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What you can and cannot do to get through the lack of infant formula, according to experts




The California doctor has received phone calls, emails and messages on social media – not just from her patients, but from families across the United States – along with pictures of empty store shelves that once had breast milk substitutes.

“It’s scary for these mothers and their babies, and it’s starting to become a real problem,” Altmann said.

Supply chain problems and product recalls have triggered the nationwide shortage of infant formulas. As of early April, seven states reported that between 40% and 50% of baby replacement products were sold out. Manufacturers have said that they produce at full capacity to earn as much as they can, but this week 43% of the baby replacement was sold out, according to a new report from Datasembly.
The U.S. Food and Drug Administration is working with Abbott Nutrition, the company involved in the recent recall, to safely resume production and find tools to support the supply of infant formula, according to an FDA spokesman. But the facility in Michigan is probably still about two weeks away from being back online, pending deregistration from the FDA, and it will likely take another six to eight weeks before the products are back on the shelves, according to a statement from the company.
Some people turn to online communities of caregivers to get some ideas on what they can do if they can not get the baby’s source of nutrition. However, pediatricians are concerned about the health effects of some of the ideas posted online, said Altmann and Dr. Steven Abrams, a professor of pediatrics at the University of Texas at Austin and former chair of the American Academy of Pediatrics Committee on Nutrition.
The pediatricians said that there are ways to get through the lack of too many people, and it is important to work with your pediatrician to meet the infant’s special needs. Here are answers to some of your questions about what is safe and what is not.
Baby substitutes appear on the shelves of a grocery store in Carmel, Ind., Tuesday.

Can I make formula at home?

No.

“There’s a lot of discussion about making your own formula at home and stuff like that, and I really want to discourage that as much as possible,” Abrams said.

Formulas are complex, and researchers have spent years developing the right relationship to give babies the nutrients they need, Altmann said.

Breastmilk substitutes must be dense with protein, fat, vitamins and minerals, many of which you can not buy in the grocery store. And the balance must be precise for babies’ health and development, she added.

“You can see how it would be very difficult to duplicate in your own kitchen,” she said.

Homemade formulas can cause a baby to not get proper nutrition or the relationship between their electrolytes to be disrupted, which can be dangerous, Altmann said. There have also been cases of bacterial contamination, which can make infants sick.

Can I extend my formula supply?

No.

Adding other food sources or adding more water to the formula is tempting as you approach the end of the last container of formula, but pediatricians said it is not a good idea.

Families can begin introducing solids into an infant’s diet when the baby is around 4 to 6 months old, Altmann said. However, these foods are not a nutritional substitute for the formula at that age.

“Even when you start with solids, breast milk or infant formula is still the most important source of nutrition for your baby,” Altmann said.

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And adding extra water to stretch the formula you have can dilute the essential nutritional profile and lead to serious health problems and disrupt proper growth and development, she added.

“We are not irrational. If there is nothing you can put in your baby’s mouth other than cow’s milk, you will do it,” said Abrams. “But that’s not what we want people to do.”

Can I use infant formula or cow’s milk instead?

May be.

It really depends on how old your baby is and what your pediatrician says.

For at least the first six months, the formula specified for infants is very important, Altmann said. But the closer they are to a year, the more flexibility there can be.

“You can actually choose a toddler formula at the time you would normally wait until they are exactly one year old,” Altmann said. “Talk to your pediatrician, always first.”

“We do not recommend using cow’s milk until one year of age, but it is absolutely true that since the baby is close to a year old, especially if there is simply no formula to be found, you can use either it or a toddler substitute,” he said. Abrams. “None of them are ideal, but the closer you are to the year, especially in the short term, there are alternatives.”

Can I buy international formulas online?

May be.

Altmann said that there are some high quality products made in Europe and Australia she likes that are available online. But it is important to make sure you are ordering from reputable retailers.

She recommended buying from reputable pharmacies in the country the formula is from and checking how the formula’s nutrition compares to the FDA-approved formula.

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“Not all international formulas are created equal, so you may want to make sure you know what you are getting and that it is a high quality product,” she said.

But Abrams warns against imports, reminding families that imported formulas are not considered by the FDA.

“It’s a less than ideal alternative, but if that’s what they have to do, then that’s what they have to do,” he said.

The FDA recommends against importing formula online because it could potentially be counterfeit, a spokesman said.

Can I change the formula brand?

Yes.

“What we want people to do if at all possible is to be as flexible as possible and make formula changes,” Abrams said.

It may take your baby a few days to get used to a new formula brand, but in most cases it is okay to change, Altmann said. You can find great formula choices for your baby here.

However, it becomes more complicated in cases where a child may have a particular formula due to allergies or sensitivities.

“If your child has an allergy or sensitivity and has had previous reactions to formulas, please consult your pediatrician before switching off because not all formulas are the same,” Altmann said. “But in most cases, there are other options available that we can help you with.”

The FDA allows Abbott Nutrition to release the product on a case-by-case basis to some families who have an urgent need for specialty and metabolic formulas, according to the agency.

Can I restart breast milk supply?

It’s complicated.

There have been cases where parents can induce breastfeeding for the first time or start breastfeeding again after choosing not to breastfeed, Altmann said. However, the process is complicated and probably requires the help of a breastfeeding specialist.

There are also banks where you can buy breast milk donated by other families. You can find milk banks near you through the Human Milk Bank Association of North America.



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