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The Formula Shortage, Explained

In May 2022, news and discussion about a formula shortage in the United States ticked upward — but the severity of the issue and its implications were rarely clear in broad reporting.

Complicating matters were the narrow and uneven — but no less potentially catastrophic — effects of the ongoing formula shortage. On May 8 2022, CNN reporter Gabby Orr described some of what parents of infants then-currently faced as “unreal”:

For many readers, news about a shortage of formula caught their attention in early May 2022, but the problem went back farther than that.

Did the Formula Shortage Begin in May 2022?

No.

On parenting subreddits, posts dating back as far as March 1 2022 referenced signs of a waning supply of formula:

Formula shortage? from beyondthebump

In that post, an expectant parent posted after noticing their local Target’s baby formula section was “basically empty.” One commenter observed similar stock fluctuations at a Costco location:

Even Costco is running low stock of their Kirkland formula. They are limiting it to two per day so my husband and I bought some each day enough for two months.

On April 21 2022, another post described a much more alarming situation, noting that Amazon.com’s product availability went from sporadic to nil:

Formula Shortage is crazy and frustrating! from beyondthebump

That post outlined what would become major sub-issues with the formula shortage. In it, the original poster (OP) explained that their baby relied on a specific formulation for medical reasons, and that they’d been advised to use whatever was available.

A commenter described a facet of the problem unique to a shortage of formula. When they finally located formula to buy, they had to wait three days to receive the product — a timeframe reasonable for household items, but not for the only form of sustenance for an infant:

I ordered on the similac website lastnight and it shipped today. 3 days for it to arrive though. I got a discount for signing up through their site, pretty sure it was $8 and some change. People are panic buying, which when it comes to feeding your baby – yea people are going to. Try to make do with what you can find while you wait for an online order. This kind of stuff, and other reasons, make me really sad I never made enough to feed my son.

When the problem began appearing on general subreddits like r/news on May 5 2022, people discussed the impracticality of suggestions they had heard in the media:

“I like the “please don’t hoard. Only keep 10 to 14 day supply at home”

“Yeah. Parents will totally do that … Only keep 2 weeks on hand and hope they can find this scarce resource again next week…”

“Yeah, there’s not a snowball’s chance in hell that parents will leave feeding their child up to the kindness of strangers. You can’t fuck around with formula; some babies can only tolerate very specific kinds.”

On r/news, the post’s submitter linked to a May 5 2022 CBS News article (archived). It was headlined, “The nationwide baby formula shortage is getting worse,” and its URL rendered in part as “cbsnews.com/news/baby-formula-shortage-ration-limit-purchase-walgreens-target-cvs.”

Originally, it began with context about when the baby formula shortage first began registering among retail metrics:

Baby formula is getting even harder to come by at retailers across the U.S., amid a nationwide shortage of one of the most important products for new parents.

At retailers across the U.S., 40% of the top-selling baby formula products were out of stock as of the week ending April 24 [2022], a new analysis from Datasembly, which tracked baby formula stock at more than 11,000 stores, shows. National out-of-stock levels jumped nine percentage points, from 31% to 40% between April 3 and April 24 [2022]. That’s up sharply from 11% in November [2021].

“This is a shocking number that you don’t see for other categories,” Ben Reich, CEO of Datasembly told CBS MoneyWatch.

Later in the archived version, CBS News reported:

In six U.S. states, more than 50% of formula was out of stock as of late April [2022]. Parents in Iowa, South Dakota, and North Dakota are grappling with severe shortages of 50%-51%, according to Datasembly. Out-of-stock levels are even higher in Missouri (52%), Texas (53%), and Tennessee (54%). At the same time, between 40%-50% of baby formula products were out of stock in 26 states.

“We’ve noticed it being difficult to find maybe a couple months ago — two, three months ago — and then just recently we can’t find it,” San Francisco resident Irene Anhoeck told CBS News earlier this year. “We’ve tried all the local Targets. We checked Costco, Costco online, Walgreens, Long’s. Can’t find it anywhere.”

In that reporting, CBS News linked to an article they published on January 24 2022, “Parents scramble as some types of baby formula now harder to find in parts of U.S.” It included the above-quoted statement, and described an alarmingly reduced supply of baby formula:

Many parents around the country are reporting the same thing: bare shelves or very low stocks of baby formula — from New York to Washington state. The Infant Nutrition Council of America acknowledged there are some supply issues.

“Broadly, there are reports of challenges across retail supply chains, from transportation and logistics to some anecdotal evidence suggesting pantry-loading behaviors, which can put increased pressure on in-store inventory,” a spokesman for the group said in a statement.

[…]

Baby formula accounted for more than $4 billion in U.S. sales in 2021, a 4.5% increase from 2020, according to retail research firm IRI. Krishnakumar “KK” Davey, the firm’s client engagement president, said the current shortage has become worse over the past three or four weeks.

For major brands of baby formula powder, the average national in-stock rate before the pandemic was 95%, he said. But his firm found that as of last week, rates of availability across 10 national retailers ranged from 98% to as low as 75%. Powdered formula was less available in cities including Seattle, Wichita and Tucson.

“Some of the shortages are related to procuring the raw materials, some of it in production, some of it is in packaging… and then labor shortages in the factory, transportation,” Davey said.

Clicking the same link shared to Reddit on May 5 2022 led to a CBS News article dated May 10 2022, still bearing the headline, “The nationwide baby formula shortage is getting worse.” It seemed to serve as a landing page for updates on formula supplies:

Supply-chain snarls related to COVID-19 are contributing to the shortage of formula around the U.S. They include manufacturers having more difficulty procuring key ingredients, packaging hangups and labor shortages, with those factors combining to affect production and distribution. In addition, a major baby formula recall in January exacerbated shortages.

However, the updated article also noted another contributing factor — a formula recall:

Product shortages were further exacerbated in February [2022], when Abbott Nutrition issued a widespread recall of its powdered baby formula products, following reports of illness among infants who had consumed the baby products. The U.S. Food and Drug Administration [in April 2022] issued a warning telling consumers not to use any of the recalled products manufactured at Abbott Nutrition’s Sturgis, Michigan, facility, after it found the plant to be unsanitary.

Formula Recalls

CBS News referenced a Food and Drug Administration (FDA) statement, presumably the one issued on April 29 2022: “Powdered Infant Formula Recall: What to Know,” “Do not use recalled Similac, Alimentum and EleCare powdered infant formulas produced in Sturgis, Michigan.”

In the statement, the FDA indicated that “Illnesses occurred in Minnesota, Ohio, and Texas between September 6, 2021 and January 4, 2022,” and the directive began:

If you use powdered infant formula, be aware certain Similac, Alimentum and EleCare products have been recalled and should not be used.

The U.S. Food and Drug Administration (FDA) is investigating consumer complaints of bacterial infections in four infants who consumed powdered infant formula produced in Abbott Nutrition’s facility in Sturgis, Michigan. All four infants had to be hospitalized and the bacterial infection may have contributed to death in two patients.

The FDA has published a full list of recalled brands. Recalled products should no longer be available for sale. But if you have these products in your home, check the lot code on the bottom of the package to determine if they are included in the recall.

The FDA also is providing additional information for parents and caregivers of infants receiving medical specialty infant formula and individuals using certain medical foods.

Because infant formula is the only source of nutrition for many newborns and infants, the FDA understands and shares the concerns parents and caregivers may have.

Back on February 17 2022, USA Today reported on a recall involving Abbott Nutrition’s products:

Abbott Nutrition is voluntarily recalling three types of infant formula after four babies became sick with bacteria infections after consuming the products.

The recall, announced Thursday, is for select lots of Similac, Alimentum and EleCare formulas that were manufactured at an Abbott facility in Sturgis, Michigan.

The Food and Drug Administration warned consumers not to use or purchase the formulas or certain powdered infant formula produced at the facility.

“The FDA is investigating complaints of four infant illnesses from three states,” the agency said in a statement on Thursday. “All four cases related to these complaints were hospitalized and Cronobacter may have contributed to a death in one case.”

On April 28 2022, Politico published information about potential contamination of formula dating back to late 2021, before the voluntary recall began (“Whistleblower warned FDA about formula plant months before baby deaths.”) The outlet described an FDA investigation in January 2021, based on the whistleblower’s complaints about formula safety:

A former employee at Abbott Nutrition’s Sturgis, Mich., infant formula plant flagged concerns about food safety violations directly with senior FDA officials in October [2021] — months before two infants died and another was hospitalized from bacterial infections after ingesting formula made at the plant, according to a document reviewed by POLITICO.

In a 34-page document sent to officials Oct. 19 and 20 [2021], the whistleblower outlined allegations of lax cleaning practices, purposely falsified records and efforts by plant officials to keep FDA from learning about serious issues related to the plant’s own system for checking for bacteria in formula, among other things. The warning came weeks after health officials in Minnesota had already reported to both FDA and CDC that an infant in the state had been hospitalized for Cronobacter sakazakii — a rare but deadly bacteria — after consuming formula from the same plant.

[…]

FDA officials interviewed the whistleblower sometime in December [2021], DeLauro said [in April 2022].

FDA initiated a weeks-long inspection in response to the Cronobacter complaints on Jan. 31 [2022]. Inspectors ultimately uncovered serious food safety issues and found five strains of Cronobacter in the plant, though none of the strains matched the two samples of bacteria that underwent genetic sequencing in cases where infants were hospitalized, a fact that has undoubtedly complicated the investigation.

Abbott Nutrition and FDA ultimately announced a massive recall of infant formula Feb. 17 [2022] — roughly five months after the first known hospitalization.

Why is a Formula Shortage Such a Big Problem?

For the first six to eight months of their lives, infants are almost entirely dependent on breastmilk or formula to survive, and cannot consume other foods or liquid nutrition.

Centers for Disease Control (CDC) guidance explained that solid foods can be safely introduced between the ages of six and eight months. That period of introduction occurs while infants rely primarily on breastmilk or formula for hydration and nutrition:

The Dietary Guidelines for Americans and the American Academy of Pediatrics recommend children be introduced to foods other than breast milk or infant formula when they are about 6 months old. Introducing foods before 4 months old is not recommended. Every child is different.

As infants typically consume primarily formula or primarily breastmilk, formula-fed infants have no other safe alternative for sustenance for most of the first year of their lives.

Formula Shortage Risks, Limited Options for Parents

In early May 2022, news articles about the risks of the formula shortage were common.

A May 10 2022 article (“As baby formula shortage worsens, health officials warn parents against unsafe alternatives”) reported that stopgap measures could quickly become deadly. Even diluting formula with water can cause severe illness or death:

A worsening baby formula shortage is forcing some parents to take drastic measures that health experts warn could be harmful to babies … Some parents are trying to stretch their formula by mixing it with more water, others are trying to make their own formula at home; both of which could be very dangerous.

[…]

Some parents are trying to stretch what they have, but formulas are made with very specific combinations of calories, fat, protein, carbohydrates, vitamins, and minerals.

Camila Martin, a registered pediatric dietitian with UW Health, said, “So if this is diluted with water, this can actually be really dangerous to an infant.”

Martin says store-bought formula goes through a rigorous process in order to get FDA approval. But she adds, “homemade formulas can be quite dangerous, and have resulted in hospitalizations for patients that I’ve seen in the past.”

A PBS piece published on the same date underscored the severity of the problem and lack of alternatives, reporting:

For now, pediatricians and health workers are urging parents who can’t find formula to contact food banks or doctor’s offices. They warn against watering down formula to stretch supplies or using online DIY recipes.

“For babies who are not being breastfed, this is the only thing they eat,” said Dr. Steven Abrams, of the University of Texas, Austin. “So it has to have all of their nutrition and, furthermore, it needs to be properly prepared so that it’s safe for the smallest infants.”

[…]

The shortages are especially dangerous for infants who require specialty formulas due to food allergies, digestive problems and other conditions.

“Unfortunately, many of those very specialized formulas are only made in the United States at the factory that had the recall, and that’s caused a huge problem for a relatively small number of infants,” Abrams said.

A May 10 2022 Newsweek.com piece also cautioned parents against “homemade formula” recipes, describing how quickly illness could result:

… creating your own formula can be dangerous, with pregnancy nutritionist and baby-weaning expert Katie Angotti describing it as “a real risk” … She told Newsweek: “Infant formula is a controlled food created to meet the specific nutritional needs of babies. Trying to get the right balance of all those nutrients at home would be impossible.

“Too much protein could affect a baby’s kidneys or too little calcium and vitamin D will affect their bones, for example.

“I’d be really concerned about the level of different salts that could be present, or lacking, meaning that babies could become dehydrated quickly.”

Many of the articles touched on the very real dangers posed by an absence of formula. Furthermore, little tangible guidance was offered to parents, as a May 10 2022 Forbes contributer’s post explained:

Diluting formula in order to enable this pricey product to stretch a bit longer is not new, but the added concern of limitation on quantity (many retailers have set strict limitations on the number of cans of formula per person per purchase) has led many more to make this life-sustaining powder last a bit longer. Dr. Tanya Altmann, founder of Calabasas Pediatrics and spokesperson for the American Academy of Pediatrics, shares some strong advice for parents:

  1. Do not make homemade infant formula, as it won’t meet a baby’s essential nutritional needs and can even be very dangerous.
  2. Do not add extra water to stretch your formula supply as this can dilute the nutrition and lead to major health problems.
  3. Do switch brands If your routine formula is not available. It can take a baby a few days to get used to the new formula, so be patient.
  4. If your baby is on a special formula because of allergies or sensitivities, or has had a reaction or issue with a previous formula, always talk to your pediatrician first before switching.

A May 10 2022 New York Times tweet reported formula rationing and price gouging as the situation worsened:

The article described specific incidents of rationing formula, quoting parents of children with severe dietary restrictions — several of whom were diluting formula:

For Darice Browning, the specialty formula shortage in Oceanside, Calif., has been so acute that she has considered going to the emergency room just to feed her youngest daughter, Octavia, who is 10 months old and has rare genetic conditions that currently make it impossible for her to eat solid foods. The food allergies she shares with her 21-month-old sister, Tokyo, cause both babies to vomit blood if they ingest dairy proteins.

At one point, Ms. Browning said, she called all of her daughters’ doctors looking for formula, only to be told that none had any.

“I was freaking out, crying on the floor and my husband, Lane, came home from work and he’s like, ‘What’s wrong?’ and I’m like, ‘Dude, I can’t feed our kids, I don’t know what to do,’” Ms. Browning said … In Pell City, Ala., Carrie Fleming has been putting half a scoop less of formula into every bottle she makes for her 3-month-old daughter, Lennix.

Ms. Fleming had originally tried to breastfeed Lennix but could not produce enough milk. Then, Lennix had severe allergic reactions to nine different dairy-based formulas: She broke out in rashes, cried constantly and threw up everything she ate. The only formula Lennix can stomach is a hypoallergenic kind called PurAmino, which Ms. Fleming cannot find anywhere nearby.

Alarming anecdotes about formula scams were also reported:

Parents who have tried to buy online said they have encountered not only higher prices, but scams. Two weeks ago, K-Rae Knowles, of Oregon, Ill., sent money to a stranger in exchange for cans of a specialty formula she needed for her 4-month-old son, Callan. The cans never came, she said, and the seller’s Facebook profile was deleted a few days later.

“Switch brands” was the most common form of advice in articles urging parents not to turn to homemade or diluted formula — advice that was unhelpful to infants requiring specialized care.

Is the American Government Addressing the Formula Shortage?

On May 9 2022, CNN covered remarks made by White House Press Secretary Jen Psaki during a briefing on that date — including a response to a question about a “national stockpile” of formula:

White House press secretary Jen Psaki said Monday [May 9 2022] that the US Food and Drug Administration is “working around the clock” to address the baby formula shortage, as manufacturers say they’re producing at full capacity and making as much formula as they can — but it’s still not enough to meet current demand.

“The FDA issued a recall to make sure that they’re meeting their obligation to protect the health of Americans — including babies who, of course, were receiving or taking this formula — and ensure safe products are available. That’s their job,” Psaki said.

“Ensuring the availability is also a priority for the FDA and they’re working around the clock to address any possible shortage,” she added.

Psaki said the FDA is taking “a number of steps” to address the issue, including working with major infant formula manufacturers to ensure their increasing production and working with the industry to optimize supply lines, product sizes and prioritizing product lines that are of greatest need.

“The FDA, it is not just their responsibility in their view to ensure that we’re meeting our obligations to protect Americans, it is also their obligation to take steps to make sure supply can be met when they take these steps,” Psaki said.

Psaki also said she didn’t believe there was national stockpile of baby formula when asked.

On May 10 2022, the FDA issued a statement about its current efforts to address the formula shortage. The primary advice to parents was noticeably brief and vague, even as several parents quoted in news stories were unable to obtain formula or applicable advice from pediatricians:

The [FDA] continues to advise against making infant formulas at home and encourages caregivers to work with their child’s health care provider for recommendations on changing feeding practices, if needed.

Summary

In May 2022, a nationwide formula shortage in the United States came to widespread attention. Reporting over the course of months indicated that formula shortages were exacerbated by a formula recall, as well as ongoing supply chain problems. News outlets urged parents not to resort to “homemade formula” or diluted formula, despite a lack of alternative measures. Even the FDA had no concrete advice for parents of infants unable to obtain formula.

The Formula Shortage, Explained
The Formula Shortage, Explained
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