Baby Formula Shortages

From the American Academy of Pediatrics:

Updated 5/19:

Since the outbreak of COVID-19, there have been significant shortages of infant formulas in stores. Current shortages have been largely caused by supply chain issues and the recent recall of several baby formula products over concerns about contamination.

Here are some tips on finding formula your baby needs during the shortage, and what you may safely consider if you absolutely can’t find any.

Keep in mind, this advice is strictly during this current URGENT formula shortage. If you have any concerns about your baby’s nutrition, please talk with your pediatrician.

What if baby formula is out of stock everywhere I look?

• Check smaller stores and drug stores, which may not be out of supply when the bigger stores are.
• If you can afford it, buy formula online until store shortages ease. Purchase from well-recognized distributors, grocers, and pharmacies rather than individually sold or auction sites.
• Check social media groups. There are groups dedicated to infant feeding and formula, and members may have ideas for where to find formula. Make sure to check any advice with your pediatrician.
• If you find it in stock, it can be tempting to buy as much formula as possible right now, but the American Academy of Pediatrics (AAP) advises buying no more than a 10-day to 2-week supply of formula to ease shortages.
• Call your pediatrician if you cannot access the formula you need for your baby. They may have samples in stock, connections to other local organizations, or ideas of other places to call, such as your local WIC clinic.

I found small amounts several different formulas. What is the best way to switch among the brands?

For most babies, it is OK to switch to any available formula, including store brands, unless your baby is on a specific extensively hydrolyzed or amino acid-based formula such as Elecare (no store brand exists). Ask your pediatrician about recommended specialty formula alternatives available for your baby.

It is very likely that your baby will do just fine with different formulas as long as they are the same type. If your baby does not like the taste or has a hard time tolerating a different formula, you may want to try gradually introducing small amounts of the new formula mixed with the usual formula. Slowly increase the amount of the new formula.

My infant needs a specialty baby formula, but I can’t find any. What should I do?

Abbott is releasing limited quantities of Similac PM 60/40 and other metabolic formulas for babies in urgent need. Your pediatrician’s office can fill out a request and if it is approved, the formula can be shipped to your home. Talk to your pediatrician about safe comparable specialty formulas for your baby.

Only one brand of baby formula is covered under the WIC program, but I can’t find any. What should I do?

Most states are allowing parents who use WIC benefits to buy other brands of formula or different sizes and forms like ready-to-feed formula. (To find out what your state is allowing, you can check here.)

I have a 3-month-old infant and can’t find my usual baby formula. What should I do?

This is a very difficult problem. If you can find another similar formula, it’s okay to make the switch. If not, your pediatrician’s office can work with you to access all community resources.

Can I add extra water to formula and give my baby a multivitamin to make up the nutrients?

This should never be done. Watering down formula to stretch it out can cause nutritional imbalances in your baby and lead to serious health problems that require hospitalization. Always follow label instructions or those given to you by your pediatrician. Always mix formula as directed by the manufacturer.

Can I make my own baby formula? I’ve seen a recipe online that people say was used safely in the 1940s.

Homemade formula is not recommended. Although used in the distant past, online recipes have significant safety concerns regarding contamination and nutrient concentration. Even if recipes for homemade formulas circulating on the internet may seem healthy or less expensive, they are not safe and do not meet your baby’s health needs. Infants have been hospitalized from reported use of some homemade formulas.

What is the earliest age I can start giving my baby solid food to stretch my formula supply?

Solid foods should not be used to stretch formula supply. Formula contains many nutrients young babies need. Infants generally are ready to eat solid food when they are 6 months old, but it depends on their rate of development. You can introduce solid foods as early as 4 months of age, but infants 4-6 months of age will continue to need breastmilk or formula to supply the majority of their nutrition.

Is it safe to get breast milk from a friend or online group?

We can’t know for sure whether breastmilk from a friend or online group is safe. It is better to check with a local milk bank that is accredited through the Human Milk Banking Association of North America. To find an accredited milk bank, check here.

I heard the government will be importing baby formula from other countries. Is that safe?

The U.S. Food & Drug Administration (FDA) is considering accelerated approval of certain imported formulas. The FDA is working to assure procedures are in place to verify production standards, labeling and shipping of brands that have not been sold in the U.S. previously. European formulas are regulated by the European Food Safety Agency similar to how the FDA regulates formula in the U.S. and are highly reliable. But while they may contain adequate nutrients, they must be imported in a way that maintains temperature and other safety issues. That’s why FDA oversight is critical.

Can toddler “formula” substitute for regular formula?

Toddler drinks, often found in the formula isles, are not recommended for infants. However, if you absolutely have no other choice, these products can be safe for a few days for babies who are close to a year of age.

Can I give my full-term baby premature formula?

Formulas designed for babies who were born premature (and have “catch-up” growth to do) can safely be used for a few weeks to feed full-term babies if nothing else is available.

Is cow’s milk a safe alternative to baby formula?

If your child is older than 6 months of age and is usually on regular formula (not a specialty product for allergies or other special health needs), this may be an option. In a pinch, you could feed them whole cow’s milk for a brief period of time (no more than a week).This is not ideal and should not be done for more than one week. However, it is a better option than diluting formula or making homemade formula.

We don’t have a specific amount of cow milk that infants 6-12 months should drink in this situation. Continue to look for alternative sources of baby formula. One concern with giving cow’s milk to a baby who is 6-12 months old on a long-term basis is that it does not contain enough iron like formula does. This can lead to anemia. If you have to use cow’s milk, ideally do so for as short a time as possible and give the baby plenty of iron-containing solid foods, such as baby food made with meat or iron-fortified cereals.

If you need to give your baby cow’s milk for a week, talk with your pediatriican.

What about feeding my baby goat’s milk?

Goat’s milk is not approved for babies in the United States. However, there are goat milk-based baby formulas registered in other countries that may be among those considered for accelerated import approval by the FDA.

Can I use plant-based milk instead of baby formula if needed?

Plant-based milk alternatives generally are not recommended for babies under a year of age. Soy milk may be an option to give babies who are close to a year of age for a few days in an emergency, but always buy the kind that is fortified with calcium and vitamin D. Make sure to change back to formula as soon as some is available. Be especially careful to avoid almond milk or other plant milks as these are often low in protein and minerals. Talk with your pediatrician if you are considering using plant-based milk.

How long can formula be used past a “best by” date?

Generally, formula should not be used past the “best by” date because it may not be safe or have the required levels of nutrients, especially fat-soluble vitamins. Check the “use by” date on infant formula, which is required by FDA regulations to be on each container. Until that declared date, the formula will contain no less than the amount of each nutrient on the product label and will otherwise be of acceptable quality and safety.

Remember

Don’t hesitate to talk with your pediatrician if you have any concerns you have about your baby’s health and nutrition. If your child has special health needs, be sure to check with their doctor about medically appropriate and safe feeding alternatives.