Jun 6, 2022

It's been an issue for several weeks now, parents scrambling to try and find baby formula amid the shortage. So what are you supposed to do? You have a hungry baby who needs to eat.

Like many women, I was unable to completely provide enough breast milk to feed my boys. Trust me. It wasn't for lack of trying to increase my supply with supplements, medications, pumping, working with my OB and five lactation consultants. And we learned, for me, I have a medical condition that just won't allow me to make as much as my kids needed, so I had to supplement. And I find this is often the case for many of my patients' mothers.

Often, some women just choose not to breastfeed, and they want to just give formula. And that's okay too. Most important is for the baby to be fed and loved.

So what exactly happened to cause this formula shortage? The manufacturer of Similac products, Abbott Nutrition, recalled powdered formula brands due to bacterial contamination in some of their batches. This, combined with supply chain issues, triggered a nationwide formula shortage.

For families that were affected, this has triggered a lot of questions about what to do. The easiest thing that parents can do is to just switch to a different infant formula. I know that sounds scary, but many store brands and other brands, like Enfamil and Gerber, have formulas that are equivalent to Similac.

Most babies do just fine on a cow's milk-based formula, and there are a ton of variations for whatever your babies might need — gentle formulas, formulas for soft bowel movements, formulas for breast milk supplementation, formulas with extra ingredients to help with digestion and brain development. There are so many options out there.

I often recommend generic or store brand formulas because they're cheaper, but they still have the same nutritional quality as the brand names. We used generic versions of gentle formulas for both of our boys and found they actually tolerated them better than the brand names.

What if your baby is on a special formula, like for milk protein allergy or prematurity? The good news is these formulas really aren't affected by the shortage as much. Your pediatrician can help figure out what is best for your baby in those situations. There are milk banks where women who have excess breast milk donate their milk, and that's a great source for babies who are preemies. Neonatal intensive care units often work with milk banks to get milk for preemies. The milk is strictly screened and totally safe.

What about mixing infant formula differently to make it last longer? This is a big fat no. Adding extra water to make diluted formula is bad. I've seen it happen more than once, where parents do this and it has actually landed their babies in the intensive care unit. What happens is that too much water upsets the balance of salts in their body because the babies' kidneys can't process that much water. That causes the babies' sodium levels to drop to the point that the babies have seizures, and it could be fatal.

Babies will not get the correct amount of nutrients if the formulas are diluted. That is why we have specific instructions on how to properly mix formulas.

What about all of those homemade baby formula mix recipes? Those aren't a good idea either. While, in the past, people made their own baby formula, that was before we had a really good handle on the specific nutritional needs of infants. And those homemade baby formulas don't provide the right concentration of nutrients that we now know babies need. Some babies have even been hospitalized after being given homemade formulas.

Finally, what if your baby is close to turning 1? Can you start milk early? Well, it depends on how early. Babies actually need the nutrition that is in formula until they're 12 months old. I would say that if they're within two weeks of turning 1, you can start transitioning to whole milk. Transitioning before that puts them at risk of iron deficiency anemia because milk has no iron in it. Also, once they start drinking milk, they need to limit their consumption to 16 to 24 ounces per day, or they could develop iron deficiency anemia as toddlers.

Parents often ask what milk kids can have if they don't want to give their kids cow's milk. Luckily, there are a lot of alternatives. Soy and pea milk are the most similar to whole milk in terms of nutrition. They can also have oat milk or nut milks, like almond or cashew milk. Plant-based milks are good for calcium and vitamin D, but they may not have the best nutrition when it comes to protein, fat, and calories, things toddlers need from ages 1 to 2, as their brains are still developing. And other milks, like goat's milk, can cause pernicious anemia due to vitamin deficiencies.

The good news is there are reports that the formula shortage should start to improve in a few months once the factories get the okay from the Food and Drug Administration to resume production. Until then, hopefully, parents are able to find alternatives.

For Patients