As of last week, formula stockpiles were 43% lower than normal nationwide, according to a report by retail insights group Datasembly. That has parents and doctors worrying that infants - particularly those from low-income and rural families, who are some of the most vulnerable - won't get the nutrition they need for healthy development.
Several pediatricians and health experts said there are options, but cautioned that some alternatives might not be right for every baby. The Washington Post reached out to pediatricians for advice for caregivers searching for alternatives. Joshua Wechsler, a pediatric gastroenterologist at Lurie Children's Hospital of Chicago, said parents need to do their due diligence and avoid shortcuts.
"Don't dilute your formula. Don't buy formula on the internet from someone you can't verify. Don't add cow's milk to formula," he said. Most important: Talk to a pediatrician to determine the best alternative for a child's nutritional needs.
Q: Is it OK to switch brands?
A: Many parents who are having trouble finding baby formula are searching for specific brands, said pediatrician Katherine Williamson, a spokeswoman for the American Academy of Pediatrics. In these cases, she said, parents should buy any brand that is not under a current recall - including generic brands.
Except in special circumstances - such as for babies who have milk protein allergies - "pretty much all other formulas are nutritionally the same, and it is OK to switch to a generic or a different brand," she said.
Williamson added that parents should not be concerned about feeding their babies previously recalled brands as long as they have been cleared by the Food and Drug Administration. The FDA has published a list of recalled brands and states that they should no longer be available in stores, but parents who have them at home should be aware.
Wechsler, of Lurie Children's Hospital, noted that the North American Society for Pediatric Gastroenterology, Hepatology & Nutrition maintains a list of suggested formula substitutions.
Parents struggling to find any brand should contact their baby's pediatrician and see whether he or she has heard from other parents about which stores might have formula in stock.
Q: Are solid foods an option?
A: For babies over 6 months of age, parents with a limited supply of formula can try adding in more solid foods to increase calories, Williamson said. She said babies at this age can try just about anything that isn't a choking hazard, except for raw honey.
"They can have all different kinds of food, from avocado to yogurt to fruits and vegetables," she said.
Wechsler noted that the ability to handle solid foods is entirely dependent on the developmental readiness of the child, with many children not ready for solids until they're closer to a year old. He added that common baby foods derived from fruits and vegetables can add calories, but "the foods that help us grow are proteins and fats," like those that come from milk - meaning formula is often still needed.
All the experts who spoke to The Post said parents should talk to their pediatrician before altering their baby's diet.
Q: Is diluting formula a solution?
A: Christoph Diasio, a pediatrician in Southern Pines, N.C., said one thing parents should not do is dilute baby formula to try to stretch it out because infants' kidneys cannot properly process the additional water.
Q: What about homemade formula?
A: "Homemade formula is very, very dangerous, and the reason for that is because it is so easy for the electrolytes to be incorrect and that can cause babies to get very sick - vomiting, diarrhea, dehydration. This is a huge, huge concern," Williamson said.
Wechsler agreed, saying he "definitely recommends against it."
"We have formula fed children who have received a 'blenderized diet,' " he said, referring to a mix of formula and either baby food or even table food. "But that's a really specific term where a registered dietitian has come up with a formula for a kid that has a feeding tube."
It's not simply a matter of having a blenderized diet worked up by a dietitian but worked up by a dietitian who knows a child's particular health history and nutrition needs. In other words: Skip the well-meaning recipe sharing among parents whose kids have been on such a diet.
"The risk there is that [a person] is not using a formula that's a complete nutrition for their child," he said.
Q: How can I find donor breast milk?
A: Experts say the short answer on donor breast milk is it can be an option, but you need to know the details about the source.
Pediatricians agree it is not the best idea to get donor breast milk on your own, not even from a family member or friend who is nursing. Donor milk should be tested for potential infectious diseases and bacteria, and recipients should have a full understanding of what medications or supplements the donor may be taking that could affect the baby drinking the supply. Reputable milk banks should take these steps to ensure that milk is safe, experts said.
"Donor breast milk can be a viable option for a baby, but it depends on the rigor in which it was collected," Wechsler said. "People have to do their due diligence."
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