May 18, 2022 - Health

Baby formula shortage puts spotlight on how America feeds its young

Illustration of a tipped over baby bottle dripping milk into a milk puddle the shape of the United States.

Illustration: Aïda Amer/Axios

America's dependence on baby formula has come under the spotlight as a national shortage sparked a nutritional crisis.

Why it matters: The U.S. Dietary Guidelines for Americans and the American Academy of Pediatrics recommend infants be exclusively breastfed for about the first six months. But, in practice, most babies get some type of formula.

What they're saying: “Although we're doing a better job of breastfeeding nationally, we still have most infants — or a little over half — that are requiring some type of formula within the first six months of life," James Franciosi, chief of gastroenterology, hepatology and nutrition at Nemours Children's Hospital in Florida told Axios.

The big picture: Years of public health campaigns about the nutritional benefits of breastfeeding for babies have resulted in more than four out of five babies starting out on breastmilk.

  • Hospitals have adopted programs to support new mothers with early skin-to-skin contact while not introducing any formula, as well as in-person lactation support to help them become comfortable with breastfeeding.
  • Public support for breastfeeding has also grown, at times exposing major cultural dividing lines. Case in point: The firestorm sparked by Bette Midler's "Try breastfeeding!" tweet about the shortage, which critics said was insensitive and uninformed.

While breastmilk is considered nutritionally "best," parents ultimately switch exclusively to using formula or supplement breastfeeding with formula for many reasons, Franciosi said.

  • In many cases, breastfeeding is simply not possible due to medical concerns, including an infant's food allergies or metabolic conditions.
  • Breastfeeding can also be physically and mentally taxing, or simply incompatible "with the demands of work outside the home," the New York Times reports.

Between the lines: As parents scramble to find scarce formula, they've turned to online communities for help.

  • In one notable example, gymnast Shawn Johnson and her husband Andrew East, launched a website for parents to share formulas called Baby Formula Exchange.
  • But these efforts by parents have also led to the spread of misinformation, including recipes of how to make homemade formula or stretch their formula with water — which experts urge parents not to do.
  • "Formulas are made try to closely resemble, but not perfectly, breastmilk. It's a hard thing to get right. We don't want people to try make their own," Franciosi said adding it has landed babies in the hospital due to malnutrition, or electrolyte or calcium imbalances.

What to watch: That's left many Americans dependent on a heavily concentrated industry that manufactures the product. Four companies — Abbott Laboratories, Mead Johnson, Perrigo and Nestle — account for more than 87% of the market, according to IBISWorld.

  • House Democrats on Tuesday proposed an emergency funding bill that would give the FDA $28 million to beef up its inspections of formula before it hits store shelves and to prepare for future shortages, Axios' Herb Scribner reports.
  • A House panel plans a hearing next week with formula manufacturers and FDA food safety officials.

The bottom line: "This infant formula crisis is really heartbreaking and it's really sad that it's happened in America," Franciosi said.

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