In February 2022, the closure of an Abbott formula factory in Michigan, due to food safety concerns, precipitated a national shortage in infant formula. This quickly became a crisis for many families with infants, and infants with special nutritional needs or from families with low income were particularly impacted.
This week, Pediatrics is early releasing an article and accompanying video abstract in our Equity, Diversity, Inclusion, and Justice section entitled, “Formula for a Crisis: Systemic Inequities Highlighted by the US Infant Formula Shortage,” by Dr. Rita Wang, Dr. Neha Anand, and colleagues at Boston Medical Center and Boston Children’s Hospital (10.1542/peds.2023-061910).
The authors outline factors that contributed to the infant formula shortage:
- The US formula market is dominated by 3 manufacturers (Abbott, Mead-Johnson, and Nestle-Gerber), who produce and sell 90% of infant formula.
- Production is carefully monitored to be just enough without any reserve supply.
- During the COVID-19 pandemic, there were labor force shortages.
- Additionally, the pandemic made it difficult to maintain regular safety inspections.
The problem of the infant formula shortage was exacerbated for the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), whose clients use more than 50% of all infant formula in the US. Every year, formula manufacturers need to competitively bid for WIC contracts in each state, creating a monopoly for a manufacturer in any given state. If there is a shortage of formula made by a manufacturer, and that is the only formula available to WIC clients in a specific state (which happened in many states because of the Abbott factories closing down), there are few options for those clients.
I remember stories of parents driving 2–3 hours to find formula. The Centers for Disease Control and Prevention (CDC) provided suggestions for families, such as using a different brand of formula, including formulas made in other countries. However, for many families who receive nutrition support from WIC, these are not viable options. Thus, these families bear a disproportionate burden when these crises occur.
I urge you to read this article. The authors describe current efforts to make WIC benefits easier to access and to prevent crises such as this formula shortage from reoccurring. Pediatricians and others who care about children can advocate for these efforts with their state and national representatives.
