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    A large survey of 11,000 stores have found that fully 43% are sold out of baby formula. More mothers are breast-feeding their babies these days, but most still find themselves using baby formula at one point or another in their child’s first six months of life. A formula shortage panic is part and parcel of a society that is unprepared for shortages in the face of disasters and other upheavals.

    In this case, the formula shortage is thought to be due to a major recall by one of the three companies that make the product: Abbott labs. Recently, several infants were hospitalized with cronobacter sakazakii, a bacterium that was identified in the company’s Michigan plant. One of the babies is reported to have died. Supply chain issues may also be a factor in the current crisis.

    If you have Abbott products in your pantry, the Food and Drug Administration (FDA) asks that you check to see if it might be at risk for contamination. Recalled lots can be identified. Check to see if the first two digits of the product code are 22 through 37, the code contains K8, SH, or Z2, and has an expiration date later than April 1, 2022. Abbott’s website has a search feature that allows you to plug in your lot numbers to see if it’s part of the recall.

    Baby formula is meant to be as close to human breast milk as possible, making an acceptable substitute difficult to find. What to do? You should first consult with your pediatrician, of course, about the issue. Some pediatricians say that Pedialyte is an option for a day or so to keep the baby hydrated. Others say that toddler formula will do for a few days while you’re hunting for the right stuff. Infants over one year of age on formula can slowly transition to whole milk. A few say small amounts of cow’s milk can even be given in babies 6 month of age or over for a short time.

    The brands removed from supermarket shelves include popular brands like Similac, Alimentum, and Elecare. Pediatricians from Prisma Health are reported in South Carolina’s Greenville News as suggesting the following substitutes for recalled products:

    Similac 360 Total Care/Advance substitutions: Gerber Good Start Gentle, Enfamil Infant, Enfamil NeuroPro, Enfamil Enspire, Up&Up Advantage/Infant, Parent’s Choice Advantage/Infant

    Similac Soy Isomil substitutions: Gerber Good Start Soy, Enfamil Plant Based, Up&Up Soy, Parent’s Choice Soy

    Similac Neosure substitutions: Enfamil Enfacare

    Similac Sensitive/360 Total Care Sensitive substitutions: Gerber Good Start Soothe, Enfamil Gentlease, Up& Up Sensitivity, Parent’s Choice Sensitivity

    Similac for Spit-up substitutions: Enfamil AR, Parent’s Choice Added Rice Starch

    Similac Total Comfort substitutions: Enfamil Reguline, Up&Up Advantage Complete Comfort, Parent’s Choice Tender

    Similac Alimentum substitutions: Gerber Good Start Extensive HA, Enfamil Nutramigen, Up&Up Hypoallergenic, Parent’s Choice Hypoallergenic

    Similac Elecare substitutions: Nutricia Neocate Infant, Enfamil Puramino, Nestle Alfamino

    If these options are not available, there isn’t a lot of advice that the government or the pediatric establishment give as alternatives. They recommend continuing to breastfeed or returning to breastfeeding if the infant was recently weaned. Another suggestion is to search for it in places other than supermarkets: pharmacies, for example. Look in areas where the infant population is low (such as senior communities), you may find more available there. Of course, if you can find your baby’s formula online from a trusted source, use that avenue.

    If you do find a supply, though, the government says not to get more than a month’s worth (because that’s just greedy). Needless to say, advice like this goes against the grain for preparedness folk.

    It’s possible that an infant could transition to solid food. A baby that’s ready should be able to:

    • remain stable in a sitting position.
    • hold their head steady while sitting up.
    • have sufficient coordination so they can look at food, pick it up, and put it in their mouth by themselves.
    • swallow food easily without frequently spitting up.

    Other behaviors could be mistaken as ready for solids. Chewing fists and wanting extra formula are not indications to switch over.

    The opinion of the FDA, CDC, and almost all pediatricians is that no formula shortage should result in using cow’s milk in young infants, plant milks like soy or almond, watering down existing formula, or making your own. They explain that all these options are dangerous and can overload an infant’s kidneys or cause electrolyte imbalances that can lead to seizures. The CDC states that homemade formula recipes you’ll find online can contain harmful ingredients or be contaminated.  They recommend you ignore those “mommy blogger” recipes.

    Unfortunately, solutions to the problem are scarce. Some websites actually advise mothers to borrow a can of formula from a neighbor as a strategy. Not exactly a long-term answer.

    Of course, families with infants should listen to their pediatricians, but what happens when the approved commercial substitutes are sold out? What if a disaster knocks out formula manufacturing altogether? In the old days, there were nursemaids, but that doesn’t seem like a popular career path today. Up until the 1960s, some mothers were even sent home with homemade formula recipes.

    If the formula shortage continues, you might have little choice but to buck the pediatric establishment and make your own. I’m not a pediatrician and haven’t been in a situation where I needed formula and there was none to be had. Having said that, you have to do something if you can’t find formula and your baby needs to eat. Here are a number of links to various “mommy blogger” homemade recipes (none of which, I have to admit, I’ve tested myself):

    https://wehavekids.com/parenting/Emergency-Baby-Formula

    https://dustyoldthing.com/1950s-homemade-formula-recipes/

    Formula – Homemade Baby Formula – The Weston A. Price Foundation

    https://wellnessmama.com/wprm_print/203435

    It should be noted that no formula recipe using honey is safe for infants, due to the risk of botulism.

    For now, it may take a little searching to find the formula you need, but be sure to consider what you’d do if there was none to be found. That’s part of being prepared; if we all had a plan of action for every contingency, we’d be a nation that could weather any shortage.

    (Addendum: There’s a program called “Healthy Mothers Healthy Babies” that has formula stockpiles in various parts of the country. Worth checking into.)

    Joe Alton MD

    Dr. Alton

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