KC docs: Here’s what not to do during baby formula shortage


Parents in much of the United States are scrambling to find baby formula after supply disruptions and recalls have swept many leading brands from store shelves. Pediatricians and health officials urge parents to be cautious about alternatives they feed their children.
Parents in much of the United States are scrambling to find baby formula after supply disruptions and recalls have swept many leading brands from store shelves. Pediatricians and health officials urge parents to be cautious about alternatives they feed their children.

Associated Press

A few days ago an Ohio mom with more than 12,000 Facebook followers shared a recipe for homemade baby formula that’s making the social media rounds. The ingredients? Water, Karo syrup, evaporated milk and baby vitamin supplements.

“This is how a lot of kids grew up!!!” she wrote.

Facebook flagged the post for missing context: “Independent fact-checkers say this information could mislead people.”

Overland Park pediatrician Natasha Burgert is so worried that parents are following advice like that that she recently issued a warning on Twitter. She and other pediatricians and health officials are cautioning parents who are scrambling for alternatives during the ongoing baby formula shortage.

“Do not feed your baby homemade formula. Do not feed your baby homemade formula. Do not feed your baby homemade formula. Do not feed your baby homemade formula,” Burgert tweeted.

The shortage began in February when a voluntary product recall by Abbott Labs, the largest maker of baby formula in the country, aggravated supply chain problems among formula manufacturers. Store shelves in Kansas City and across the country are bare and retailers are limiting purchases.

And as empty-handed, anxious parents scramble, doctors worry that some of the alternatives they’re reaching for can be risky for infants.

Making your own formula with a recipe you grabbed off TikTok, for instance, is a big no-no. Your baby’s health and nutrition are too important to do that, warns the Missouri Department of Health and Senior Services.

“We have certainly seen desperate parents make the dangerous decision to make formula with home kitchen ingredients,” Burgert told The Star this week. “This shortage is so dire in our region, at the moment it may seem like the only choice. However, there is a reason that infant formula is one of the most regulated food products by the FDA (Food and Drug Administration).”

Recipes are being posted online by people who say their own mothers fed them these homemade concoctions when they were babies back in the day — the ’60s, ’50s, even earlier.

“There are many social media conversations about how homemade formula was used a long time ago and babies were just fine,” the Missouri health department noted in its advice to parents. “They weren’t just fine. Babies died before commercial formula was widely available. The infant mortality rates were higher and babies were malnourished.”

“This is where we’re really going to get worried about this,” Dr. Steve Lauer, a pediatrician with The University of Kansas Health System, said during a recent medical briefing.

“The formulas are really complicated mixtures, trying to replicate as closely as they can breast milk. The worry is these simple, straightforward, little bit of this, little bit of that, just is not going to be able to replicate that.”

A baby’s growth and development, especially brain development, said Lauer, “is critically reliant on getting the right nutrients into them at this early age. So these things that might meet most or some of the protein requirements are not going to meet all the requirements that a baby needs for proper growth and development.”

“So beware those adhoc mixtures. They can be dangerous,” he said.

Here are a few other things doctors want parents to avoid. As always, it’s best to consult your pediatrician or health care provider before switching things up for your baby. (The Star gathered information about hotlines and other resources for local parents.)

“I’m strongly encouraging everyone in our area to please reach out to their pediatrician or health care clinician for safer alternatives,” said Burgert.

Just say no to goat’s milk

There’s a lot of discussion online about feeding babies goat’s milk. But the American Academy of Pediatrics says goat’s milk is not approved for babies in the United States.

However, there are some goat milk-based formulas used in other countries that the Food and Drug Administration might approve as the United States looks elsewhere for supplies during the shortage, the academy says.

Missouri health officials also caution about giving cow’s milk or other milk substitutes to any baby younger than 1.

Before that age, cow or goat milk could put babies at risk for intestinal bleeding, they warn. Those milks also contain too many proteins and minerals for a baby’s kidneys to handle, state health officials caution.

They also typically lack nutrients babies need. Goat’s milk, for instance, is missing critical vitamin B12, pediatric nurse practitioner Sallie Page-Goertz said during the KU briefing about the formula shortage. Almond and oat milk are also not recommended for infants, she said.

The pediatric academy does not recommend plant-based milk alternatives, including soy milk, for babies under the age of 1 because they too are often low in needed proteins and minerals. But, during the shortage, they can be an option for babies close to that age, but not for longer than one week, the pediatricians’ group says.

If you temporarily switch to soy milk, buy one that is fortified with calcium and vitamin D, and switch back to formula as soon as possible, pediatricians advise.

Also, the pediatrics academy says if your child is older than 6 months and on regular formula — not a specialty one for allergies or other special health needs — whole cow’s milk could be an option for families in a pinch.

It’s not ideal and should only be used for a brief period, no more than a week, the pediatric group advises. If you need to use it longer than that, consult the baby’s doctor or health care provider first.

And because of how it might affect the baby’s intestinal system, parents need to keep a close eye on how baby reacts to it and report anything unusual to their pediatrician.

Cow’s milk doesn’t have enough iron for babies 7 to 12 months old to drink for an extended period of time. It could lead to anemia. If you have to use it longer than a week, supplement it with iron-fortified cereals or baby food made with meat, pediatricians recommend.

Don’t water down formula

Resist the temptation to water down baby formula, another suggestion floating around on the internet. Diluting formula changes the ingredients ratio and can make your baby sick, health experts say.

“We don’t want people adding water to their formula in order to stretch out the supply they have at home,” said Page-Goertz, who has seen families do that when they can’t afford formula and want to make it stretch.

“We have admitted babies to the hospit
al who have gotten quite sick when their families (mixed) coconut water and a protein powder, for example, thinking they were doing the best thing for their baby. That baby got quite dehydrated.”

Adding extra water to formula can dilute the levels of minerals and protein, the pediatrician’s group cautions, and lead to low sodium levels in the blood and other electrolyte disorders that could put your baby in the hospital.

Don’t switch to solid food too soon

Pediatricians caution against switching a baby to solid food to stretch the baby formula supply.

Solid foods might not contain all the nutrients babies need, like formula does, the pediatric association says. Infants are generally ready for solid food at 6 months, but that will vary from child to child. Your pediatrician can help you decide when to make the switch.

The Missouri state health department recommends Food to Grow On: Birth to 12 months, a guide to the nutritional intake needed by babies in their first year of life.

Be careful using someone else’s breast milk

Parents considering using milk from an informal milk-sharing network online should be careful. You can’t know for sure whether breast milk from an online group — or a friend, sister, neighbor — is safe, the pediatrician’s academy warns.

“It’s a little more complicated to make sure the donor is a healthy mom,” said Page-Goertz. “Harder to know if the milk is healthy milk, so there’s a level of trust that has to happen between the donor and recipient.”

She found a safety checklist on one website that links breast milk donors to other baby moms. One tip: Parents need to make sure the donor isn’t using a substance that might cause the milk to be unsafe for a baby.

They should also make sure the donor collected the breast milk “using a clean technique” and stored it safely so it’s not contaminated.

The American Academy of Pediatrics recommends using a milk bank accredited through the Human Milk Banking Association of North America. A milk bank collects, screens, pasteurizes, tests and distributes breast milk from mothers who have more than their babies need.

Much of the milk goes to hospitals for preterm babies, but some is available to babies in the community, Becky Mannel, executive director of the Oklahoma Mothers’ Milk Bank in Oklahoma City, said during the KU briefing.

Take a second look at that expiration date

Physicians would never, ever, tell parents to ignore the expiration date on baby formula. However, during this emergency situation …

“What we’re really worried about is families are literally going to be stuck at 10 p.m. with nothing to feed their baby,” said Lauer. “And the No. 1 rule is feed the baby.

“In no way can we recommend it and say it’s a good thing, but those expiration dates don’t mean that that formula goes bad on that date. That’s the recommended use date.

“We try to avoid using expired formula, or expired any medical product, if at all possible. But we’re very concerned there will be families in that position … watch carefully and try to find some current formula as quickly as you can.”

Don’t substitute toddler formula

The Kansas Department of Health and Environment strongly discourages giving toddler formula to infants.

Toddler formulas are not the same as infant formula, said Burgert. FDA regulations are less strict for toddler formulas and the nutritional ingredients are different, she said.

But, toddler formulas can be an option for babies 9 months or older, she said.

Toddler drinks, usually found in the formula aisle, are safe for a few days for babies close to 1 year of age if you have no other choice, according to the pediatrics academy.

Don’t be afraid to switch formulas

If you have to switch your baby from one formula to another, don’t worry about doing it slowly, Burgert told Momtastic parenting blog. Most babies — unless they have a special circumstance like allergies or need a special diet — can tolerate a quick switch like that without much consequence.

It’s OK to switch from one form of formula to another, too. They typically come in three forms — concentrated, powder, ready-to-feed.

Doctors say regular formulas on the market are all generally the same nutritionally, so switching to a generic, or different, brand should be fine.

But if the baby experiences gassiness or its poop changes, talk to your doctor about gas drops, stool softeners and probiotics, Burgert recommends.

If your baby uses a formula for allergies or other special health needs, the North American Society For Pediatric Gastroenterology, Hepatology & Nutrition provides a list of comparable formulas on its website.

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Lisa Gutierrez writes about medical and health-related issues for The Kansas City Star. She is a Kansas native and veteran of five newsrooms. She was a caregiver for her husband, who had dementia, until he died in July 2019.


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