Health Matters: Follow these safety tips as great baby formula shortage of 2022 continues
Last week, a patient waking up after a minor surgery asked if she could breastfeed her 3-month-old when she went home later that day. The textbook answer is to “pump and discard for 24 hours” to prevent residual anesthetics from getting into the baby. However, this patient didn’t have extra breast milk stored and given the ongoing baby formula shortage, it’d be hard to find a substitute.
Since September 2021, four infants from three states became ill with infections caused by the bacteria Cronobacter sakazakii. Two of them died. The only common factor was that they were all fed with Similac brand formulas produced at a factory in Sturgis, Michigan. The cases were reported to the CDC and FDA, triggering an investigation. By mid-February, Abbott, the manufacturer, initiated a recall and closed the factory. Soon, Similac and its sister brands, Alimentum and EleCare, disappeared from stores and online vendors.
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This isn’t the first time. Outbreaks of Cronobacter disease linked to baby formulas have been reported since the 1980s. Cronobacter lives on dry surfaces and can colonize the human gut. But in hosts with immature gut linings or weakened immune systems, the bacteria can enter the bloodstream and brain, causing serious infections with up to 75% mortality. In previous outbreaks, the bacteria were found in cans of powdered formula and on preparation tools such as spoons and blenders, resulting in some products being recalled, but never at the scale and impact of today’s crisis.
The business of making baby formulas has a high barrier to entry and low profitability. The formula composition and manufacturing facility must meet stringent federal standards. Most formulas in the U.S. are sold through the Women, Infant and Children programs to low-income mothers. Each state usually has an exclusive contract with one brand to obtain formulas at a heavy discount. The market is dominated by just a few players – Abbott mentioned above, Mead Johnson (Enfamil brand), Nestlé (Gerber Good Start brand), and Perrigo (all generic formulas sold at places like Costco and Walmart). When Abbott shut down the factory responsible for a quarter of the country’s formula supply, the other companies simply couldn’t fill the large void. Lingering pandemic supply chain issues only exacerbated the problem.
The shortage has sent desperate parents to solicit family members cross the country to search their local store shelves, pay high prices in secondary markets, turn to social media for formula sharing, and bring babies into emergency rooms to get fed. Particularly vulnerable are babies of mothers who cannot breastfeed and babies who rely on specialty formulas because of allergies or medical conditions.
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Recognizing the dire situation, the government intervened. On May 18, the White House invoked the Defense Production Act to prioritize ingredients for baby formula and launched “Operation Fly Formula” to import foreign formulas that meet the American safety standards. The first batch of European formulas landed last week. The FDA has reached an agreement with Abbott to reopen the Michigan factory on June 4, but it may take months for production to ramp up.
Knowing that the formula shortage will likely last through the summer, here are a few reminders on formula safety
* Use boiling water to dissolve powdered formula to kill any potential bacteria. Completely cool before serving
* Practice hand hygiene and regularly wash baby bottles and tools with hot soapy water
* Consume prepared formula within an hour from when feeding starts. Don’t let it sit at room temperature for more than 2 hours or in a refrigerator for more than 24 hours
* Don’t dilute the formula to stretch out your supply. Formula prepared at an inappropriate concentration can upset the electrolyte balance and make babies sick
* Contact pediatrician and ob-gyn offices for samples of formulas and regional breast milk banks for extra assistance
* If you require specialty formula, check with your pediatrician before substituting with a different product to make sure the nutrients are equivalent
* Because Abbott is the only manufacturer of several prescription formulas for babies and adults with metabolic diseases, the company is now releasing these previously held products on a case-by-case basis
* Only purchase imported formulas from brands and countries that have been FDA approved.
Qing Yang and Kevin Parker are a married couple and live in Springfield. Dr. Yang received her medical degree from Yale University School of Medicine and completed residency training at Massachusetts General Hospital. She is an anesthesiologist at HSHS Medical Group. Parker has helped formulate and administer public policy at various city and state governments around the country. He is formerly the group chief information officer for education with the Illinois Department of Innovation and Technology. This column is not intended to substitute for professional medical advice, diagnosis or treatment. The opinions are those of the writers and do not represent the views of their employers.
This article originally appeared on State Journal-Register: Follow these safety tips as baby formula shortage of 2022 continues
