Baby Formula Shortage Alternatives: What You Need to Know
A baby formula shortage isn't just a supply chain issue. It’s about safety, security, and having enough nourishment to feed our infants.
The baby formula shortage hits home for so many families. Approximately 19.2% of newborns and 42% of infants 6 months and older depend on infant formula for nutrition and supplementation.
The current baby formula shortage crisis is an incredibly stressful time for the parents and caregivers of infants.
Grocery store shelves have been empty for weeks, and online retailers are “out of stock.” The guidelines from the American Academy of Pediatrics (AAP) have helped ease some of the anxiety. Still, parents want solutions so they can feed their babies today.
Let me guide you through this uncertain time.
Keep reading for my breakdown of the AAP's guidelines, baby formula alternatives, and how to switch formulas.
Why is there a Baby Formula Shortage (and what is being done)?
A few months ago, the baby formula maker Abbott Nutrition voluntarily recalled powdered infant formula after learning about the catastrophic death of a baby who tested positive for the bacteria Cronobacter sakazakii. As a result, the plant in Michigan temporarily shut down and won’t reopen for another 6-10 weeks.
The Defense Production Act prioritizes baby formula manufacturing in the U.S. government. The government also expedited approvals and facilitated imports of some baby formula from Europe. However, the Food and Drug Administration (FDA) hasn’t approved all baby formulas from overseas. So the recommendation is still for parents to avoid ordering formula directly from other countries.
The first shipment of infant Nestle formula from Europe has now arrived in Indiana. A small batch of this shipment should be on grocery shelves in a few days. It's a hypoallergenic formulation, so babies with a cow’s milk allergy get priority.
While these developments are hopeful news, the shortage will most likely continue for several more weeks.
Baby Formula Alternatives that are Not Recommended (and Why)
When you're desperate to nourish your baby, it might be tempting to follow advice you may seeing on social media to make homemade baby formula or dilute formula with water in order to stretch a dwindling supply. Unfortunately, many of these recommendations can be downright dangerous and even life-threatening, especially for babies that need specialized formulas.
The AAP warns parents against these baby formula alternatives:
Making homemade baby formula
A DIY formula doesn't have the right combination of essential nutrients an infant needs, nor the sterile environment needed to make it. As a result, homemade baby formula can cause food borne illnesses, electrolyte imbalances, kidney damage, and poor growth, among other issues.
Watering down formula
A diluted formula doesn’t have enough calories and nutrients to adequately nourish an infant. Stretching an amount of formula by watering it down may be tempting, but diluting formula can also lead to life-threatening electrolyte imbalances and even seizures.
Buying formula from overseas
European formulas meet EU standards and are safe to consume when purchased in Europe. However, obtaining these in the U.S. usually means getting them through third-party vendors which are imported outside of the normal “chain of control,” bypassing EU and U.S. FDA safety regulations. As a result, European formulas may be subject to tampering and contamination, incorrect storage temperatures (which can affect nutrient content), and confusion over use-by dates and instructions on how to properly mix the formula due to labels that may be written in an unfamiliar language.
So, how are parents supposed to find baby formula right now?
How to Find Baby Formula
You’ve been navigating the formula shortage for weeks now…I know it’s impossibly hard, but please don’t get discouraged!
Before you turn to any baby formula alternatives, here are some some guidelines from the AAP and HSS to help families through this crisis, as well as tips to try:
Try using the HHS created a formula finder that provides links and phone numbers to help you find resources in your community.
Try smaller local stores. Many neighborhoods have small local businesses that might have some stock available. These can be community pharmacies or convenience stores.
Contact community organizations. Check with food banks and religious organizations. Some local communities are getting creative and forming formula exchange groups. Check local boards on social media for parent exchange groups. Take the same precautions, such as using sealed containers that haven't expired.
WIC expanded: the Women, Infant, and Children's is a supplemental nutrition program for pregnant women, breastfeeding women, postpartum women, and caregivers of infants and children up to five years old. If you receive WIC benefits, check with your state WIC program for any changes to your benefits. For example, you might find that your state allows you to use WIC benefits to buy more formula brands. In addition, the USDA requested that WIC retailers allow exchanges for recalled Abbott formula. If you think you might be eligible for WIC, contact your local agency to apply for benefits.
Call your pediatrician for guidance. If your baby needs a specialized formula or has a milk allergy or intolerance, talk to your pediatrician before using a different formula. Pediatricians often have formula samples from their local formula representatives that may help get you through a few days until you can find your baby’s formula.
Switch formulas, if possible. Most babies who tolerate dairy-based regular formulas do just fine switching between brands. It’s likely that at least some brands (or generic store brand versions) of powdered formula will be available on the shelf. Just make sure the formula you switch to is fortified with iron and similar in nutrient composition to what your baby has had before. Here is an Infant Formula Quick Guide from Perrigo that can help you figure out comparable options.
How to Switch a Baby’s Formula
Switching formulas until your baby's formula is available might be a good short-term solution for many families. You may find comparable formulas to your baby’s regular formula.
There are several basic types of formulas:
Cow’s milk formulas are usually the first recommended type of formula. Cow's milk formula is generally fortified with iron, an essential nutrient for kids.
Soy-based formulas are used to substitute cow's milk for babies with allergies. But, soy is a common allergen and soy-based formula may not be an option for some babies.
Extensively hydrolyzed formulas are “predigested,” meaning that the proteins have already been broken down into smaller pieces, making them easier to digest. This type of formula is used for babies with allergies or other health conditions.
Specialized formulas are for infants with specific disorders or diseases.
No matter which type of formula or brand name you use, all non-specialized U.S. cow’s milk formulas have the same basic ingredients and are tightly regulated by the FDA.
Believe it or not, one of the biggest differences between most brands is the taste, and your baby may have a preference for one over another.
When you can’t find the cow’s milk-based, non-specialized brand you usually use, it is safe to switch to another cow’s milk-based formula. To ease the transition for your baby, gradually switch to the new formula if you have enough of your baby’s formula left.
Start by combining ¾ of the new formula with ¼ of the old formula. Once you see that your baby tolerates the new brand, gradually increase the ratio of the new formula to the old formula.
Signs that a New Formula isn’t Agreeing with Your Baby
Switching formulas is considered safe for babies that don’t require specialized or hypoallergenic formulas.
There’s a difference between an allergy and intolerance. Food intolerance mainly affects digestion, so diarrhea, gas, and stomach pain are common signs. Your baby might be a little gassy, poop more frequently, or become constipated during the transition. Belly discomfort should be temporary and isn't necessarily a sign of intolerance.
An allergy is not the same as intolerance. Symptoms of an allergic reaction are usually more severe. Symptoms of a genuine cow's milk or soy formula allergy are:
Diarrhea
Hives
Respiratory symptoms (e.g., coughing, difficulty breathing, wheezing)
Swelling
Vomiting
Infants allergic to cow's milk or soy can have symptoms that look a little different from other food allergies. If you notice any of these systems, be sure to contact your pediatrician:
Excessive fussiness or Colic
Blood in the child's stool
Poor growth
What About Milk Banks?
Milk banks provide pasteurized breast milk from screened donors to primarily premature infants in neonatal intensive care units. According to the New York Milk Bank, other reasons families can request donor milk are:
Failing to thrive on formula
Mother has a low milk supply
Adopted, foster, or surrogate babies
Illness or health risk from the mother that prevents or requires interruption of breastfeeding
More women are donating their extra milk during this crisis. Donated milk is usually reserved for premature infants, but some milk banks also provide milk to healthy full-term babies.
Milk banks are available in many states, and there may be one available where you live. To find out if you can receive donor milk, look for an accredited milk bank near you through the Human Milk Banking Association of North America.
Emergency Baby Formula Alternatives
Breast milk and/or formula are the main source of nutrients for babies under the age of 1.
When all the recommendations and tips for finding formula and/or breast milk have been exhausted and none can be found, what can be done to provide nourishment for an infant?
In the absence of both, there are alternatives that each come with risks and caveats
They do not necessarily follow established pediatric nutrition guidelines, but we are living in unprecedented times and babies need to be fed.
Please note that these options should not be used as long-term solutions, but as short-term ways to provide some nourishment until formula can again be accessed.
Always make every effort to access infant formula and talk through the available options/risks with your pediatrician first.
Alternatives for Babies 4-6 months:
Donor breast milk that comes from an established milk bank
In conversation with the pediatrician and in an emergency only, purees and/or iron-fortified infant cereal + oral rehydration solution can be offered for 1-2 days until formula can be accessed.
This is not an option for every baby – not all are developmentally or physiologically ready for solids before 6 months and their response to purees is unpredictable.
While purees and cereal are not an all-in-one solution, they offer at least a potential source of some nourishment for some babies (who are at least 4 months of age and showing signs of readiness for solids) until formula and/or breast milk can be provided.
Always speak to the pediatrician first and switch back to formula as soon as possible.
There are many critical potential downsides to extending this method of nourishment beyond 2 days, which include dehydration, inadequate protein, inadequate micronutrient intake, so the importance of switching back to formula right away cannot be stressed enough.
Alternatives for Babies 6-8 months (the above, in addition to the list below)
Prioritize nutrient-rich solid foods in baby-safe forms.
Consider a combined feeding method (finger foods + purees to help maximize nutrient intake).
Know that digestive issues are common in newer eaters and that these issues may be exacerbated with the intake of more solid foods.
Per the AAP, in an emergency, if a baby (6-12 months) tolerates regular dairy-based infant formula, whole cow’s milk (pasteurized, fortified with vitamin D) can be offered for up to 1 week under the supervision of the pediatrician until formula can be accessed, as long as no adverse symptoms are noted (i.e., blood in the stools).
In addition to oral rehydration solution, small sips of water may also be offered (up to 4 fluid ounces per day) in conversation with the pediatrician, to help avoid dehydration.
Babies 9-12 months (the above, in addition to the list below)
Per the AAP, while toddler formulas are not recommended for infants, they can be offered for a couple of days in conversation with the pediatrician until infant formula can be accessed.
Look for toddler formula options that DO NOT CONTAIN HONEY and that meet FDA nutrient requirements for infant formula.
In addition to oral rehydration solution, some water may also be offered (up to 8 fluid ounces per day) in conversation with the pediatrician, to help avoid dehydration.
Final Thoughts
This is such a scary and stressful time for the parents and caregivers of infants. However, most parents empathize with what you're going through, no matter how far along they are in their parenting journeys, so look for support in your community and consider joining (or starting) a community formula exchange like this one which was created by my friend, Karrie Locher, RN-BSN,CLC.
Unfortunately, the baby formula shortage is expected to continue for a few more weeks, so we’ll need to pull together in order to get through it.
I’m here to help you, throughout. If you’re getting ready to start your baby on solids, download my FREE Baby-Led Feeding Essential Checklist to make sure you have everything you need to get started. And I’m always available for a 1:1 virtual nutrition consult if you need some personalized nutrition support for your baby. Hang in there - we will get through this.
