Infant formula shortages forced distressed mothers into unsafe diets: study

In February 2022, infant formula maker Abbott Laboratories massively recalled its baby formula due to bacterial contamination. The recall, which came at a time when supply chains were still suffering from the strain of the pandemic, affected multiple lots of Abbott’s Similac, Alimentum and organic formulas. As the largest infant formula company, Abbott supplies over 40 percent of the nation’s infant formula. Grocery store shelves across the country were empty for months, leaving parents desperate for ways to feed their children.
As Salon previously reported, some parents were frantically scouring Facebook groups for milk formula retailers or, in some cases, buying breast milk from online platforms. Scammers and price gougers wasted no time in taking advantage of this crisis.
Now a new study is to quantify how parents had to cope during the crisis. Published in the magazine BMJ Pediatrics, Researchers at the University of California, David, found that nearly half of the parents who relied on infant formula to feed their babies during the crisis resorted to unsafe feeding methods.
“I think what’s exciting about this publication is that it reports for the first time how parents with infants who were formula-dependent responded to the infant formula shortage in the midst of the crisis last year,” said lead author Jennifer Smilowitz, a Faculty member in the Department of Food Science and Technology at UC Davis, Salon said. “This is unique because we’re not asking people to remember what they were doing six months or a year ago, but what they’re doing right now.”
“These practices may seem harmless when we think about adult nutrition, but we have to remember that infants need a very specific balance of nutrients to grow and develop.”
In fact, the survey took place in May 2022, when some states had out-of-stock rates as high as 90 percent. Specifically, Smilowitz and her colleagues found that the number of people using at least one unsafe dietary practice increased from 8 percent before the shortage to almost 50 percent during the peak of the shortage. Unsafe practices included watering down infant formula, using expired infant formula, using homemade infant formula, or using breast milk from informal sources.
“These practices may seem harmless when we think about adult nutrition. Kind of like you water down chicken soup, but we have to remember that infants need a very specific balance of nutrients to grow and develop,” Smilowitz said. “So too much or too little of anything could actually be dangerous for their developing systems. For example, watering down infant formula is unsafe because it can lead to electrolyte and mineral imbalances, so homemade infant formula may seem safe. But in fact it is unsafe because it can lead to nutritional deficiencies if not prepared by a recognized nutritionist.”
In addition, impurities can be introduced during the preparation process. As Salon previously reported, recipes for homemade formulas were circulating online during the shortage.
“Using expired formula is unsafe because the nutrients in formula can degrade over time, which in turn can affect the growth and development of the infant,” Smilowitz said. “Finally, informally purchasing breast milk — that is, sharing milk, whether online or with friends and family, as opposed to purchasing pasteurized donor milk — is unsafe because it can pose health and safety risks.”
“Another crisis is imminent unless there is systematic change in US regulatory, health and workplace policies.”
According to the survey, these risks have skyrocketed during the scarcity. The proportion of parents who shared breast milk rose from 5 percent to 26 percent, while the proportion of parents who used diluted formula rose from 2 percent to 29 percent. The number of parents turning to milk banks, which is considered safe practice, rose from 2 percent to 26 percent. However, donor milk from milk banks can be expensive — anywhere from $3 to $5 an ounce.
The study revealed that low-income families were hit hardest, with 75 percent of study participants participating in either the special nutritional supplement program for women, infants, and children (WIC) or participated in the program in the past 12 months. Smilowitz said she hopes this will be a wake-up call for policymakers to change the monopoly in the US infant formula market. In the US, the infant formula supply is controlled by US trade regulation and tariff policies.
“This creates a concentrated infant formula market in the US,” Smilowitz said. “So there are really high tariffs, up to 25 percent, and that prevents the import of infant formula from manufacturers from other countries, including Canada, into the United States.”
Smilowitz added that there are also strict labeling regulations that prohibit diversification in the infant formula market.
“This geopolitics reduces the variety of infant formula options in the US market,” Smilowitz said. “While this study reflects a catastrophic event 13 months ago, let’s not forget what happened because another crisis is imminent if regulatory, health and workplace policies in the US don’t change systematically.”
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about the shortage of infant formula