America's baby formula shortage: 8 key questions, answered

Updated: May 18, 7:50 p.m. | Posted: May 16, 4 a.m.

Parents have struggled to consistently find baby formula for months now. It’s a dire situation with serious impact.

“I think it’s scary for families,” Park Nicollet pediatrician Dr. Andrea Singh told MPR News Morning Edition. “When you don’t have assurances that the next meal will be present for your baby, that is really frightening.”

As of last week, the U.S. is now 43 percent out of stock, according to Datasembly. That’s up from 30 percent in April and 23 percent in January.

Between pandemic-related supply chain issues and February’s recall of several formulas including the popular Similac, shelves nationwide are often empty, with stores lacking even a low supply of formula products.

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The factory responsible for the recall, Abbott in Sturgis, Mich., is one of the country’s four biggest producers of baby formula. It remains closed and under U.S. Food and Drug Administration investigation, although manufacturing could resume within weeks.

Hopefully, supplies increase soon. Until then, here are eight questions — with answers — key to understanding the shortage and how to navigate it.

1) How can I find baby formula during the shortage?

If you’re striking out at your regular stores and online, check the formula stock at smaller stores and pharmacies in your area. They might have different supplies than the big box retailers. Local food shelves or community organizations may also have formula on hand, or know how to find it.

Some parents are using community groups on social media to find formula. Of course, use your discretion with these and only feed a child formula from reputable brands from trusted sources.

2) Should I stock up?

If you find a decent supply, buy only what you need. Stockpiling will only exacerbate the problem for others in need.

At least three retailers with stores in Minnesota — CVS, Walgreens and Target — are all limiting how much baby formula customers can purchase online and in-store to avoid hoarding during the shortage.

The American Academy of Pediatrics says to buy a 10-day to two-week supply of formula at most.

3) How do I know if the formula I have was recalled?

Abbott’s website allows consumers to check if the product you have was impacted by its recall. Enter the lot number found on the bottom of the container, and talk with your doctor if the formula you used was recalled.

4) What is the government doing to help?

The FDA says it’s working with manufacturers to increase supply of formula. Last week the Biden administration said the nation is taking other measures, including boosting baby formula imports. On Wednesday, the Biden administration invoked the Defense Production Act to speed production of infant formula. This requires suppliers of formula manufactures to fulfill orders from those companies before other customers to hopefully eliminate the production bottlenecks caused by the shortage.

5) What’s the advice from doctors?

Doctors recommend getting in touch with your doctor or pediatrician to see if they have any specific advice regarding formula, especially if your child is fed a particular type for health reasons.

“For kids with complex medical needs, there are sometimes resources that your medical offices will be able to use to help get specialty formulas,” said Singh, who chairs the Park Nicollet pediatrics department.

Some clinics or hospitals also might have samples of baby formula on hand to distribute. Switching formulas temporarily is another an option.

“For most babies who are healthy, it’s safe to use a different formula, unless there is a medical reason for being on a certain formula,” said Children’s Minnesota pediatrician Dr. Abdul Kadir Abdi.

To be safe, check with your doctor before making a switch.

6) How does the shortage affect Minnesota WIC recipients?

Participants in the state’s WIC (Women, Infants and Children) Program, which provides formula for low-income families, are usually limited to Similac formulas, made by currently shuttered Abbott.

The state is temporarily expanding WIC benefits to cover dozens of other options. Here are the alternatives the Minnesota Health Department is recommending as substitutes for different types of Similac formulas.

“If you can’t find your preferred formula brand, check the allowed formula substitutes list and try to find another at local stores,” said Minnesota WIC director Kate Franken. “Stock can vary by store and region.”

WIC recipients might not have access to the transportation needed to check stores in different places for supply or the financial means to buy formula available online.

“Families who receive WIC are more affected by this,” said Abdi.

For help, Franken advises those with WIC benefits to contact their local WIC agency. And if you think you might qualify for WIC, that’s another reason to call. You can apply online or call WIC at 1-800-942-4030.

Minnesota WIC also has more information and resources related to navigating the formula recall.

7) Should I try to make formula at home or dilute the formula I have?

No to both.

“Formula is very specifically tailored to meet the metabolic and nutritional needs of babies at different stages in their lives,” said Singh.

Because of that, it’s nearly impossible to recreate the correct nutrient balance that’s in formula. There’s also a risk of bacterial contamination when trying to make or alter formula.

“The best diluting analogy that I can make in this situation is that if there’s a gasoline shortage for the car, you don’t water down the gas. That’s going to be quite dangerous to your engine and the infrastructure,” Singh said. “The same thing is true with baby formula.”

She knows of cases in Minnesota hospitals where children have been admitted after getting sick from diluted formula.

8) What about milk alternatives?

If nothing else is available, formula for premature babies is safe to use for a few weeks, according to new guidance from the American Academy of Pediatrics. Toddler formula can also be used in an emergency for a few days with babies close to 1 year old.

The AAP urges strongly against plant milks like almond, cashew, rice, oat and hemp milk, which often lack the protein and minerals babies need.

Soy milk, however, can be fed to infants who are almost age 1 until formula is available. The AAP says to purchase soy milk that’s fortified with protein and calcium.

Feeding infants cow’s milk isn’t ideal, as it can cause intestinal bleeding and kidney damage in very little babies. Singh says cow’s milk can be OK for children who are almost 1 year old, at least until their regular formula is back in stock.

“But I would really encourage people to talk to their medical provider if they’re thinking they might be in this situation and that’s their only option,” Singh said.

The American Academy of Pediatrics has more detailed advice on using cow’s milk as an alternative.

Goat’s milk is not approved for infants in the U.S.

Parts of this story were heard first on MPR News Morning Edition. Click on the audio player above for Cathy Wurzer’s full interview with Dr. Andrea Singh. The story was also updated with additional advice from the American Academy of Pediatrics.

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