New Information for Families During the Formula Shortage

Reposted from HHS.gov

There’s nothing as important to families as the health and safety of their babies, and the formula shortage has left many people feeling anxious about how they’ll feed them. Some young children, teens, and adults with medical needs also rely on formula for their nutrition. They may be impacted by the shortage, too.

We know it’s not easy to change your baby’s diet. However, if you can’t find formula in stock, here are some tips for finding safe substitutes.

Find Safe Substitutes

Information provided reflects input from physicians and other experts at the Department of Health and Human Services, American Academy of Pediatrics (AAP), and the North American Society For Pediatric Gastroenterology, Hepatology & Nutrition (NASPGHAN).

Try a New Brand of Formula

Most babies will do just fine with different brands of formula, including store brands, as long as they're the same type, like cow's milk-based, soy, hypoallergenic (extensively hydrolyzed), or elemental (amino acid-based). Keep in mind that your baby may seem to not like the taste, or may have a hard time tolerating a different formula, initially. If this happens:

• Try slowly introducing small amounts of the new formula by mixing it with your regular formula. Slowly increase the amount of the new formula over time.
• Be patient, since it may take some time for your baby to get used to it.
• If your baby is vomiting, has gas pains, is crying or can't be calmed down during feedings, is losing weight, has diarrhea, has blood or mucus in their poop, or is straining to poop, they may not be tolerating the new formula. Call your pediatrician or other health care provider if you have questions.

If you need help figuring out which formulas you may be able to substitute:

• Your pediatrician or other health care provider is always the best resource because they know your baby and their health history.
• You can also check this list of comparable formulas developed by an organization of pediatric gastroenterologists called NASPGHAN. Keep in mind that this list focuses on substitutes for formulas that were part of the February 2022 recall, so you might not see your baby's formula listed here. Any substitution should only be done under the recommendation and supervision of your pediatrician or other healthcare provider.

Try Formula That’s Made in Another Country

You can also consider buying formula that's made outside of the United States in U.S. stores. Stores will start carrying these options soon. The Food and Drug Administration (FDA) has allowed these formula companies to market certain products in the United States, and may allow more infant formula products that meet its criteria for exercising enforcement discretion. When preparing formula made in other countries:

• Read the mixing instructions carefully for preparing powdered formulas. They may require different amounts of powder or water than formulas made in the U.S.
• Use the FDA's conversion chart to convert milliliters to fluid ounces and common conversions from Celsius (°C) to Fahrenheit (°F).

Consumers should be vigilant when buying formula that’s made outside of the U.S. from online marketplaces, as it has the potential to be counterfeit. Learn more about how to spot counterfeit infant formula: What are counterfeit infant formulas? How can I avoid buying such products?

Talk to Your Pediatrician or Other Health Care Provider About Substitutes for Hypoallergenic or Specialty Formula.

If you need hypoallergenic or medical specialty formula, it may be harder to find a substitute. Talk to your pediatrician or other health care provider about acceptable substitutes. Depending on which formula they need, they may be able to submit an urgent request for specialized formula to Abbott Nutrition, which is releasing some specialty and low-iron formulas on a case-by-case basis.

Feed Your Baby Safely

If you can't find enough formula, there may be some short-term options that can help in an urgent situation. You should also know about serious safety concerns related to certain alternative preparations for feeding your baby. Always talk to your pediatrician or other health care provider first if you don't have enough formula to feed your baby.

Talk to Your Pediatrician or Other Health Care Provider About Short-Term Options

If you can’t find any formula and your baby is older than 6 months, talk to your pediatrician or other health care provider about using whole cow’s milk as a short-term option.

If you can’t find any formula and your baby is close to one year old, talk to your pediatrician or other health care provider about using soy milk as a short-term solution. Avoid other plant-based milks, like oat or almond milk.

If you can’t find any formula and your baby is close to one year old, talk to your pediatrician or other health care provider about using a toddler drink for a few days.

Explore Resources for Breast Milk or Breastfeeding

Talk with your pediatrician or other health care provider about using human milk from a human milk bank.

• If possible, consider a local milk bank that is accredited through the Human Milk Banking Association of North America (HMBANA). Keep in mind that most of the milk from milk banks is given to hospitalized babies, and they may not have enough to serve healthy babies at all times.
• Sharing human breast milk with friends or purchasing it on the internet is not recommended. When you get human breast milk from friends or through the internet, it's hard to know if the donor was screened for infectious disease or contamination risk. There could also be safety risks related to how the milk was collected, processed, tested, or stored.

For families who are using both breast milk and formula, consider shifting more of your baby’s diet to breast milk.

• This could mean you need to increase your breast milk supply. You can do this by breastfeeding your baby more frequently or by adding pumping sessions between breastfeedings. Pumped milk can be kept in a refrigerator and stored frozen for later use.
  The CDC provides resources for breastfeeding support for mothers who are breastfeeding.

Avoid Unsafe Formula Practices and Buying More Than You Need

• Don't try to make formula at home. There are serious health and safety concerns with homemade formula. Your baby's nutritional needs are very specific, especially in the first year of life. Homemade formula may contain too little or too much of certain vitamins and minerals, like iron. Homemade formula also increases the risk of contamination, which could make your baby sick or lead to infection.
• Don't water down formula. Adding more water can take nutrients away from your baby and lead to serious health problems, like seizures.
• Don't use formula past the "best by" or "use by" date. The formula may not be safe and may have lost some of its nutrients.
• Don't buy more formula than you need. The shortage is affecting families who are already navigating the stress of parenting during a pandemic. It can be tempting to buy as much formula as possible right now, but the AAP suggests buying no more than a 10-14 day supply to help improve shortages.

Get Help From WIC

If you need help buying formula, you’re not alone. About 43 percent of all babies in the U.S. receive help from the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). WIC provides formula and food for your family, and can connect you to trained professionals who provide health screenings, breastfeeding support, and nutrition advice. You can also participate in WIC while you’re pregnant. Contact your local WIC clinic to see if you or your family is eligible.

Check your eligibility

Get Help Finding Formula

Organizations in your community and formula companies may be able to help you find formula or safe substitutes.

Community Resources

• Locate your nearest Community Action Agency (CAA): Your local CAA may be able to give you formula or connect you with local agencies that have formula.
• Call 211: United Way’s 2-1-1 can connect you to a community resource specialist who may be able to help you find local food pantries and other sources of formula.
• Find an accredited milk bank: The Human Milk Banking Association of North America (HMBANA) gives donated breast milk to families in need. You may need a prescription from your pediatrician or other health care provider to get donated breast milk from HMBANA.

Formula Company Phone Numbers

Formula companies may be able to help you find formula or safe substitutes. Because a lot of people are looking for formula, you may experience long wait times. Most types of formula may also be out of stock.

• MyGerber Baby Expert: Reach a certified nutrition or lactation consultant by phone, text, Facebook Messenger, web chat, or video call to help you find a similar formula that may be more readily available.
• Similac (Abbott’s) urgent product request line: Ask your gynecologist (OB/GYN) or your baby’s pediatrician or other health care provider to submit an urgent product request for metabolic or low-iron formula by downloading and completing the form. - PDF 
• Enfamil (Reckitt’s) customer service line: Call 1-800-222-9123 (BABY-123) for help finding formula.

Learn About How the Shortage Started

Supply chain issues from the pandemic contributed to the current formula shortage. It worsened when Abbott Nutrition, one of the country’s largest formula producers, voluntarily recalled formula and closed one of its production facilities in Sturgis, Michigan. The President, agencies across the U.S. government, retailers, and the formula industry are working around the clock to address this shortage and get formula back on shelves. To date, production has ramped up 30-50%.

Learn About Actions the U.S. Government is Taking

• The President invoked the Defense Production Act. This law puts U.S. formula manufacturers first in line to receive the resources they need to increase formula production. The President is also working with other countries to airlift formula to the U.S. through Operation Fly Formula.
• The FDA and the U.S. Department of Justice negotiated a consent decree with Abbott Nutrition, under which Abbott Nutrition agreed to take specified corrective actions in order to start producing formula again at their Michigan facility. Abbott Nutrition has stated that it will focus on specialty formulas for people with metabolic and other needs first. FDA has also been meeting regularly with other major formula manufacturers who are working to produce more formula to meet the demand. Read more about FDA’s actions.
• The U.S. Department of Agriculture is working with states, tribal nations, and territories across the country to ensure that families who participate in WIC can use their benefits to purchase additional types of formula.
• Read more about the additional steps that President Biden is taking to address the formula shortage.

Content created by Assistant Secretary for Public Affairs (ASPA) 
Content last reviewed June 2, 2022