Addressing the Formula Shortage: What To Do and Avoid in Ensuring Proper Nutrition for Baby

The infant formula shortage that’s worsened over the past several months due to recalls and supply chain disruptions is enough to daunt most parents. But perhaps no one feels this terrifying reality more than those who are quickly running out of options for their baby and those who already have.

If you’re one of the many individuals desperately trying to navigate the fears and uncertainty of this formula crisis, here’s a guide to help ensure access to the nutrition your baby needs.

Stay Proactive and Shop Around

Being proactive is crucial when it comes to keeping your baby healthy. If you cannot seem to find the formula your baby needs, here are some tips:

• Check smaller drug stores or retailers. If you need to, call around to see what formulas – if any – these stores have. Ask friends and family members to help you do the same. There’s strength in numbers when finding what you need.
• Look online. Search the sites of reputable U.S. distributors and try ordering online. Some retailers may even point you to the in-stock locations in your area. Scour social media for tips, alerts and information on formula availability.
• Consider a different formula. Many babies will tolerate a different formula just fine. Although prepared liquid formula may be more expensive than powdered versions, it’s safe and convenient. Just be sure to check with your pediatrician – especially if your baby is currently on a special formula for their medical needs.
• Reach out to your child’s pediatrician. They may be able to provide you samples or small amounts of formula, or direct you to where it’s available.
• See if you’re eligible for specialized programs and services. Programs like WIC and SNAP provide infant formula to families who qualify.
   

Avoid Drastic and Dangerous Measures

In times of desperation, it may be tempting to consider drastic measures or alternatives that simply aren’t suitable for infants.

• Do NOT dilute formula. Trying to stretch your formula by diluting it with more water will cheat your baby out of the necessary calories needed for growth and development. It can also lead to serious health problems.   
• Do NOT make your own formula. By making your own formula, which is not medically recommended, you risk feeding your baby with a product that hasn’t been tested for quality and safety. Homemade formulas can also lead to serious health problems.
• Do NOT substitute cow’s milk, goat’s milk or plant-based milks for formula. These milks and milk alternatives do not contain the nutrition your baby needs. If your child is approaching one year of age, talk to your pediatrician about weaning off infant formula.
• Do NOT resort to using toddler formula for infants less than a year old. The nutritional needs of infants are simply different than those of toddlers.   
• Do NOT purchase formula from outside the country. Formulas from other countries are not approved by the U.S. Food and Drug Administration (FDA), and their safety cannot be guaranteed.
• Do NOT stockpile formula. There are a lot of families just like yours struggling to find what they need to feed their babies. The American Academy of Pediatrics advises families to avoid buying more than a two-week supply of formula to help offset the shortage. 
   

Familiarize Yourself With Formula Substitutes

There is a wide variety of different infant formulas available. Most babies can tolerate formulas other than the one they are used to, and substitutions can usually be made with minimal differences in tolerance. Use the information below to help find comparable formulas, and talk to your pediatrician if you have questions about making a switch.

Standard

The following standard formulas contain intact protein. They vary slightly in types of ingredients, but they all generally provide appropriate nutrition for healthy full-term infants and can usually be substituted for one another.

• Enfamil Infant or NeuroPro Infant
• Enfamil NeuroPro Sensitive (low lactose)
• Enfamil Enspire
• Enfamil Simply Organic
• Enfamil Premium A2
• Enfamil A.R. (contains rice starch for thickness)
• Enfamil Reguline
• Enfamil Prosobee Simply Plant-Based (soy protein)
• Similac Advance, Pro-Advance or 360 Total Care
• Similac Pro-Sensitive or 360 Total Care Sensitive (low lactose)
• Similac Organic
• Similac for Spit-Up (contains rice starch for thickness)
• Similac Pure Bliss
• Similac Isomil (soy protein)
• *Any standard store brand infant formulas

If you’re unable to obtain any of these standard formulas, talk to your pediatrician about substituting with formulas from the Gentle, Hypoallergenic/Semi-Elemental or Elemental categories below.

Gentle

Gentle formulas are suitable for most healthy infants who seem to be somewhat sensitive to standard formulas or have family histories of food allergies. These formulas contain partially digested protein and include:

• Enfamil Gentlease or NeuroPro Gentlease
• Similac Pro-Total Comfort
• Gerber Good Start GentlePro
• Gerber Good Start SoothePro
• *Any gentle store brand infant formulas

If you’re unable to obtain any of these gentle formulas and you’re concerned about your infant’s tolerance, talk to your pediatrician about substituting with formulas from the Hypoallergenic/Semi-Elemental or Elemental categories below.

Hypoallergenic/Semi-Elemental

Hypoallergenic/semi-elemental formulas are designed for infants who may have feeding intolerance or milk protein allergies. These formulas, which contain ingredients that are extensively predigested, include:

• Enfamil Nutramigen
• Similac Alimentum
• Enfamil Pregestimil
• Gerber Good Start Extensive HA
• *Any hypoallergenic/semi-elemental store brand infant formulas

If you’re unable to obtain these hypoallergenic/semi-elemental formulas and you’re concerned about your baby’s tolerance, talk to your pediatrician about substituting with formulas from the Elemental category below.
 

Elemental

Elemental formulas, which are needed in rare cases for infants who may have severe allergies, reduced absorption or feeding tolerance, include:

• Neocate Infant
• Elecare Infant
• Enfamil PurAmino
• Alfamino Infant

If you’re unable to obtain any of these elemental formulas, talk to your pediatrician about other substitutes.

Preterm

Preterm formulas are for premature or low birth weight infants, as prescribed by a medical professional. Preterm formulas include:

• Enfamil EnfaCare or NeuroPro EnfaCare
• Similac NeoSure

If you’re unable to obtain these preterm formulas, talk to your pediatrician about temporarily substituting with formulas from the Standard, Gentle, Hypoallergenic/Semi-Elemental or Elemental categories above until you’re able to find more preterm formula. If possible, avoid using formulas made with soy protein for preterm infants when other options are available.

When using a substitute formula, follow the mixing instructions on the back of the container. If your infant’s usual formula is not listed in the categories above, contact your pediatrician to identify substitutes.

*Names and/or descriptions of store brand infant formulas (such as Parent’s Choice, Up&Up, Kirkland, Earth’s Best, etc.) are usually similar to other formulas in each category. U.S. store brand infant formulas are approved by the FDA and nutritionally complete for infants less than a year old.
 

Peace of Mind

If you’re ever unsure about a formula substitute or have questions regarding the health and nutrition of your baby, don’t hesitate to reach out to your pediatrician. Maintaining communication with them will help ensure your peace of mind as you weather this shortage and the challenges that continue unfolding because of it.

(This article was written in collaboration with Melissa Thoene, PhD, RD, University of Nebraska Medical Center, and Julie Wagner, MS, RD, LMNT, CNSC, Methodist Women’s Hospital Neonatal Intensive Care Unit.)