Here's how the baby formula shortage is affecting Cumberland County families

If breastfeeding were an easier option, Fayetteville resident Amber Echols would choose it over formula.

But Echols' 3-month-old son Jackson has a lip and tongue tie that made it difficult for him to latch on.

“I want to breastfeed, but I struggle with supply,” she said. “Sometimes I feel like I’m failing because I can’t provide him what my body should, and now I can’t provide the formula.”

Because he was born at 35 weeks, Jackson started out on a specialized formula for premature babies to supplement his needs.

When Jackson was almost 2 months old, he was diagnosed with a dairy and soy allergy and uses Nutramigen to address the allergies.

Since February, Echols and parents across the country have hunted for depleted supplies of baby formula that followed Abbott Nutrition recalling contaminated batches and closing a plant in Sturgis, Michigan.

According to the Food and Drug Administration, it is investigating consumer complaints of bacterial infections in four infants — two who died — who consumed powdered infant formula from the plant.

Hunting for a formula

Echols didn’t notice the impact of the recall and the facility’s closure in February, but said that when she ran out of formula at the beginning of April she started to notice the problem.

“I was ordering it online from a grocery store, but got a notification they were out and started calling stores all over that day in South Carolina, Wilmington and Raleigh, and they were all out,” she said. “My sister, who lives in Charlotte ended up finding two cans at her local Walmart. That was the closest — three hours away.”

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Echols said her son’s allergies leave him limited on what substitute brands he can try, which she is concerned will cause adverse reactions like spitting up or gas.

“We’re really struggling to get his specialized formula, and like a lot of other parents, we’re having friends and family hours away and out of state look for it,” she said.

Liz Jasso is another Cumberland County mother impacted by scare supplies.

Unable to breastfeed because of a medical condition and medication she takes, Jasso has used formula for her 3-month-old daughter Xaylynn, who has milk and food allergies.

By the time Xaylynn was 3 weeks old, her mother noticed she was having agitated bowel movements and spitting up, which turned to vomit, because of the formula she used.

Jasso tried using Nutramigen formula for Xaylynn, which also caused her to throw up.

During a 1-month-check up, Jasso tried another formula, which also caused problems.

A pediatrician suggested PurAmino, and Jasso noticed Xalynn wasn’t as fussy, wasn’t vomiting or spitting up as much and didn’t seem to have stomach cramps.

“We stayed on PurAmino,” Jasso said. “At her 2-month appointment, the pediatrician listened to my woes again, this time about not being able to find the formula and my fear of running out now that Xaylynn was on something that worked for her.”

The pediatrician gave her the last of the sample cans available and recommended finding a soy-based formula once the product ran out.

Jasso said she started to notice formula shortages when she still was pregnant because she works at a store that sells select varieties of formula and was constantly asked if items would be back in stock.

By the time she found a formula that seemed to work for Xaylynn, she was traveling an hour to find it.

“Then it disappeared altogether,” Jasso said.

Jasso has not been able to find the formula since April 3 and has tried calling “around the entire state” to find it with no luck.

She checked to see if her employer could order it and then asked a friend at another store to check on it but was told that store also was unable to order it anymore.

Several pharmacies she called told her the same thing — the order couldn’t be placed.

An attempt to use her electronic benefits card on a website that claimed the formula was in stock left her disappointed that she couldn’t place the order.

The 14.1 ounce can usually costs about $50, but in one online search, Jasso noticed one provider selling the formula for $128 per can.

A can lasts Xaylynn about four days.

The manufacturer, Enfamil, “is so backlogged” that grocery stores and drug stores have not been able to replenish it, Jasso said.

She said there is not a generic brand option for the amino acid-based formula that is mixed with tapioca starch.

Similac makes an amino acid-based formula that she can’t find, and she’s found one for Nestle that’s sometimes stocked on Amazon, but costs about $50 a can.

As a single mother, Jasso relies on the Women, Infant and Children program, but has not heard about whether she can substitute PurAmino with another brand.

Fayetteville mom Tanilya Montgomery is also searching for Nutramigen — one of the recalled formulas — for her 5-month-old son Makai.

Montgomery said breastfeeding was a goal, but because of a breast reduction she had several years ago, she hasn’t produced enough milk.

WIC allowed her to buy the smaller cans, with one can lasting Makai about a week.

But since the shortage, Montgomery has not spotted her son's formula in local retailers, and has noticed a shortage of the formula online, too.

She’s resorted to using the off-brand Parent’s Choice, which is not covered by WIC and has caused changes in Makai’s bowel movements.

Advice for parents

WIC, which is funded through the U.S. Department of Agriculture, provides nutrition assistance to mothers and their young children and usually covers costs of specific brands and sizes of formula.

The program serves about 11,000 clients in Cumberland County, said Ashley Curtice, deputy health director for the county.

Of those clients, it’s not known how many are impacted by the formula shortage because clients use different brands, supplement with breast milk or breastfeed, Curtice said.

Cumberland County WIC officials are following guidance from the North Carolina Department of Health and Human Services and advising parents unable to find formula to contact health care providers.

According to an update from the state health department Monday, it is working with the federal government to waive rules for the WIC program to make it easier for WIC-enrolled families "to purchase other types of formula and in a wider variety of sizes based on availability and health care provider recommendations."

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Benefits for Cumberland County WIC clients can be changed by calling the office if the change is something “as simple as” opting for concentrate instead of powder, Curtice said.

“However, if you are requesting a change in the type or brand of formula, you will need a prescription note from your doctor in order for WIC to make that change,” she said.

Dr. Ashok Jain, president of KizCare Pediatrics in Fayetteville and across the state, said in most instances babies can switch to another formula or generic brands.

Parents whose babies have certain milk protein allergies, lactose deficiencies or baby reflux should discuss alternatives like soy milk with their pediatrician, Jain said.

Parents should not supplement with cow’s milk for babies younger than 6-months old.

Cow’s milk, Jain said, has high casein and less whey protein, along with a protein known as lactoglobulin that causes a milk protein allergy and bloody stools.

Infant formula has been modified to provide adequate casein and whey protein, he said.

Parents also should not use goat’s milk, soy milk, nut-based milks or toddler formula because of not having the correct amount of proteins, carbohydrates and fats required for an infant’s normal development, Jain said.

Diluting formula, using homemade formula or expired is also advised against, he said

Unless a mother has a disease that can be transmitted through breast milk, Jain said breastfeeding is the best option, and mothers can discuss medications with their doctors to help increase breast milk supply.

Curtice said Cumberland WIC has a breastfeeding peer counselor program for parents interested in the option or families can reach out to a local lactation specialist.

Jain said parents should not obtain breast milk from other parents because their health status or medication intake could impact their supply.

Curtice said there are milk banks accredited by the Human Milk Banking Association of North America, but some banks require a prescription from a medical professional for the service.

What's being done to address the shortage?

On Monday, the Food and Drug Administration entered into a consent decree with Abbott, which would reopen the Michigan facility to allow it to produce formula again, but also hold the company accountable by requiring product testing.

Officials have estimated that once the plant reopens, it could take about two months for supplies to replenish.

The FDA also issued guidance about importing formula from other counties.

President Joe Biden spoke to major retailers last week to identify transportation and logistical needs to “cut through red tape,” and speed up shipments.

For mothers like Echols and Jasso, the wait is daunting.

“I’m crossing my fingers that we can make it,” Echols said.

Echols said insurance will cover the cost of Jackson’s formula, which lasts him about six days because she supplements with breastmilk, but she’s unable to find it anywhere.

She said for herself and other mothers who she knows, the shortage is terrifying.

“I’m thankful I’m able to supplement half his needs, but I know of moms who have twins or who can’t breastfeed because of medical reasons and are reaching out to other breastfeeding moms because they’re panicking,” she said.

Jasso said Xaylynn switched to a soy formula “she’s tolerating,” but has had a medical appointment indicating there may be possible acid reflux.

“It hurts when she is in pain, and she screams when she has bowel movements, but it is working as an alternative to at least keep her fed until I can get PurAmino again,” Jasso said.

Jasso said her “heart breaks” for other mothers who don’t have the option to switch formula.

“Knowing that I have the ability to eat and be OK but I can't provide that same thing to my child is a terrible feeling,” she said.

How Cumberland County parents can check on formula

Curtice said families can turn to community organizations, reputable online retailers, distributors, and manufacturers as sources for finding formula or contact United Way by calling dialing 211 to chat with a community resource specialist who might be able to identify food parties and charitable sources with formula.

Families can also contact manufacturers to help find formula at Abbott’s Consumer Hotline is 1-800-986-8540, and Reckitt’s customer service line is 1-800 BABY-123 (222-9123).

Parents can also visit  HHS.gov/formula. 

Staff writer Rachael Riley can be reached at rriley@fayobserver.com or 910-486-3528.

This article originally appeared on The Fayetteville Observer: How formula shortage is affecting the Cumberland County area