Breastfeeding in a Formula Crisis
![person working with headset at call center](/2022/may/images/infant-risk-call-center-1200x628.jpg)
The IRC is a worldwide call center located in Amarillo
On Feb. 17, the FDA warned consumers not to use certain powdered infant formula products
from the Abbott Nutrition facility in Sturgis, Michigan. A voluntary recall of certain
products followed. Since that time, the FDA has been working with Abbott and other
manufacturers to bring safe products to the U.S. market. But the Abbot shortage, coupled
with supply chain issues, has sent parents across the country into a panic. Store
shelves are bare. Baby formula products simply are not available.
Texas Tech University Health Sciences Center Assistant Professor of Pediatrics Christine
Garner, Ph.D., R.D., says if your baby's normal brand of formula isn't available,
you can swap it out for a different one.
“You may have a preference for one formula over another,” Garner says. “But they all
need to meet those minimum nutrient requirements to be put on the shelves. If you
need to switch formulas, I would suggest trying to transition over the course of a
few days– starting with a little bit more of the formula that they are used to. If
that is just not possible because you don't have enough left, that is also okay; it
is safe to switch to a different formula all at once.”
She advises that parents should not dilute their formula to make what they have last
longer. It decreases the concentration of nutrients and the increased water can actually
cause severe problems, particularly in the younger babies whose kidneys are not developed
enough to handle it. She also says to make sure to dispose of recalled formula.
“It was recalled for a reason,” Garner says. “It's been determined not to be safe
or to pose potentially severe risks to the infant.”
While some parents have resorted to making their own formula at home using recipes from the internet, Garner begs parents to avoid the experiment.
“These have been found to be dangerous, and they can be harmful to infants,” Garner
adds. “ They do not contain all of the necessary nutrients or in the correct amounts.
They can even be harmful and the risk for contamination is high.”
She says what you feed your infant also depends on their age. If a child is under
six months of age and is not breastfeeding, parents really need to give the baby infant
formula. Garner says it is recommended to consult a doctor about switching to another
alternative. For infants between 6 and 12 months old, the American Academy of Pediatrics
has provided guidance that it may be okay to give them cow's milk or toddler formula for a very short period
of time–up to a few days– but parents should switch back to infant formula as soon
as possible. Infants have different needs than toddlers, and these temporary alternatives
do not meet the nutrient requirements of infants.
Prolonged use of cow’s milk or toddler formula could result in nutrient deficiencies
in infants.
When it comes to purchasing formula from another country, Garner says a country like
Canada has similar safety regulations to the U.S.
“There are some slight differences, but I would say they are not really going to have
a drastic effect for a normally-developing healthy infant,” she says. “The formula
is regulated by Health Canada much like here in the U.S. with the FDA as baby formula
needs to have central proteins, vitamins and nutritional requirements. So, formulas
in both countries are tightly regulated.”
Meanwhile, the shortage of baby formula has reignited a discussion on the importance
of breastfeeding. Garner, who is a researcher in the TTUHSC InfantRisk Center (IRC),
strongly encourages parents to continue to breastfeed or start breastfeeding once
their baby is born. Garner acknowledges, however, that there are obstacles for some
people to start and continue breastfeeding.
Research indicates that younger women, particularly under the age of 20, less-educated
women, women with low-income and socioeconomic status and women from culturally and
linguistically diverse backgrounds are more inclined to not breastfeed their babies.
Barriers to breastfeeding success include a lack of knowledge, social norms associated
with breastfeeding, poor family and social support, lactation problems, returning
to work and accessing supportive childcare. There is also a major lack of understanding
of drug interaction and breast milk.
“Years ago, we realized that no one was doing drug research in breastfeeding mothers
and that it was ultimately up to us to do this research,” Thomas Hale, Ph.D., founder
of the IRC, said. “Since 2013, we’ve published dozens of drug studies on the topic.”
The IRC, a worldwide call center located in Amarillo that is used by physicians, nurses,
lactation consultants and parents, was established to support breastfeeding individuals
as these sorts of questions arise.
“We do our best to help anyone evaluate the risk to the infant of exposure to maternal
medications and help keep mom breastfeeding safely,” Kaytlin Krutsch, PharmD, a researcher
in the IRC says. “We work every day to answer difficult and often unknown problems
for our callers, and we're almost always able to find a way to help find safe treatments
for these mothers.
The IRC has also created two easy-to-use mobile apps that help pregnant and breastfeeding
people and their providers decide if a medication is okay to use. The apps have a
database of more than 20,000 drugs. The MommyMeds ($3.99) and the InfantRisk HCP ($12.99)
apps are available on Apple and Google platforms and can be accessed at all times.
Annual subscriptions directly support IRC research.
“Unfortunately, medical providers are not usually breastfeeding specialists. And they
tend to err on the side of caution whenever it comes to the infant,” Krutsch says.
“And so, in general, a lot of moms are told to stop breastfeeding when it might not
be necessary. You might also have moms that choose not to take their medications because
they're trying to prevent drug exposure to their baby. They're really well-intentioned;
everyone is just trying to do what's best for the baby, but sacrificing their own
health isn’t the best way to keep the mom and the baby healthy.”
Parents, both those who are breastfeeding and those who are formula-feeding, should
always have a conversation with a health care provider before making any changes to
their current routines.
For more information on the IRC, visit www.infantrisk.com or call (806) 352-2519.
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