Here's Why It's So Important Not To Dilute Your Baby's Formula — & Other Crucial Info
Doctors weigh in with safe, actionable advice... because men on the internet telling moms to “just breastfeed” isn’t helping anyone.
In recent weeks, the nationwide infant formula shortage has hit a fever pitch — the one-two punch of ongoing supply chain complications due to the pandemic and a recall impacting multiple formula brands means parents are scrambling to feed their babies. And that's without mentioning that the average cost of formula has risen as much as 18 percent in the last year, making the formula you can find markedly more expensive than pre-pandemic.
The situation has become so dire that the Biden administration has said that the Food and Drug Administration (FDA) is "working around the clock to address any possible shortage," as White House press secretary Jen Psaki said during a press briefing. Still, in the immediate time frame, parents are left wondering how, exactly, they're supposed to navigate these shortages and safely feed their infants — all the while dealing with the unsolicited internet chorus, mansplaining the crisis with "just breastfeed; it's free."
Here's what parents really need to know about the infant formula shortage, including expert advice from pediatricians on what to do and not do.
What is the government doing to help?
On May 12, President Biden announced his administration is taking additional steps to help ease the shortage, including:
- Expanding benefits by the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) program, which will allow WIC participants more formula options than currently available
- Pushing states to waive packaging regulations so that manufacturers can get formula on store shelves more quickly and with less red tape
- Calling on the Federal Trade Commission (FTC) and state officials to crack down on price gouging
Health officials predict that the steps being taken can at least help restart manufacturing plants shut down by recalls within a few weeks. However, it could still take up to 8 weeks for new formula to hit shelves and even longer for industrywide issues to even out.
Who can parents reach out to for help?
Your first point of contact should be your pediatrician, who can help you determine safe, comparable alternative options depending on your baby's nutritional needs.
"As parents navigate the national formula shortage, it is important to keep in touch with your pediatrician," says Sara Siddiqui, M.D., a pediatrician at Hassenfeld Children's Hospital at NYU Langone and Huntington Medical Group in New York. "Babies usually require nursed milk or formula from birth to 4 to 6 months. During this time, babies require specific nutritional content. Some formula brands can be exchanged for certain other brands, but should be discussed with your pediatrician prior to changing."
Your pediatrician can not only help you find comparable options, adds Allison Kidwell, M.D., an East Lansing, Michigan-based pediatrician, but "local physician's offices may also have leads on where families are most recently finding formula in your area." Siddiqui adds that "some pediatrician offices have samples that can be given to parents. Contacting the manufacturer also may assist some families in obtaining formula."
Can you dilute your formula? What about making your own?
There are definitely some things you should not try in your efforts to secure more formula or ration the supply you have, note both doctors. "Making one's own formula is absolutely not advised as this can result in contamination or irregular electrolyte balance for the baby," says Siddiqui. "If parents have already given babies a homemade formula, it is advised to contact your medical provider to discuss evaluation. It is also not recommended to dilute or add water to the formula. This can result in an imbalance or dilution of electrolytes, which can result in detrimental effects on babies. In extreme cases, seizures can be the result of abnormal electrolytes."
"Parents should know that cutting formula with any liquid (water, cow's milk, etc.) can be extremely dangerous to babies," adds Kidwell. "Formulas are made to be easily metabolized by a baby's kidneys into urine. The most common adverse effect of diluting formula is seizures, which are life-threatening."
Is weaning babies off formula early an option?
Switching off formula altogether isn't advised unless your pediatrician has explicitly said so, notes Siddiqui. "Babies require formula for ease of digestion up to 1 year. Switching to whole milk prior to 12 months in babies can result in anemia and/or bleeding in the intestine. The gastrointestinal tract in babies is not fully developed and may be irritated if milk is initiated too early. Please contact your medical provider for a discussion on whether this is advisable for your baby."
If you do get the green light from your pediatrician to switch formulas, Kidwell says, "Parents should look at the packaging of the formula that worked best for their baby and look for generic formulas in any store brand that offer similar characteristics. This will allow them to search multiple stores for similar formula types." Still, getting your pediatrician's approval is crucial, notes Siddiqui. "For those families that are on hypoallergenic formula, or another formula specific for their baby, it would be important to discuss with their pediatrician other providers or specialty pharmacies that can be used to obtain the specific formula."
Is it safe (and/or ethical) to get formula from online groups?
With some parents turning to online groups and marketplaces like Craigslist or Facebook in desperate search of formula, both doctors advise using extreme caution, particularly as price gouging has been reported. "Formula banks or people helping to obtain formula should be looked at carefully to ensure that the formula is obtained in the correct process and that it is not damaged or expired," says Siddiqui.
"Groups who are trying to help families by purchasing large quantities to distribute could actually be making the shortage worse for families," notes Kidwell. "If groups want to help, they could join a 'search party,' checking online at various websites, or calling around to stores. Helping a few families find enough formula to last them in the short-term can ensure that these families are helped quickly and that we're resourcing ourselves efficiently."
If you find formula, should you stock up?
Even though it's tempting, loading up on formula isn't advised, either, says Kidwell. "Parents should adhere to store limits (such as two containers per family) because purchasing more can actually cause the shortage to be worse. By adhering to store limits, we're ensuring that we're keeping as many babies fed as we possibly can while we await the production of more formula."
Why is the "just breastfeed" argument so ill-informed?
Among the many frustrating facets of the formula shortage are social media debates about why babies even need formula in the first place, with online trolls insisting that moms "just breastfeed."
As Carla Cevasco, Ph.D., a historian studying infant feeding at Rutgers University, has pointed out on Twitter, breastfeeding is not only time-consuming and challenging, but it's also flat-out not acceptable to many moms, as it requires supplies, lactation support and education, and space to pump. That's only for moms who can breastfeed — not every baby is able to latch, and not every mom can safely and comfortably produce milk.
Cevasco also mentioned that throughout history, people have needed to feed infants using foods other than breastmilk, and prior to the advent of formula as we know it today, many infants died of illness or starvation due to a lack of adequate nutrients.
The bottom line: Formula is crucial for the health and well-being of parents and babies everywhere. This shortage presents a serious public health crisis that will disproportionately affect the millions of families at nutritional risk who rely on formula to safely feed their little ones.
Sara Siddiqui, M.D., a pediatrician at Hassenfeld Children's Hospital at NYU Langone and Huntington Medical Group in New York
Allison Kidwell, M.D., an East Lansing, Michigan-based pediatrician