Stephen A. Abrams
But what is behind the deficit? And how can this be prevented from happening again? The conversation asked Dr. Stephen Abrams, the presenter child health expert at the University of Texas, which advised the formula industry and the government on infant nutrition, these questions along with what advice he could give to parents facing the challenge of getting enough baby formula supplies.
1. Why is there a lack of formulas now?
In fact, there are two factors that have caused the current deficit. First, we have supply chain problemthat has affected all kinds of goods since the beginning of the pandemic. It eased a bit, but then in early 2022 got worse.
Then in February a a large plant for the production of baby formula in the United States has failed. FDA closed the Abbott Nutrition factory in Michigan. The closure came after Abbott’s across the country recall of several brands of formulasincluding conventional Similac cow’s milk-based formulas such as Similac Advance, and several special formulas for children with allergies, including Similac Alimentum and Similac EleCare.
I had to close the factory in the background study of bacterial infections due to the powder mixture produced at the plant, and the deaths of at least two infants. The problem is that there is not much in the production of baby formula in the US. In other words, there are not enough other plants to lift the slack when one of them falls. The plant in Michigan is the largest producer in the country, so when it goes down, it puts extra strain on the entire mix distribution system in the U.S., especially for some mixes for children at high risk for allergic diseases and metabolic disorders.
Over the past couple of weeks, the deficit has worsened. I can’t say exactly why this happened. But I suspect there is some accumulation going on because the parents are worried. Stores may limit the number of formulas that people can buy, but that doesn’t stop people from going online to buy more.
In addition, the deficit was widely reported in newspapers, on television and in political speeches. All of this advertising contributes to the public understanding that the system is failing, causing more panic purchases and hoarding.
2. Who is affected by the deficit?
Most parents will feed their children the mixture at some point to meet their nutritional needs, especially older children. About 80% of children receive it at birth and a few days after it all their nutrition through breast milk. But under 6 months old most babies get at least some mixture. The proportion of one-year-olds receiving the mixture is even higher. This is mainly the result of social dynamics and pressure – mothers return to work after childbirth, but do not receive sufficient support for the production and storage of sufficient breast milk.
But some parents will be more affected by the deficit than others. Not surprisingly, the lowest-income parents suffered the most. Federal Nutrition Program for Poor Women, Infants, and Children called WIC, provides a mix for most children in low-income families. But costs have risen and the formula has become smaller.
I’ve heard that some families drive two hours to find stores that sell blends. Obviously, this will be harder to do for poor families as it requires costs. In addition, wealthier parents can buy more expensive, so-called elite brand formulas.
Another thing to note is that the disadvantage affects both regular baby formulas and specialized versions. The regular or standard formula is the type most families are familiar with, and about 95% of formula-fed children receive the standard type. The specialized mixture is designed for children with unusual requirements, due to allergies, damaged intestines or special nutritional needs. Prior to the closure of the Michigan plant, it produced most of the specialized baby formulas used in the United States, so this is an absolute crisis for families who need this type of formula.
3. What are the possible consequences of the deficit?
In the first six months children should eat only breast milk or formula – everything they feed will be incomplete. Thus, there is a risk that the deficiency will lead to the fact that children will not receive the necessary for the development of nutrition. This can lead to a number of health problems that affect their physical growth and brain development.
There are also fears that parents may use unsafe alternatives, such as reducing infant formula. It is known that people try to cook them themselves by mixing powdered milk or vegan milk with vitamins. These are not the only alternatives not wholesome foodthey may not be completely sterile.
After the age of six months things get a little better when the baby can start eating solid foods. But even in this case, the mixture or breast milk remains the main source of nutrition. Thus, there may still be a risk of malnutrition, such as iron deficiency.
4. Are there viable alternatives?
Aged over six months, only for fairly short periods of time, parents can feed their babies whole cow’s milk and pay attention to iron supplements.
It is not perfect and only applies to older children. For those under six months old, cow’s milk is a real challenge. It does not have the right mixture of proteins for babies and has almost no iron – the risk of anemia in very young children. Cow’s milk also has an mineral imbalance, especially for young children.
So what are the guidelines for low-income parents?
It’s tricky and I can’t give a magical answer. But food banks and the WIC program were a crucial lifeline. The WIC program, in particular, has proven to be very flexible during this deficit. When Abbott had to recall products and then failed to provide enough unanswered formulas in the states where they were a WIC provider, WIC was able to change providers and reprogram EBT cards to allow low-income parents to buy different brands.
5. What can be done to prevent this situation from happening again in the United States?
We must first help families regain confidence in the production and supply system of formulas. This will prevent problems such as the accumulation or preparation of homemade brew mixes.
Then we need to see how to make sure that one plant that falls does not affect the whole system. The federal government cannot accumulate the formula in the same way that it could accumulate oil because the formula has an expiration date. But it is possible to diversify the production of infant formula. This will include the belief that several factories and companies are making the formulas that this country needs. This does not necessarily mean an increase in costs – competition can potentially lower prices.
I believe that America also needs to look at the breastfeeding support system in the country. Don’t get me wrong, some parents will always need a blend. But those who want to breastfeed need to do their best to support them. This includes better family leave policies and assistance to low-income mothers who want to express and store milk while working.
Stephen A. Abrams is Professor of Pediatrics at the University of Texas at Austin. He wrote this work for Conversationwhere he first appeared.