By Chelsea Bailey-BBC News, Washington
https://www.bbc.com/-Image source, Angelica Casas, BBC News
Brandy Sloan feeds formula to her adopted two-month-old son.
Brandy Sloan was close to tears. The 43-year-old mother of two had reached a breaking point in her desperate search for baby formula when the fifth grocery store she rushed into contained the same as the previous four: empty shelves.
“You feel so defeated because you’re supposed to be able to feed your children and you can’t because there’s nothing there,” she told the BBC.
Brandy, who has a 15-month-old daughter and a recently adopted two-month-old son, is among the millions of American families struggling to feed their children amid a nationwide shortage of formula.
Some are so desperate that they are attempting to make their own infant formula substitutes. Google searches for how to make formula at home have increased by 2400% in the last 30 days, according to Google Trends.
Brandy is sceptical – and for good reason – but it’s understandable why some parents feel compelled to ask the question.
Supply chains have been strained throughout the pandemic, but an industry-wide infant formula shortage began to intensify in February when Abbott, a large manufacturer of powdered infant formulas, closed a facility and issued a voluntary recall after finding contamination.
The company has since reached an agreement with US regulators to work to re-open, but cautioned it could take up to two months for products to hit the shelves.
On Wednesday, US President Joe Biden – who is under mounting pressure to solve the crisis – invoked the Defense Production Act, a war-time measure, to boost domestic production of baby formula. He also ordered the Pentagon to fly in shipments from overseas.
A bill to alleviate the shortage was also overwhelmingly passed by the House of Representatives.
An analysis by the retail research firm Datasembly found that 43% of formula products were unavailable nationwide in the first week of May, and soared even higher in states like Tennessee, Texas and Iowa.
In San Antonio, where Brandy lives, the shortage was 57% in late April, according to Datasembly.
To cope, Brandy said she’s seen a lot of people circulate a 1950s recipe for baby formula. “You get the [people] from older generations saying, ‘I turned out fine,’ but things are a lot different than they were a generation ago,” she said.
Dr Steven Abrams, former chair of the American Academy of Paediatrics’ Committee on Nutrition, has also seen the same 1950s recipe online – and strongly advises against using it, diluting formula or attempting to come up with other homemade substitutes.
“The standard by which we develop infant formula is breast milk. We’ve come to understand breast milk better and better,” over the last 60 years, Dr Abrams said. “If they’re not breastfeeding, [the formula] has got to have all the nutrients in there”.
Indeed, according to the US Centers for Disease Control and Prevention, infant mortality rates have fallen dramatically in the last half century, from 29.2 deaths per 1,000 live births in 1950, to 5.6 deaths in 2019.
So-called “homebrews” are particularly dangerous in the first months of infancy, Dr Abrams said, when nutrients like iron – critical for brain development – must be present in a baby’s diet.
Homemade formulas also pose challenges with sterility and continued use can result in severe malnutrition and, in extreme cases, death.
If formula is not available in stores, the American Academy of Paediatrics advises parents to contact local paediatricians for samples, avoid big box-stores where supplies are more likely to be low, or switch to a store brand formula unless advised otherwise medically. In those cases, paediatricians can recommend available formula alternatives.
This week, the Academy also said that infants over six months could be given whole cow’s milk as a stopgap. Though cow’s milk “is not ideal and should not become routine”, it is a better than diluting formula or attempting a homemade substitute, it said.
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The Academy also encouraged parents to use online communities and social media as a resource. But as the crisis deepens, in some online spaces those conversations can become toxic.
Becoming a new parent is already a stressful time, Brandy said her “nerve-wracking” journey has been made more difficult by online comments that pit breastfeeding parents against those who use formula.
“People don’t understand that not every mom is just able to breastfeed like it’s so easy,” she said, adding that she feels families with adopted children like hers have been “erased” from the conversation.
The shortage has also disproportionately impacted low-income women and children that rely on state-subsidised nutritional programmes to buy groceries. Nearly half of all infant formula sold nationwide is purchased through government-subsidised benefits.
It can take a crisis for those in power to recognise the existing inequalities impacting the most vulnerable, said Jessica Owens-Young, an assistant American University professor who researches health inequity. As prices rise to meet an increased demand, she fears there will be long-term effects on low-income families.
“In urban areas, where things tend to cost a little bit more anyway, where are people pulling their money from? Are they taking away money that could pay rent or electricity?” she asked.
Comments encouraging parents to “just breastfeed” or shaming those who rely on formula, tend to overlook the realities of breastfeeding, she said.
“The way we construct the dialogue around maternal and infant health is reflective of the broader society’s values around women and birthing people and children,” she said. “Mothers and nursing people have been shamed for their choices for centuries”.
Without an immediate end to the shortage in sight, Brandy said she’s trying to stay focused on the positive interactions she’s had online and acknowledges that a lot of parents are just scared. She also said she feels lucky. After putting an “emergency SOS” out on social media, a friend in Arizona mailed her a few cans of formula that she hopes will hold her over until the shortage eases.
“I could waste time being mad, but that’s not going to feed our babies,” she said. “It’s time to get resourceful. I think more should be done to safeguard us and prevent this from happening again”.
Additional reporting by Angelica Casas