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Opinion | The Formula Shortage Isn't an Excuse to Be Cruel

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I'm often frustrated by the way many American parents are treated, but this week my exasperation — my outrage — has been intense. That's because there's a formula shortage in the United States, and the extremity of the shortage — the national out-of-stock rate reached 43 percent for the week ending Sunday, according to a report in The Times — is because of a February recall of select batches of Similac, Alimentum and EleCare formulas, but also because of supply chain issues that predate the recall.

There are parents who are desperate to feed their babies, so this should be a very straightforward issue — feed those babies! — and yet there are some people trying to score partisan points, either by juxtaposing the issue with American aid to Ukraine, as some who voted against aid have done (as if our current Ukraine policy hinges on a formula recall), or suggesting that babies of undocumented immigrants in federal custody should just go to the back of the line.

This isn't the first time since the beginning of the pandemic that families have scrambled to find formula. Even absent the pandemic, or the kind of shortage we're seeing now, formula is expensive — a potential cost of $1,200 to $1,500 in a child's first year, per a 2011 fact sheet put out by the Surgeon General's Office. Today, it would cost more like $1,500 to $1,900.

Instead of calling attention to this ongoing problem and looking for a more permanent solution to make sure parents do not have to stress over basic nutrition for their infants, I've seen a spate of ignorant comments on social media using this opportunity to shame women who can't or don't want to breastfeed. I've also seen people say that parents shouldn't have babies they can't afford, which is just cruel: Babies need to be fed. Full stop. And even if their mothers could breastfeed to begin with (which is not always the case), restarting the process when you have already weaned can take weeks or even months. Babies can't wait for the nutrition they need.

We've been here before. In 2020, I spoke with parents in similar straits, when panic buying emptied shelves of formula, diapers and wipes. Those who were recipients of the Special Supplemental Nutrition Program for Women, Infants and Children, often called WIC, had the most trouble finding what they needed, because each state program sets different limits on the brands, sizes and quantities of formulas that can be purchased. Catie Weimer, whose baby was put on Alimentum, a hypoallergenic baby formula, told me back then, "The way the checks work, if I only find three cans at a store, I can't get a reimbursement to get an additional can later," adding, "I find a store with four cans, or I'm just down a can."

Since the beginning of the pandemic, formula need has increased, according to diaper bank executives from across the country. Cori Smith, the executive director of Sweet Cheeks Diaper Ministry, based in Memphis, told me over the phone that her diaper bank started distributing formula in addition to diaper and period supplies at the beginning of the pandemic. "We listen to our clients when they ask for things, and we kept getting requests, so we thought that was something super needed," Smith said.

"Some of the clients do get WIC," she said, "but it's never enough to get through the month, and we try to be the ones who fill the gap." Some families start their babies on whole milk too early because they can't afford formula. When Sweet Cheeks first started distributing formula, Smith said, it was giving out 30 to 50 cans a month; that jumped to 100 to 200 cans a month until this year, when the recall made it nearly impossible to get formula from the bank's usual providers, and it's been the worst for families whose babies need specialized formulas. "It's been a mess. The past three months, we have not had formula to give out," Smith said.

Holly McDaniel, the executive director of the Austin Diaper Bank, told me, "Usually we give away 400 to 500 cans each month. This month we have eight in stock. Which is devastating." She suggested that people looking for formula call their pediatricians' offices if they can't find formula anywhere else, as they may have a supply. Community clinics may also be an option. She — along with many other experts — wants people to make sure they're getting formula from a trusted source. Many caution against homemade formula. As Dr. Steven Abrams told The Times's Catherine Pearson, "The nutrients in homemade formulas are inadequate in terms of the critical components babies need, especially protein and minerals."

McDaniel added, "There's so many barriers to living in poverty in general, and it adds to the struggle and the stress. It's so hard."

She said that she knows many people are working behind the scenes to fix the immediate shortage, but, as Dr. Abrams told me, it's not the kind of situation where you can just have a truckload of formula sent over from Canada. "Infant formula is regulated by statute," said Dr. Abrams, a professor in the department of pediatrics at the University of Texas at Austin Dell Medical School and a former chair of the American Academy of Pediatrics's committee on nutrition. Specific ingredients are required by statute, he said, because in the late 1970s, a product reformulation resulted in deficient levels of an essential nutrient, which led to severe reactions in infants. The current statute has strict labeling and factory inspection rules, Dr. Abrams said, and, "If you're going to create an emergency opening for different formulas, you have to be very cautious."

Because formula expires, it's difficult to have a national stockpile of formula the way you can with other goods. Some have analyzed this as an issue of too much regulation. In The Dispatch, Scott Lincicome wrote, "Infant formula — with its protectionism, regulations and heavy dose of government direction — is pretty much the poster child for what nationalist 'industrial policy' advocates today propose for all sorts of 'strategic' industries. And, well … here we are." I don't know if rapid policy changes are advisable or feasible in the short term, but I'm not against considering some of them to prevent this from happening again.

What I do feel strongly about is babies getting fed, right now, without additional stress, shame or roadblocks. Smith told me she had reached out to local politicians for additional formula funding but hadn't heard back when I spoke to her earlier this week. (I reached out to two congressional staffers about the issue and so far, crickets.) Smith said people are less likely to donate formula than they are diapers, because of the higher price point of formula. But she can buy directly from suppliers in a way individuals buying retail cannot, so donating to organizations like hers is always a good idea, even when we're not in times of such acute crisis.

Even in a wealthy country such as ours, there are always parents who can't afford to feed their infants. The need has grown. It should be treated as one of our most urgent national problems to solve.

Parenting can be a grind. Let's celebrate the tiny victories.

When we had our second baby, I thought I knew "how things worked." I was wrong. This poor little guy cried a ton, vomited every time I put him down and pooped all day. I ended up giving up on breastfeeding because I thought there was something wrong with my milk. A new formula, reflux medicine, probiotics, gas drops, gripe water, feeding him on a sitting position, and keeping him upright for 30 minutes after each feed, and today he finally took a two hour nap by himself in his crib. I'm so proud of both of us.

— Adriana Thompson, Herndon, Va.

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