This past Spring, I was discussing with my family the passage of time and how the beginning of the COVID-19 pandemic seemed so remote and yet still so recent. We shared pictures we had taken years prior in our local stores of empty shelves with no toilet paper back in March 2020. Surprisingly, not even 2 years later, many families in the US were dealing with a similar reality due to a national shortage not of toilet paper but rather of infant formula.
While I have had patients and families with food insecurity due to an inability to afford food, this was the first time in my career (and I suspect many US pediatricians’ careers as well) when there was an inability to even find food. The cupboards, and the store shelves, were bare of suitable formula, and we were helpless to do much. I can recall a few children with rare metabolic diseases being urgently admitted to our hospital due to this acutely life-threatening food unavailability.
The supply shortage came from concerns for contamination of certain powder-based formulas with the bacteria C. sakazakii. The shortage was exacerbated by supply chain issues during the COVID-19 pandemic as well as other factors. These shortages were felt by families across the country and by their pediatricians. These events led to increased scrutiny on the reliability of our country’s formula production capacity along with how such products are regulated, particularly in comparison to infant formulas made in other countries. The importation of European-produced formulas ultimately helped ease the shortage, but the subtle differences between formulas produced in the US and Europe was a source of consternation and confusion at an already trying time for all.
The July 2024 issue of Pediatrics in Review features the article “Pediatric Formulas: An Update,” by Dr. Imdad and colleagues addressing, in part, this sentinel infant formula shortage (10.1542/pir.2023-006002). The authors also address broader topics in the realm of formulas for infants and children, including composition and nutritional characteristics. They also discuss older infant and young child formulas and plant-based formulas, which are becoming increasingly popular too.
While the infant formula shortage has thankfully eased, it would be naïve to think that something similar would not happen again in US formula production. The prepared reader would be well served keeping this article within arm’s reach in anticipation of the next unanticipated formula shortage, as this article provides helpful graphics and information on suitable formula substitution. After all, in the words of Louis Pasteur, someone who knew a few things about bacterial contamination, “chance favors only the prepared mind.”
