How Parents Can Manage the Baby Formula Shortage

Lauren Levine, MD, a Columbia pediatrician, is hearing lots of questions from worried parents about the baby formula shortage: What if I can’t find my usual formula—or any formula? What can I substitute for my baby’s specialized brand? Can my child just switch to cow’s milk early?

Her guidance depends on the infant’s age and whether the child has special dietary needs. But one piece of advice fits every family: If you’re having or anticipating problems getting formula, call your pediatrician, who can help you come up with the best plan for your child. “There’s a solution for every baby at every age; it just has to be worked out between the health care provider and the parent,” says Levine, assistant professor of pediatrics at Columbia University Vagelos College of Physicians and Surgeons.

Levine also shares her insights on resources to try, ways to plan, and what never to do.

Base your plan on your baby’s age

In general, the older the infant, the less critical the formula supply. Infants 10 months old and up could likely add some cow’s milk to their diet and increase their solid foods with your doctor’s guidance. For younger infants, parents have more cause for concern. Even children under 10 months old who have started solids need formula for proper nutrition. And infants who are 4 to 6 months old and younger can be completely dependent on formula, meaning their families have to pound the pavement for resources if supply runs low.

Research equivalent baby formula brands

If your preferred brand has been recalled, you probably want to find a brand that is close to it. This up-to-date chart on formula substitutions from the North American Society for Pediatric Gastroenterology, Hepatology & Nutrition shows formulas that are similar to the ones that have been recalled. You might find options that you have yet to consider that are available in your area. If you do find an alternate, discuss the change with your pediatrician.

If you’re running low on formula

Start by calling your pediatrician, who may have samples or supplies to get you through a day or two while looking for other options. It’s also worth checking smaller stores, which may have inventory when larger chains sell out. In addition, the U.S. Department of Health & Human Services has published this guide to formula shortage resources, which includes manufacturer hotlines and community groups. If you’re eligible, contact your local office of the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), which can help connect families with formula supplies.

Never water down baby formula

Formula is developed to be as much like human breast milk as possible, with exact ratios of protein, fat, carbohydrates, electrolytes, and minerals, all calibrated for infant kidneys. Watering down formula decreases the calories and changes those ratios, resulting in potential damage to the baby’s renal system. “This is why formula is tightly regulated: It’s really more like a medication than food,” Levine says. “You wouldn't water down an antibiotic if you didn't have enough.”

Don’t make your own formula

Physicians, scientists, and nutrition experts have spent decades creating precise formulations, and this expertise can’t be copied in your kitchen—even if you’ve found a recipe online. According to the American Academy of Pediatrics (AAP), some infant deaths have been reported as a result of homemade formulas.

Don’t resort to these switches

Avoid giving toddler formula to younger babies because a smaller infant’s kidneys cannot handle the unique composition of formula for an older child, Levine says. In addition, while infants who are 10 months and older may have some cow’s milk with your doctor’s consent, it should be avoided for younger babies. Such substitutions for young infants may only be considered in emergencies for a few days with your doctor’s guidance. What’s more, don’t rely on plant-based milks, such as almond, because they can lack essential nutrients, says the AAP.

Understand the risks of European brands

Dr. Levine joins the AAP in cautioning against buying European formulas online for several reasons: They’re not currently regulated by the U.S. Food and Drug Administration (FDA), and you may not be notified in the event of a recall. In addition, these products may be counterfeit or stored improperly. However, to ease the formula shortage, the FDA is now working towards evaluating and approving some European brands for use in the U.S.

Consider breast milk, but only from the right sources

Never use a friend or family member’s breast milk because it could transmit viruses. If you can’t find formula, it may be worth reaching out to a local milk bank (such as the New York Milk Bank), which makes donated milk safe through pasteurization. However, be aware that this resource is primarily for medically fragile infants, such as those in the hospital, and a doctor’s prescription is required.

Get breastfeeding support

For mothers currently breastfeeding young infants, now is not the time to wean, says Levine, who acknowledges this can be a difficult decision when challenges such as lack of employer support arise. She also hears from mothers who have stopped breastfeeding and wonder if they should restart due to formula shortages. She suggests contacting resources such as the NYC Breastfeeding Warmline, reachable by phone at (646) 965-7212, which provides lactation/re-lactation support.

Think about your baby’s long-term health

A change to your infant’s formula intake can have lasting impacts, and your pediatrician can help you manage them. For example, if you start your 10-month-old on cow’s milk, talk to your doctor about starting your child on an iron supplement and checking them for anemia early. “We’ll figure out a plan based on your particular circumstance with your baby,” says Levine.