***Please note that this does not substitute for medical advice. Before any changes are made that can affect your child, discuss those changes with your pediatrician or family physician first.
Many families in Calaveras County and the US are facing significant challenges when it comes to finding formula for their babies.
Within the first few days of life, nearly 20% of babies get formula. By three months of age <50% of babies are exclusively breastfeeding in this country.
Black, Hispanic, Asian, and American Indian parents are more likely to use formula. So the availability and access to formula are both factors that affect families here in our county and beyond.
Baby formula is displayed on the shelves of a grocery store with a sign limiting purchases in Indianapolis on Tuesday. Michael Conroy/AP
Why is prepared formula so important?
Parents should be cautious about is substituting their normal formula with unsafe alternatives such as cow's milk, goat's milk, soy milk, watering down formula and making DIY formulas because of the unsafe changes that can happen in a baby's body due to unsafe substitutions.
Parents may elect to add additional water to the formula to give their baby the same volume and to conserve their supplies. This can lead to a number of complications – first, the infant will not get the necessary calories and thus will be at risk of poor growth and second, this puts a baby at risk of hyponatemia, or lowering of the sodium levels in the body.
Acute hyponatremia can develop in <48 hours. What happens is the brain cannot adapt to the abrupt change in sodium. Below certain sodium levels a baby can demonstrate neurologic symptoms – nausea and malaise are first, followed by a decrease in consciousness and seizures if the sodium levels are too low.
Offering cow’s milk before 12 months of age
It is recommended to give whole milk to toddlers who are 12 months of age and older, not to infants. Under 12 months only breast milk and formula contain enough nutrients.
Bleeding in the gut can happen in up to 40% of infants who are put on cow’s milk exclusively.
Reduced Iron Absorption & dehydration can happen because calcium and casein, present in higher amounts in cow’s milk, can lead to reduced iron absorption. Excess calcium leaves via the urine leading more water to leave with that calcium as a result. When water leaves at an abnormal rate, electrolyte abnormalities and dehydration can happen. So, even though a parent can be giving a baby "adequate volumes" of cow’s milk to their infant, their baby can still become severely dehydrated.
What about goat’s milk?
Goat’s milk does not contain enough vitamin D, vitamin B12, iron and especially folate.
Anemia can result as a result of a deficiency in iron and folate especially.
What about soy or almond milk?
Soy and Almond milk are deficient in calories and essential nutrients like protein, calcium, vitamin D and more. Although we do see soy milk generally fortified in calcium and Vitamin D, we generally see nut and plant based milks as deficient in calories
DIY or homemade formula recipes
Infant formulas are engineered and one of the most regulated food products on the market because that's how complex they are with dense concentrations of protein, fat, vitamins, minerals and more.
Commercial formulas are engineered so they closely mimic human breast milk and are held to high regulatory standards to ensure infants have the nutrients they need. It's extremely challenging to guarantee the proper nutrition profile exists with a do-it-yourself recipe. The Food and Drug Administration strongly advises against making formula at home.
A 2021 report from the US Centers for Disease Control and Prevention illustrates the dangers of homemade formulas. A 4-month-old infant went into multiple episodes of cardiac arrest and suffered brain damage after he’d been fed a concoction made of sea moss, hemp seeds and coconut water for a month. Another 5-month-old exhibited breathing issues and had bone deficiencies.
So what are safe substitutes for the formula my baby normally uses?
It is important to remember that the latest Abbott recall affects the supply of Similac, Alimentum and EleCare formula products. There are many alternatives that exist.
Here is a great guide compiled by Dr. Jessica Madden, MD, a pediatrician, IBCLC, neonatologist, and mother of 4. Here you can find a list of formulas and their alternatives that we recommend discussing with your pediatrician.
Check out her BABY FORMULA GUIDE with listed substitutes HERE
Also it is important to remember that store brand formulas are not affected by the Abbott recall. Below is a graphic showing alternatives to Abbott formulas as well.
So what do I do next?
Discuss your thoughts, challenges and concerns with your pediatrician or family physician if your family is affected by the formula shortages.
*Update: Mom and Gymnast Shawn Johnson has created a Formula Exchange Site HERE.
Big Trees MD, A Concierge-Style Direct Primary Care Clinic
US Breastfeeding Report Card by the CDC: HERE
What is in Infant Formula: HERE
FDA Advisory against making formulas at home: HERE
Effects seen from making formula at home: HERE