In a groundbreaking study conducted by esteemed researchers at the renowned University of California, Davis, it has come to light that a staggering proportion of parents, approximately half, who heavily relied on formula to nourish their beloved infants during the unprecedented infant formula shortage experienced last year, resorted to employing perilous feeding methods. The profound implications of these distressing findings underscore the urgent need for systemic reforms to rectify the prevailing issues surrounding infant nutrition. This revelatory investigation was recently published in the esteemed journal BMC Pediatrics.
Through an anonymous online survey administered to parents across the United States, the researchers observed an alarming escalation in the utilization of unsafe feeding practices, surging from a mere 8% prior to the onset of the formula shortage to an astounding 50% during the scarcity period. These hazardous practices encompassed diluting formula with excessive water, employing expired or homemade concoctions, or even resorting to human milk acquired through informal sharing networks.
Notably, the percentage of parents partaking in the sharing of human milk rose exponentially from 5% to 26%, while the employment of watered-down formula skyrocketed from a mere 2% to a concerning 29% during the scarcity crisis.
Jennifer Smilowitz, the lead author of this groundbreaking study and a distinguished faculty affiliate associated with the esteemed UC Davis Department of Food Science and Technology, expressed her profound concern over these alarming statistics. She asserted, “These staggering figures are indeed cause for alarm. The acute shortage of infant formula exacerbated food insecurity, endangering the nutritional well-being of countless American infants. Disturbingly, our survey reveals that parents were not presented with an abundance of safe alternatives, leading them to resort to precarious measures in an attempt to nourish their vulnerable infants.”
Moreover, the research sought to gain a comprehensive understanding of the parents’ experiences during this crisis in order to identify viable strategies that can effectively prevent future infant feeding emergencies from arising.
Insufficient availability of formula manufacturers and milk banks compounded the challenges faced during the period of scarcity. The United States experienced an acute shortage of infant formula in 2022 due to a recall by the industry titan, Abbott Nutrition, and the voluntary shutdown of its Michigan-based manufacturing plant. Abbott Nutrition, a paramount entity in the realm of formula production, accounts for over 40% of the country’s supply. The scarcity was further exacerbated by trade policies that impeded the importation of formula. Disturbingly, by the conclusion of May 2022, several states grappled with a dire out-of-stock rate that surged as high as 90%.
It is worth highlighting that the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), catering to over 40% of U.S. infants and responsible for more than half of infant formula consumption, predominantly relied on Abbott Nutrition’s offerings. Consequently, the scarcity significantly impacted low-income communities, thus unveiling systemic failures precipitated by the stranglehold of a mere four companies that control 90% of the infant formula market within the United States. Jennifer Smilowitz elucidated, “This highly concentrated market domination has resulted in systemic failures that disproportionately affect impoverished communities.”
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Remarkably, the survey also divulged that parents sought refuge in pasteurized human donor milk procured from milk banks, an alternative that offers safety and security. However, this solution is encumbered by the scarcity of milk banks throughout the nation, coupled with the exorbitant costs associated with acquiring donor milk, which can range from $3 to $5 per ounce. Consequently, amidst the scarcity, the number of parents resorting to milk banks surged from a mere 2% to a notable 26%.
The implications of this study strongly indicate the pressing need for comprehensive policy changes within the regulatory and healthcare systems to proactively extend clinical prenatal and postnatal lactation support to families. Additionally, increased accessibility to banked donor milk and expanded availability of commercially viable products must be prioritized. Concurrently, workplace policies necessitate a paradigm shift to adequately support the needs of breastfeeding women. Inadequate family leave policies inadvertently contribute to premature formula feeding, while some workplace regulations fail to provide the requisite privacy and dedicated time for pumping, thereby disproportionately affecting lower-income parents.
Jennifer Smilowitz emphatically declared, “The memory of this formula shortage should not be forgotten. Unless healthcare, workplace, and regulatory policies in the United States undergo systemic transformations, another crisis is undoubtedly on the horizon.”
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Smilowitz expressed her ardent hope that the repercussions of the infant formula shortage will not yield detrimental health consequences for the affected infants. She emphasized, “The aftermath of this scarcity crisis shall linger for a generation, and only time will reveal if it engendered any enduring impact on the cognitive development of these infants. Let us fervently aspire that the scarcity merely resulted in transient effects, and that the resilience of these infants will surmount any potential long-term ramifications.”
Karina Cernioglo, a fourth-year medical student at UC Davis, collaborated as a co-author in this seminal study. The 2020 UC Davis Chancellor’s Innovation Award provided the essential funding necessary for the execution of this extensive research endeavor.
