American Society for Nutrition addresses infant formula shortage

A new published perspective addresses the current shortage of infant and pediatric formulas and offers recommendations to help prevent future occurrences and regain the public’s trust.

According to the perspective, which was published in the American Society for Nutrition’s The American Journal of Clinical Nutrition, the shortage of infant and pediatric formula has been particularly problematic for specialized formulas for infants and children with food allergies, intestinal failure, kidney disease, and metabolic disorders. The perspective was written by Christopher Duggan, MD, MPH, editor in chief of The American Journal of Clinical Nutrition and Steven Abrams, MD, professor of pediatrics at Dell Medical School at the University of Texas, and past chair of the American Academy of Pediatrics’ Committee on Nutrition.

Addressing the supply chain shortages due to the novel coronavirus (COVID-19) in 2020, the perspective’s authors reported shortages impacted all formulas and were seen in parallel with other food and household item shortages. As a result, families were encouraged to avoid hoarding and be flexible in the brands they purchased.

However, the situation changed dramatically, according to the paper, in February 2022 when one of the major suppliers of infant formula announced a voluntary recall of powder formula from one of its plants in Michigan. The U.S. Food and Drug Administration (FDA) reported multiple infants with Cronobacter sakazakii infection that may have been related to formula produced in this factory, with two deaths associated with this outbreak. This factory ceased production of the formula and as of mid-May 2022 has not resumed any production or distribution of infant formula or other enteral feeding products for infants or older children, the perspective said. 

This factory was responsible for the production of a range of formulas, notably formulas used for infants and children with severe allergies, renal failure, intestinal failure, and various metabolic disorders, according to the report. Many of these formulas have either no alternatives available in the U.S. or extremely limited supplies of alternatives that were rapidly depleted following a surge in demand. This has led to much distress for parents and caretakers of infants who have lost access to specialized formulas that they need as a primary or exclusive nutritional source.

In the perspective, the authors provide strategies and interventions to improve the situation around three themes:

1. A thorough, public process aimed at instilling public confidence in the safe production of infant and pediatric formulas must ensue. This includes public hearings and release of investigational data into the events that caused the recall and shortages and guidance to families and the healthcare community about safe formula preparation and the dangers of homemade formulas. Efforts to combat misinformation in social media and other contexts are paramount.
2. Factors in the supply system that led to the shortages must be assessed and action taken to reduce future recurrences. The American Society for Nutrition is prepared to partner with medical and scientific organizations, government agencies, industry, and other stakeholders to consider legislative and policy actions.
3. Additional lactation support is needed to encourage and sustain breastfeeding to reach a family’s goals. While breastfeeding will not solve the current shortage and formula will always be needed for many infants, particularly those with special medical needs, lactation support is integral to a comprehensive strategy to prevent the consequences of critical shortages of formula. The U.S. lags many countries in breastfeeding metrics, and for many families additional support to start or maintain breastfeeding can be beneficial in reducing formula needs and the impact of formula shortages. Insurance coverage for donor human milk should be encouraged.

The American Society for Nutrition will host an online dialogue on the topic on Thursday, June 16 at its annual meeting, Nutrition 2022 Live Online.