Pediatricians may be getting calls from parents who are struggling to find formula for their infants. To help guide pediatricians in their conversations with patients and families, AAP experts provided answers to some common questions from parents.
Q: I found small quantities of several different formulas. What is the best way to switch among the brands?
A: It is likely that your baby will do just fine with different formulas as long as they are the same type. If your baby does not like the taste or has difficulty tolerating a new formula, you may want to try gradually introducing small amounts of it by mixing it with the usual formula. You can slowly increase the amount of the new formula. Be patient as it may take some time for the baby to get used to a new formula. Try not to give up unless it really isn’t tolerated. If you have questions about whether your baby is tolerating the new formula, call our office.
Q: I have a 3-month-old infant and can’t find my usual formula. What should I do?
A: This is a very difficult problem, and we’re glad that you contacted us. If you can find another similar formula, it’s OK to make the switch. If you use a special formula for allergies or other special health needs, you can find a list of comparable formulas at https://naspghan.org/recent-news/naspghan-tools-for-hcps-affected-by-formula-recall/.
Q: I have a 7-month-old infant and can’t find any formula. What should I do?
A: If your child is older than 6 months of age and usually is on regular formula (not a specialty product for allergies or other special health needs), whole cow’s milk may be a short-term option. In a pinch, you could feed your child whole cow's milk for a brief period of time (no more than one week). This is not ideal and should not be done for more than one week.
One concern about giving cow’s milk to a baby who is 7-12 months old is it does not contain equivalent amounts of iron to formula. If you have to use cow’s milk to feed your infant, ideally do so for as short a time as possible and for less than a week. It’s also important to give the baby plenty of iron-containing solid foods, such as baby food made with meat or iron-fortified cereals.
Q: My infant needs a specialty metabolic formula, but I can’t find any. What should I do?
A: Abbott is releasing limited quantities of Similac PM 60/40 and other metabolic formulas for patients in urgent need. Our office can fill out a request and if it is approved, the formula can be shipped to your home. (Pediatricians can download the form at http://www.abbottnutrition.com/metabolics and fax the completed form with a physician order to 877-293-9145.).
Q: Only one brand of formula is covered under the WIC program, but I can’t find any. What should I do?
A: Most states are allowing parents who use WIC benefits to buy other brands of formula or different sizes and types like ready-to-feed formula. (To find out what their state is allowing, pediatricians and families can check a map at https://www.fns.usda.gov/wic/infant-formula-waiver-status.)
Q: What is the earliest age I can start giving my infant solid food to stretch my formula supply?
A: Solid foods should not be used to stretch formula supply. Formula contains all of the nutrients young babies need, while solid foods may not. Infants generally are ready to eat solid food when they are 6 months old, but it depends on their rate of development. You can introduce solid foods as early as 4 months of age, but infants 4-6 months of age will continue to need breastmilk or formula to supply the majority of their nutrition.
Q: Is it safe to get breastmilk from a friend or online group?
A: We can’t know for sure whether breastmilk from a friend or online group is safe. It is better to obtain donor breastmilk from a local milk bank that is accredited through the Human Milk Banking Association of North America. To find an accredited milk bank, visit https://www.hmbana.org/find-a-milk-bank/.
Q: Can I make my own formula? I’ve seen a recipe online using evaporated milk that people say was used safely in the 1940s.
A: Homemade formulas are not recommended. Although homemade formula was used in the past, it also was associated with many risks to infants. Online recipes have significant safety concerns regarding contamination and nutrient concentration. Using homemade formula could harm your infant.
Q: Can I add extra water to formula and give my baby a multivitamin to make up the nutrients?
A: This should never be done. Adding extra water can dilute the levels of protein and minerals, and lead to low sodium levels in the blood and other electrolyte disorders, which could result in a baby needing to be hospitalized.
Q: How long can formula be used past a “best by” date?
A: Generally, formula should not be used past the “best by” date because it may not be safe or have the required levels of nutrients.
Q: I heard the government will be importing formula from other countries? Is it safe?
A: The Food and Drug Administration (FDA) is working to assure procedures are in place to verify production standards, labeling and shipping of brands that previously have not been sold in the U.S. European formulas are regulated by the European Food Safety Agency similar to how the FDA regulates formula in the U.S. and are highly reliable.