Formula Shortages

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See AAP guidance on how to manage if your formula supply is getting low.  Hopefully, this will be a very short-lived problem.

What if baby formula is out of stock everywhere?
The U.S. Food & Drug Administration announced it is taking steps to help improve supply of infant and specialty formula products. However, if you’re struggling to find baby formula during the shortage, here are some tips that can help.

Keep in mind, this advice is strictly for URGENT situations. If you have any concerns about your baby’s nutrition, please talk with your pediatrician.

Check smaller stores and drug stores, which may not be out of supply when the bigger stores are.

If you can afford it, buy formula online until store shortages ease. Purchase from well-recognized distributors and pharmacies rather than individually sold or auction sites.

For most babies, it is OK to switch to any available formula, including store brands, unless your baby is on a specific extensively hydrolyzed or amino acid-based formula such as Elecare (no store brand exists). Ask your pediatrician about recommended specialty formula alternatives available for your baby.

Check social media groups. There are groups dedicated to infant feeding and formula, and members may have ideas for where to find formula. Make sure to check any advice with your pediatrician.

Is it OK to put more water in baby formula?
No. While it may be tempting to water down formula to stretch it out, it is not safe to do that. Always follow label instructions or those given to you by your pediatrician. Watering down formula is dangerous. It can cause nutritional imbalances in your baby and lead to serious health problems. Always mix formula as directed by the manufacturer.

Can I make my own baby formula?
The AAP strongly advises against homemade formula. Although recipes for homemade formulas circulating on the internet may seem healthy or less expensive, they are not safe and do not meet your baby’s nutritional needs. Infant deaths have been reported from use of some homemade formulas.

What should I know about imported baby formula?
The FDA is considering accelerated approval of certain imported formulas. Many sold in Europe, for example, contain adequate nutrients but must be imported in a way that maintains temperature and other safety issues. That’s why FDA oversight is critical.

Can toddler formula substitute for regular formula?
Toddler formulas are not recommended for infants. However, if you absolutely have no other choice, toddler formula is safe for a few days for babies who are close to a year of age.

Can I give my full-term baby premature formula?
Formulas designed for babies who were born premature (and have “catch-up” growth to do) can safely be used for a few weeks to feed full-term babies if nothing else is available.

Is cow’s milk a safe alternative to baby formula?
If your child is older than 6 months of age and is usually on regular formula (not a specialty product for allergies or other special health needs), this may be an option. In a pinch, you could feed them whole cow’s milk for a brief period of time until the shortage is better. This is not ideal and should not become routine. However, it is a better option than diluting formula or making homemade formula. Although we don’t have a specific amount of cow milk that infants 6-12 months should drink in this situation, follow the limits of no more than 24 ounces a day for children over a year of age. See “Recommended Drinks for Children Age 5 and Younger.”

The most important concern with giving an infant over 6 months of age cow’s milk if you can’t find baby formula is making sure they get enough iron to prevent anemia. Be sure to include plenty of iron-containing solid foods in their diet while you are using whole cow’s milk. You may also talk with your pediatrician about giving your baby an iron supplement until you can find formula again.

What about feeding my baby goat’s milk?
Goat’s milk is not approved for babies in the United States. However, there are goat milk-based baby formulas registered in other countries that may be among those considered for accelerated import approval by the FDA.

Can I use plant-based milk instead of baby formula if needed?
Milk alternatives are not recommended for babies under a year of age or infants with certain medical conditions requiring specialized formulas. Soy milk may be an option to give babies who are close to a year of age for a few days in an emergency, but always buy the kind that is fortified with protein and calcium. Make sure to change back to formula as soon as some is available. Be especially careful to avoid almond milk or other plant milks as these are often low in protein and minerals.

What is the shelf life of baby formula?
Check the “use by” date on infant formula, which is required by FDA regulations to be on each container. Until that declared date, the formula will contain no less than the amount of each nutrient on the product label and will otherwise be of acceptable quality.

Remember:
Don’t hesitate to talk with your pediatrician if you have any concerns you have about your baby’s health and nutrition. If your child has special health needs, be sure to check with their doctor about medically appropriate and safe feeding alternatives.

Remember also that older babies (~6+ months) w/o allergies can have yogurt, etc, to help boost calcium intake and can drink water for fluids. A multi-vitamin w/ iron may help cover nutritional gaps, if typical formula intake is restricted for those babies.