Baby formula vs. breast milk: Doctors explain what parents should do amid formula shortage
Many American parents are searching for infant formula amid a combination of short- and long-term problems facing U.S. formula brands, thus causing anxiety among many families and expecting mothers.
"My baby isn't even here yet, and I’m experiencing anxiety over this shortage even though I plan to nurse if possible," said Taylor Gassel, a Michigan resident who is expecting her first child in October.
Nationwide about 40% of large retail stores are out of stock, up from 31% in mid-April, according to Datasembly, a data analytics firm. More than half of U.S. states are seeing out-of-stock rates between 40% and 50%, according to the firm, which collects data from 11,000 locations.
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Emily Ingrich, a 31-year-old mother, told FOX Television Stations Group that the process of finding baby formula has been challenging.
"It's been horrible. My son has a dairy allergy so he needs a specific formula that has been impossible to find," she shared. "We live in a rural area of North Carolina and have driven over three hours away to find his formula."
Baby formula is offered for sale at a big box store on January 13, 2022 in Chicago, Illinois. Baby formula has been is short supply in many stores around the country for several months. (Photo by Scott Olson/Getty Images)
Dr. Kelsey Klaas, a pediatrician at Mayo Clinic, agrees, calling the current baby formula shortage "anxiety-provoking."
"We all should be concerned when the needs of our most vulnerable, including nutritional needs, are unmet," Klass said. "The formula shortage is absolutely contributing to parents’ anxiety because a large part of what we do as parents is nourish and feed our kids to support their growth and development."
Why is baby formula in short supply?
This is likely not the first story you’ve heard, especially recently, from families struggling to find baby formula due to a nationwide shortage.
The problem was initiated by supply chain disruptions, which have caused major delays among retailers and companies. This has also caused stores to put limitations on how much baby formula customers can buy.
A safety recall issued earlier this year has also compounded these challenges.
In February, the Food and Drug Administration warned consumers to avoid some powdered baby formula products from a Sturgis, Michigan, facility run by Abbott Nutrition, which then initiated a voluntary recall.
According to findings released in March by federal safety inspectors, Abbott failed to maintain sanitary conditions and procedures at the plant.
The FDA launched its investigation after four babies became sick with a rare bacterial infection after consuming formula manufactured at the plant. All four babies were hospitalized and two died. Chicago-based Abbott said in a statement, "there is no evidence to link our formulas to these infant illnesses." Abbott noted that samples of the bacteria collected from the infants did not match those found in the company’s factory.
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The FDA announced it would allow Abbott to resume producing certain baby formula products on a case-by-case basis.
The combination of supply chain issues and the recall has wiped out many brands covered by Women, Infants and Children (WIC), a federal program like food stamps that serves to help families, though the program now permits brand substitutes.
When will baby formula shortage end?
President Joe Biden stepped up his administration's response to the baby formula shortage last Thursday, discussing with executives from Gerber and Reckitt how they could increase production and how his administration could help.
Biden also talked with leaders from Walmart and Target about how to restock shelves and address regional disparities in access to formula, the White House reported.
"We recognize that this is certainly a challenge for people across the country, something the president is very focused on and we’re going to do everything we can to cut red tape and take steps to increase supply," White House press secretary Jen Psaki told reporters.
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The administration plans to monitor possible price gouging and work with trading partners in Mexico, Chile, Ireland and the Netherlands on imports, even though 98% of baby formula is currently domestically made.
So, what should parents do if they’re having trouble finding baby formula? Should mothers try breastfeeding? Should expecting parents stock up on a supply of formula if they can find it?
"Breast milk and baby formula are both excellent sources of nutrition for infants. Both provide the right balance of fat, carbs, protein, vitamins and minerals to help babies grow," Steven Miller, a pediatric gastroenterologist at Johns Hopkins Children’s Center, told FOX.
Breastfeeding is recommended if possible
Choosing whether to breastfeed or formula feed a baby can be one of the biggest decisions expectant and new parents will make.
The decision is an important one, as formula and breast milk provide an effective balance of certain minerals that a cow’s milk cannot provide.
According to the American academic medical center Mayo Clinic, breastfeeding provides the best nutrition for an infant and is the most widely recommended way to feed a newborn.
"Breast milk contains the right balance of nutrients for your baby and boosts your baby's immune system," Jay L. Hoecker, an emeritus pediatrics specialist at Mayo Clinic, said. "It's considered the gold standard for infant nutrition."
Dr. Cynthia Blanco, a neonatologist in Texas and a member of the American Academy of Pediatrics (AAP) echoed Hoecker sayiing, "If you have a healthy term baby, your best choice will always be breast milk."
And, a number of health organizations — including the AAP, the American Medical Association (AMA), and the World Health Organization (WHO) — agree, recommending breastfeeding as the best choice for babies.
Experts say breastfeeding has chemicals that help defend against infections, prevent allergies and protect against a number of chronic conditions. Additionally, breast milk is the most cost-effective option, since it doesn’t cost a cent and formula quickly adds up.
"This shortage is a major headache, and if moms make their own milk rather than buying it from the store, that is one less thing to worry about," Miller noted adding, "The other thing doctors like about breastfeeding is that when babies breastfeed, they can decide when they are full more easily than they can with formula. This is part of why babies who are breastfed turn into kids who have a lower chance of being obese. I am definitely a big fan of breastfeeding."
Klaas noted she always encourages mothers to breastfeed when possible.
"I absolutely support breastfeeding when possible. We know that breastfeeding has benefits to both the infant and mother over formula feeding," Klass explained, adding, "The current formula shortage highlights one particular benefit of breastfeeding, which is that, for a parent who is able to produce enough milk to meet the infant’s needs, infant nutrition is not reliant on external supplies."
Health experts suggest that mothers who are exclusively breastfeeding asking their baby’s pediatrician about vitamin D supplements for their baby since breast milk alone does not provide an adequate amount of the vitamin, which helps the baby absorb calcium and phosphorus — nutrients necessary for strong bones.
Women who are breastfeeding will also need to be aware of what they eat and drink since this can be passed to the baby through the breast milk.
"It’s always exhausting and amazing to have a new baby, but right now it’s extra stressful because of the added worries around how to feed the baby," Miller continued. "If you want to breastfeed, now is an especially good time to do it, and don’t be afraid to ask for help. If you choose to use formula, be flexible about the brand, and know that formula works really well to grow healthy kids."
Mothers who are anxious about breastfeeding may want to contact friends or family who have successfully breastfed, as they may be a good source of information. Support organizations such as La Leche League, along with lactation consultants at many hospitals and clinics are available to help, as well.
Routine milk pumping is "the best way to increase supply," said Jackee Haak, a North Dakota-based registered nurse and board member of the United States Lactation Consultant Association.
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Rachel Taylor, a registered nurse, postpartum and lactation advocate from Birmingham, Alabama, told Fox News Digital that she mainly recommends lactation cookies, teas, water and a few dietary supplements or ingredients that have demonstrated beneficial results for nursing mothers.
How long should I breastfeed my baby?
The American Academy of Pediatrics recommends mothers exclusively breastfeed for the first six months after birth — followed by a combination of breast milk with solid foods until at least the age of one.
Extended breastfeeding is recommended as long as the mother and baby wish to continue.
Major infant formulas are safe, effective
While most health experts believe breast milk is the best nutritional choice for infants, breastfeeding may not be possible for all women. For many, the decision to breastfeed or formula feed is based on their comfort level, lifestyle and specific medical situations.
The topic has sparked controversy and forced parents into online groups across social media, with many users citing #MomShaming to those criticizing other mothers for opting to use formula.
"If it’s [breast milk] affecting the mother’s life, it’s affecting the mother’s mental health, if it’s’ affecting you as a woman — that’s not good for your baby either," Blanco shared.
Most doctors agree that major infant formulas are an effective source of nutrition and can help babies grow and keep them healthy, and thus parents can feel safe supplying it.
Despite this, most doctors agree that major infant formulas are an effective source of nutrition and can help babies grow and keep them healthy, and thus parents can feel safe supplying it.
"We need to recognize that breastfeeding is a lot of work. If breastfeeding doesn’t work, formula feeding is a safe alternative which provides adequate nutrition for the infant," Klaas explained.
When prepared as directed, infant formula supports healthy babies who have typical dietary needs. In fact, a baby who has special nutritional needs might require a special formula.
"Baby formula is, of course, an attempt to approximate breast milk as closely as possible. It contains macronutrients- carbohydrates, fat, and protein, as well as micronutrients. These elements can be replicated pretty effectively, which means that properly made formula will meet an infant’s nutritional needs," Klaas continued.
Most formulas are made from protein from cow's milk that has been altered to be easier to digest and has been enhanced with extra nutrients needed for growth and development.
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The FDA also regulates formula companies to ensure they provide all the necessary nutrients (including vitamin D) in their formulas.
According to a survey by the Centers for Disease Control and Prevention, 84.1% of infants born in 2017 started breastfeeding, but only 58.3% of infants were breastfeeding at six months. This means, after the six-month time period, more than 40% of parents were still required to find formula, as a baby’s digestive system isn’t ready for cow’s milk until they’re about one year old, according to Pampers.
Mothers face a number of challenges to long-term breastfeeding, including returning to work and finding the time and equipment needed to pump breast milk.
Some women who breastfeed, including Sarah Jobin-Smith, are worried they may need to join other mothers in the hunt for formula if they are not able to produce enough milk.
"My oldest is about to turn three, but when she was a newborn I struggled producing," Jobin-Smith told FOX. "Our second was just born on April 18th. And, I have this fear of not producing enough again."
She continued, "I do worry that as she grows I won't be able to keep up with the demand and I may be another parent out there looking for formula."
Where can I find formula?
There are many reasons women choose to use formula instead of breast milk, so what should a parent do if they can’t find formula?
"My advice in the time of formula shortages is not to be brand specific," Miller suggested adding, "This means that you can look around for other brands or store brands, which are often very good."
Experts say generic formulas are also FDA-approved and meet the same requirements as brand names. In addition, no generic formulas were impacted in February’s recall.
However, doctors suggest talking to your pediatrician first, especially if your baby must use a hydrolyzed or amino acid-based formula. Also, it’s not advised to give toddler formulas to young infants, especially under 9 months of age..
If you’re still struggling to find formula or your baby requires a specific brand, experts suggest talking with your pediatrician or calling a local food bank to see if they can help locate some options.
They also recommend checking with smaller stores and pharmacies, which may still have supplies when larger stores run out.
Baby formula can also be very costly, so for families who qualify based on income, the WIC can provide formula, free of charge.
Doctors also suggest seeking out local groups online. Many local parent groups have postings about unopened, unexpired formula canisters available to give away or sell. During this time, experts say it’s okay to look for formula online, but check that it is sold by a reputable supplier, unopened and unexpired.
Bottom line: Blanco says if you cannot find any formula at all to call your pediatrician or local hospital.
"There is not a parent that we have not been able to help," Blanco added.
Should I make homemade baby formula, stock up amid shortage?
While the baby formula shortage is a challenge for many parents, doctors say parents should not try to make their own formula at home from cow’s milk or add extra water to the formula to stretch supplies. Both of these things could make the baby sick.
RELATED: Pediatrician's plea to parents: Do NOT make your own baby formula
Sarah Adams, who is with Ohio's Pediatric Primary Care, Hudson, made it quite clear on this point: "I do NOT recommend making your own formula," adding "The AAP strongly advises against homemade formula."
She continued, "These [options] are not safe and not FDA approved — infant deaths have been reported."
Many do-it-yourself formula recipes are made from cow’s milk and granular sugar that may be difficult for young babies to digest. They also lack the specific vitamins and proteins found in breastmilk and FDA-approved formulas that are needed for basic nutrition.
Adams also recommends not watering down formula — citing this practice as "dangerous," that "can lead to poor nutritional balance and serious complications."
Additionally, most experts don’t defend stocking up on formula for "just-in-case" scenarios.
"In general, I’m not in favor of parents buying up a ton of formula that they aren’t sure they will need. People stockpiling formula is part of why stores are running low. " Miller explained. "That being said, it would be OK for new parents to have a can or two of formula at home, especially if they are thinking of using formula."
If you are actively using baby formula, the AAP advises buying no more than a ten-day to two-week supply of formula.
"The shortage is temporary. Parents are in this together- please avoid stockpiling, help your neighbors, and focus on infant safety," Klaas concluded.
Blanco added, "Don’t panic that you may not have any [baby formula] next week. You will have some next week, and if you don’t, then again, seek out your medical team of experts."
The Associated Press and FOX News contributed to this story.