Infant Formula Shortage Led to Risky Feeding Methods, Study Reveals

A study from the University of California, Davis, published in BMC Pediatrics revealed that a significant number of parents resorted to unsafe infant feeding practices due to the formula shortage last year.

A comprehensive online survey showed that unsafe infant feeding escalated alarmingly during the formula shortage. Before the crisis, 8% of parents admitted to using unsafe feeding methods, during the shortage that # scaled to 50%. Unsafe methods consist of diluting formula with water, using homemade or expired formula, or sharing human milk informally. Parents sharing human milk saw a rise from 5% to 26%, and those watering down formula went from 2% to 29%.

Lead author Jennifer Smilowitz, associated with UC Davis’s Department of Food Science and Technology, voiced her concerns: “The formula shortage magnified food insecurity and endangered millions of American infants’ nutrition. Lacking safe alternatives, parents opted for hazardous feeding solutions.”

The study aimed to discern parents’ experiences during the crisis, aspiring to forestall similar future crises.

In 2022, the U.S. grappled with a severe infant formula deficit, precipitated by a recall by Abbott Nutrition and the voluntary cessation of its manufacturing in Michigan. Given that Abbott supplies over 40% of U.S. infant formula, the crisis was felt acutely, with trade policies further complicating formula import. By May 2022, formula stocks were nearly depleted in some states.

The U.S. largely depends on Abbott for WIC (Special Supplemental Nutrition Program for Women, Infants, and Children), a program serving over 40% of American infants. Smilowitz noted the risk in this: “Four companies sell 90% of the U.S. infant formula. This centralized system chiefly disadvantages low-income communities.”

While some parents shifted to pasteurized human donor milk from milk banks (a safer alternative), its high cost ($3-$5 per ounce) and limited availability restricted its use. Low-income parents especially felt the crunch.

Smilowitz urges systemic changes in healthcare, workplace, and regulatory policies including better lactation support, easier access to banked donor milk, and a wider variety of commercial products. She highlights the importance of accommodating workplaces for breastfeeding mothers, given that many current policies fail to provide the necessary privacy and time for pumping.

“We shouldn’t become complacent after the formula crisis. An impending crisis awaits if systemic changes aren’t implemented,” Smilowitz warned. She further expressed concerns about the long-term health impacts on infants affected by the formula shortage. “The real consequences might only emerge a decade later, especially concerning brain development. We hope that any effects are short-lived and that children are resilient enough to sidestep any prolonged issues.”

Karina Cernioglo, a UC Davis medical student, co-authored this study. The research received support from the 2020 UC Davis Chancellor’s Innovation Award.