Burke Pediatrics, LLC 2022

Formula Shortage

The Chapter would like to share the following from the The Academy of Breastfeeding Medicine (ABM) during the ensuing formula shortage:

For those CURRENTLY PREGNANT or EXPECTING A BABY:

• Consider potential infant formula shortages and risks when making your decisions and plans about infant feeding.  Seek prenatal breastfeeding education, and connect with health care providers and hospitals that are supportive of breastfeeding.

For those CURRENTLY NOT BREASTFEEDING or CURRENTLY NOT MAKING ANY BREAST MILK:

• Consider re-lactating.  Re-lactating is the process by which a person who has given birth may ramp-up milk production after a period of not lactating or partially lactating.1–4  (Note, seek consultation with a skilled lactation provider and/or expert in Breastfeeding Medicine if you plan to try to re-lactate.  This may be a challenging process for some, especially the further out one gets from birth.)
  
• Consider pasteurized donor human milk from a certified human milk bank if you have the means and availability to purchase.
  
• If you are considering using anyone’s breast milk other than your own, consider safety and ensure informed decision making that considers the potential risks and benefits, and consider donor screening and flash pasteurization.5  Wet nursing, and close family members and friends breastfeeding is a way in which some societies and cultures have fed infants historically and in modern day. (Note, this should only be done with trusted family members and friends, and ideally the donor would have had testing to make sure they were free of any transmissible diseases.)
  
• Avoid use of “home” recipes for making your own formula unless you have consulted first with your baby’s doctor.
  
• Do not mix the formula in any way other than how it is written on the package instructions as these practices can have severe, at times fatal consequences for the infant.
  
• Avoid feeding your baby younger than one year of age regular cow’s milk as it can lead to serious consequences such as iron deficiency which can harm cognitive development.  (Note, in an emergency, for infants 6 months to 1 year of age, cow’s milk may be used for a short time {on the order of days.}  This is considered safer than diluting or making homemade formula.  Consult your baby’s doctor if you have to give your baby cow’s milk under one year of age as they will need to monitor your baby’s iron status.)
  
• You can transition from one brand of formula to another if that is all you have access to.  (Note, if your infant is on a special formula for a medical condition, speak with your baby’s doctor and/or a pediatric nutritionist before making any substitutions.)
  
• Do not purchase breast milk or infant formula on the internet from anyone or any source that you are not familiar with and can completely trust.  Consider your resources for safely ordering and shipping from a trusted source.  Seek assistance from a local breastfeeding professional.  
  
• Place only the amount that your baby will eat in the bottle, so as not to waste any of your supply.
• Talk with your baby’s doctor about the timing and appropriateness of introducing solid foods no more than 2-3 times/day in place of bottle feeding.
  
• Do not give your baby under 6 months of age any water, tea, or juice.

For those CURRENTLY PARTIALLY BREASTFEEDING:

• Consider transitioning back to full breastfeeding while the shortage remains.  This is healthy for your infant and also will help lessen some of the demand on the current supply.  (Note, if you need help with increasing your production, seek consultation with a skilled lactation provider and/or an expert in Breastfeeding Medicine. 1–4  We recommend you speak with your baby's healthcare provider because you will likely need to do this gradually as your milk production increases. Your baby's provider can monitor your baby's growth to make sure it stays on target.)
  
• Consider pasteurized donor human milk from a certified human milk bank if you have the means and availability to purchase.
  
• If you are considering using anyone’s breastmilk other than your own, consider safety and ensure informed decision making that considers the potential risks and benefits, and consider donor screening and flash pasteurization.5  Wet nursing, and close family members and friends breastfeeding is a way in which some societies and cultures have fed infants historically and in modern day. (Note, this should only be done with trusted family members and friends, and ideally the donor would have had testing to make sure they were free of any transmissible diseases.)
  
• Avoid use of “home” recipes for making your own formula unless you have consulted first with your baby’s doctor.
  
• Do not mix the formula in any way other than other than how it is written on the package instructions as these practices can have severe, at times fatal consequences for the infant.
  
• Avoid feeding your baby younger than one year of age regular cow’s milk as it can lead to serious consequences such as iron deficiency which can harm cognitive development.  (Note, in an emergency, for infants 6 months to 1 year of age, cow’s milk may be used for a short time {on the order of days.}  This is considered safer than diluting or making homemade formula  Consult your baby’s doctor if you have to give your baby cow’s milk under one year of age as they will need to monitor your baby’s iron status.)
  
• You can transition from one brand of formula to another if that is all you have access to.  (Note, if your infant is on a special formula for a medical condition, speak with your baby’s doctor and/or a pediatric nutritionist before making any substitutions.)
  
• Do not purchase breastmilk or infant formula on the internet from anyone or any source that you are not familiar with and can completely trust.  Consider your resources for safely ordering and shipping from a trusted source.  Seek assistance from a local breastfeeding professional.
  
• When feeding your infant, place only the amount that your baby will eat in the bottle, so as not to waste any of your supply.
  
• Talk with your baby’s doctor about the timing and appropriateness of introducing solid foods no more than 2-3 times/day in place of a bottle feeding.
  
• Place only the amount that your baby will eat in the bottle, so as not to waste any of your supply.
  
• For premature babies, if you are using the formula only to fortify your breastmilk and your baby is growing well, talk with your baby’s doctor about the need to continue fortification and/or do a trial with just your breast milk.
  
• Do not give your baby under 6 months of age any water, tea, or juice​.