FDA’s guidelines.

Mader shared four important health and safety recommendations for parents using formula with their infants:

• Do not dilute formula or try to make it last longer by feeding an infant less formula. This can lead to serious side effects due to lower calorie intake and lower electrolyte intake in infants.

• Do not try to make formula at home, and do not use formula made by friends or family. “Infant formula is a very complex product that requires specific nutrients for your child,” Mader said. “Avoid formula recipes found on the internet, as these have not been tested by the FDA and may cause your child harm. Also avoid formulas that have been made in other countries, since they may not be safe or may not contain the correct nutrients for your child.”

• Do not purchase more formula than a child can consume in two to three weeks. This exacerbates the shortage and may lead to other families not being able to find enough formula.

• Visit this link to determine whether a specific brand of infant formula is a part of the national recall.

Mader said there are two more contributing factors to the shortage. The first is the U.S. Department of Agriculture’s Special Supplemental Nutrition Program for Women, Infants, and Children, which is commonly known as WIC. Mader said this program purchases the “vast majority of all infant formula in the United States,” resulting in a relatively small industry in which three companies account for almost all U.S. infant formula sales.

“When one or more of these companies or pipelines is disrupted – such as by the FDA recall or a temporary facility closure – the United States is not really equipped to ramp up production of formula or divert formula from WIC, due to requirements to provide this nutrition for women and children in the WIC program,” Mader said.

A second contributing factor to the shortage is a “declining percentage of new mothers who can or who choose to breastfeed their newborns,” Mader said.

“This puts an increasing amount of pressure on the supply of infant formula, further pushing the availability and access to formula away from those who are trying to find it,” Mader said.

Mader said there are many reasons why breastmilk is not necessarily the answer or “even a viable solution” for families impacted by the formula shortage.

“Infections, medications, genetic conditions, thyroid disease and many other physiological conditions may make it difficult or even impossible for mothers to feed their baby with breastmilk,” Mader said. “Newborns require a very specific balance of nutrients and liquids for their overall nutrition, and the inability – through no fault of their own – of mothers to consistently provide this nutrition is another reason why families make the decision to supplement or completely supplant with infant formula.”

“Without this supplementary nutrition, newborns can suffer from jaundice, low blood sugar, and a general primary organ stress that can increase the likelihood of serious illness or death,” he said.

In addition, the socio-economic, cultural, emotional and physiological pressures of being a mother, compounded by balancing work, school or other familial responsibilities – plus a lack of clean, safe spaces for breastfeeding mothers outside of the home – all interact to create many challenges for mothers.

How it's going
For families struggling with the formula shortage, Mader provided three steps to take:

• Contact one’s pediatrician first. “They may have samples of formula that you can use to supplement what you’re able to purchase from the store,” Mader said. “Pediatricians may also have a stock of specialized formulas that regular stores don’t carry.”

• If there is a stock of formula available that is not one’s regularly-used formula, it is okay to switch to a different brand – or even a generic one – since most formulas are similar across different brands. However, avoid switching from cow milk protein-based formula to a soy-based type unless directed by a pediatrician.

• Call smaller stores, such as family-owned pharmacies and convenience stores, to check their stock of infant formula.

Mader said there are “several strategies being deployed” to help alleviate the shortage, including authorizing the WIC program to help supply chain issues by allocating a portion of their formula supply to retailers. He said the FDA is also currently in discussions with national retailers to determine “how best to help them meet the soaring demand.” On May 13, President Biden said the FDA is working with manufacturers to facilitate importing formula from abroad, including from Europe, to get formula back on U.S. shelves within the next few weeks.

To learn about extension programs in Arkansas, contact your local Cooperative Extension Service agent or visit www.uaex.uada.edu. Follow us on Twitter and Instagram at @AR_Extension. To learn more about Division of Agriculture research, visit the Arkansas Agricultural Experiment Station website: https://aaes.uark.edu. Follow on Twitter at @ArkAgResearch. To learn more about the Division of Agriculture, visit https://uada.edu/. Follow us on Twitter at @AgInArk.