In addition to other stresses parents are facing as the coronavirus pandemic continues to disrupt work, school and family life, some baby formulas are out of stock in parts of the country, causing caregivers to worry about how they will continue to feed their infants.
The shortages are likely driven by a combination of supply chain issues, including a scarcity of certain ingredients used to make formula, as well as staff shortages that make it difficult to get products out of warehouses and onto store shelves, Erin Moore, a pediatric nurse practitioner and certified lactation counselor in Austin, said.
"It's a very stressful time for new moms," she said. But, Ms. Moore added, there are workarounds available so parents can keep their babies fed and healthy. Here are tips that may help.
Finding Your Formula
"When you find a formula that works for your baby, it's terrifying to face a switch, because you're very nervous they won't take it and it won't settle well with them," Bridget E. Young, a maternal and child nutrition specialist at the University of Rochester Medical Center, said.
There are a few things you can try if you want to stick with the formula your child normally takes.
If your baby drinks a standard infant formula, one option is to call around to local stores to ask if and when they expect to get your formula back in stock, Ms. Moore said. Some parents have had luck buying formula online rather than in person, too, she noted.
Understand the Supply Chain Crisis
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Turning to social media, such as local Facebook groups, is another workaround. "I've seen messages of need sent out in these groups, and almost always, there are generous moms who are able to spare some or help out in some way," said Dr. Krupa Playforth, a pediatrician in Northern Virginia who has recently had trouble finding formula for her 6-month-old son.
When babies are on special formulas, such as hypoallergenic formulations, for health reasons, parents can also call their pediatricians for help. Doctor's offices sometimes have special formula samples in stock, and if not, they can guide parents to where they can find the products they need, Ms. Moore said.
Switching to a New Formula
If you cannot find the formula you usually buy, the good news is that most of the time — even with special formulas — alternatives are available and safe to use, Dr. Young said.
If you typically use a name-brand formula, the first thing to do is to look for the generic version of that formula, Dr. Young said. Generic versions are safe, she added, because all infant formulas are carefully regulated by the U.S. Food and Drug Administration. And most of the time, generic versions from different stores are the same — so "the Walmart brand of Advantage formula is identical to the Target brand of Advantage formula and the Walgreens brand Advantage formula," she said.
Before you buy anything, check the first five or six ingredients listed on the back label — the ones that appear before the phrase "and less than 2 percent" in the ingredient list. It's best to buy a new formula that matches the ingredients listed in your usual formula, Dr. Young said, to make for an easier transition for your baby. You should also pay attention to terms like "partially hydrolyzed" or "enzymatically hydrolyzed," which refer to the size of the protein molecule in the formula. If you normally buy a formula that contains "partially hydrolyzed nonfat milk," for instance, you're best off buying a replacement formula that also contains partially hydrolyzed nonfat milk, Dr. Young explained.
If your baby is on a special formula because of prematurity or other health issues, double-check with your pediatrician before switching, Dr. Playforth suggested, just to be sure you're making a safe choice.
How the Supply Chain Crisis Unfolded
The pandemic sparked the problem. The highly intricate and interconnected global supply chain is in upheaval. Much of the crisis can be traced to the outbreak of Covid-19 , which triggered an economic slowdown, mass layoffs and a halt to production. Here's what happened next:
A reduction in shipping. With fewer goods being made and fewer people with paychecks to spend at the start of the pandemic, manufacturers and shipping companies assumed that demand would drop sharply. But that proved to be a mistake, as demand for some items would surge.
Demand for protective gear spiked. In early 2020, the entire planet suddenly needed surgical masks and gowns. Most of these goods were made in China. As Chinese factories ramped up production, cargo vessels began delivering gear around the globe.
Then, a shipping container shortage. Shipping containers piled up in many parts of the world after they were emptied. The result was a shortage of containers in the one country that needed them the most: China, where factories would begin pumping out goods in record volumes
Demand for durable goods increased. The pandemic shifted Americans' spending from eating out and attending events to office furniture, electronics and kitchen appliances – mostly purchased online. The spending was also encouraged by government stimulus programs.
Strained supply chains. Factory goods swiftly overwhelmed U.S. ports . Swelling orders further outstripped the availability of shipping containers, and the cost of shipping a container from Shanghai to Los Angeles skyrocketed tenfold.
Ideally, when you transition to a new formula, you want to do it gradually, Ms. Moore said, by mixing the old and new formulas separately before adding them to the same bottle. "For a couple of days, give three quarters of your normal formula with one quarter of the new formula. And then slowly increase the amount of the new formula and wean the amount of the old formula," she said.
If you can't transition gradually because you've run out of your usual formula, that's OK — your baby will be fine, Ms. Moore said, although you might notice more gassiness or fussiness during the transition. That is expected, and normal, for the first two weeks after switching formulas, she added. If you do see worrying symptoms — such as blood in your baby's stool, a rash or signs that your baby is having trouble breathing — they could be a sign of an allergy and you should stop feeding them the new formula and call your pediatrician immediately, Dr. Young said.
Avoiding Nutrition Mistakes
If you're running low on formula, never dilute it. Continue to follow the preparation directions listed on the package. "Changing the ratio of formula to water can be extremely dangerous for infants and lead to water intoxication, electrolyte imbalances and seizures," Dr. Playforth said.
Likewise, never make your own formula at home, as doing so can cause nutritional deficiencies and other health issues, Dr. Playforth added. A 2020 study analyzed 144 online baby formula recipes, finding that nearly half included ingredients that could cause food-borne illness.
Dr. Young does not recommend feeding babies under 1 formulas that are intended for toddlers, either, unless your pediatrician gives you permission. Even if the ingredients look similar, toddler formulas can contain amounts of certain ingredients, like vitamins, that are not safe for young babies. "If you have an infant, stick with an infant formula," she said. Don't feed your baby cow's milk if they're under 1 year old, either, she said, because the proteins can be difficult for infants to digest and may not provide essential nutrients.
The bottom line is that even if you can't find your favorite baby formula, other options will work well. There are so many types of infant formulas on the market, Dr. Young said, that you'll almost certainly be able to find one that nourishes your baby.
Melinda Wenner Moyer is a science journalist and the author of "How To Raise Kids Who Aren't Assholes."
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