A committee of experts that includes AAP members has released new recommendations aimed at preventing and lessening the impact of future infant formula shortages.
In a 400-page report released Thursday by the National Academies of Sciences, Engineering, and Medicine (NASEM), authors detailed vulnerabilities that led to an “unprecedented” shortage in 2022 and called on multiple government agencies to take action.
“Infant formula is a critical food, and future disruptions need to be anticipated and prepared for,” committee Chair Barbara O. Schneeman, Ph.D., emeritus professor, University of California, Davis, said in a statement. “Our report recommends steps that should be taken now to not only reduce the risk of future shortages but also to make sure that when a disruption does occur, no parent has to face the anxiety and stress of not being able to find formula for their infant.”
About three-quarters of infants receive formula in the first six months, according to the report. The 2022 shortage was caused by a combination of supply chain issues and the shutdown of an Abbott Nutrition plant following complaints of bacterial infections among several infants who had consumed the formula. While the government took multiple steps to respond, it often took too long, the committee said.
The NASEM committee made 14 recommendations with five overarching goals to address vulnerabilities.
- Reduce and mitigate production concentration.
- Implement risk management and resiliency planning.
- Improve the speed of recovery from a shortage.
- Mitigate adverse consumer impact.
- Increase breastfeeding protection, promotion and support.
Recommendations aimed at Congress, the Food and Drug Administration (FDA) and Department of Agriculture (USDA) call for
- creating risk management plans;
- incentivizing manufacturers to modernize plants and equipment;
- facilitating formula distribution to the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) during supply disruptions;
- developing consistent guidance on how caregivers should substitute infant formula during a shortage;
- tracking critical data on infant formula supply and shortages;
- collecting information on nutrient and labeling requirements used by other countries;
- requiring manufacturers to notify the FDA of a possible supply disruption; and
- requiring hospitals that accept Medicaid to have a plan for handling supply shortages.
“There were multiple causes to the shortage and substantial action is needed by FDA, Congress and the USDA to prevent future shortages by strengthening the available data and planning related to formula production and distribution,” said committee member Steven A. Abrams, M.D., FAAP, former chair of the AAP Committee on Nutrition and current member of the Section on Neonatal-Perinatal Medicine.
The report comes just two weeks after a tornado damaged a Mead Johnson Nutrition distribution center in Indiana, impacting the company’s Enfamil formula supply. Dr. Abrams said state agencies may be able to provide more information for WIC customers who need alternate formula options.
“Parents should always be aware of why a specific formula is one that is chosen for a baby and should discuss options if this formula is not available with their pediatricians,” Dr. Abrams said. “Pediatricians should maintain awareness of reports of formula shortages and options available and should advocate for increased resiliency in the formula market.”
Authors of the report said they hope their recommendations put the country in a better position to respond to future supply disruptions.
“By capturing what was learned from the 2022 shortage and investing in steps to address vulnerabilities, as well as coordinated planning, government and industry can be better prepared to respond quickly in the future and mitigate the impact of a shortage, no matter what the cause,” they wrote.
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