Published June 1st, 2022 at 6:00 AM
“Gotta go — formula,” Mia Cathey shouted at her husband as she rushed out the door one night at 9 p.m.
Cathey was off to buy two cans of the high calorie, hypoallergenic formula her 4-month-old baby needs to survive. The previous two weeks, she had been unable to find a single can of the formula anywhere in her hometown of Blue Springs, Missouri, and she was down to her last can.
Cathey was finally able to get a couple of days worth of food for her baby thanks to a post on a community Facebook group about one store’s stock.
Such experiences are common.
In mid-February, Abbott shut down the nation’s largest formula production plant and recalled its Similac products from shelves. The company did so after the U.S. Food and Drug Administration (FDA) found dangerous bacteria in its Sturgis, Michigan, production facility.
As of May 21, out-of-stock rates for formula had risen to 70% nationwide, according to Datasembly, a retail data provider.
In Kansas City, it’s become a community effort to keep babies fed. Friends and family members have sent cans of formula to their friends with babies, folks have posted on community boards what they see at the grocery store, moms have donated excess breast milk and local agencies have worked to ship the product where it’s needed.
“It’s just trying to survive as a community, I think is the best way to put (it),” said Anne Strope, the administrative coordinator for Missouri’s Women Infants and Children (WIC) program.
Formula shortages have been an issue for some time as one of the many supply chain problems caused by the COVID-19 pandemic. Strope said in the past couple of months the issue has grown and become an “all-hands-on-deck” situation.
The recall caused parents who normally buy Similac to reach for other brands, creating a scarcity across all formula types. Like toilet paper in the early stages of the pandemic, formula became a hoarded commodity by those with the means.
Missouri WIC has contracts with Abbott, the maker of Similac, so WIC vouchers are primarily for Similac formula. If a WIC participant can’t find Similac on the shelves, Strope explained, they have to go to their closest WIC agency and request a different type of formula.
They would also have to hope that the substitute product was still available.
“It’s a frustration, and we get it and we’re sorry,” Strope said. “As a program, we don’t have the flexibility to make all the changes that we see that could help people … We’re doing what we can, within our regulations, to help as best as we can.”
Sometimes, this means Strope is calling retailers herself trying to track down a can of formula to help a participant.
“People are mad at WIC, and I feel some of it is justified because we’re supposed to be helping,” Strope said. “The majority of us are moms or grandmas that work at WIC, and we would go make formula if we knew how (or go) work at a plant for a while and help out if we knew it would help.”
In Missouri, WIC has more than 82,000 participants. Even prior to this shortage, the program would facilitate direct shipments of formula from distributors to WIC agencies that couldn’t get the product.
Last year, the program did about 10 of these a month. Now, it’s averaging 20 a day.
“That number kind of speaks volumes as to the difficulty our participants are having to find formula,” Strope said. “And we’re not always able to find it either.”
These shipments are especially important to rural areas of the state with fewer grocery stores and WIC retailers than urban areas.
While the shortage definitely affects WIC participants, Strope was adamant that the shortage affects everyone.
“That fear is everywhere, whether you’re on WIC or not,” Strope said.
To bolster the nation’s inventory, oversea shipments of formula have landed on U.S. soil, but it’s unclear if those shipments will reach the Kansas City area. The New York Times reported one shipment has enough formula to feed around 9,000 babies and 18,000 toddlers for a week.
“If it was just Missouri, I would say it would be a huge help, but when you look at it from a broader perspective … that doesn’t even cover one state, what is needed,” Strope said.
The Sturgis formula plant has remained closed since the recall in mid-February. Other Similac plants have ramped up their production to help fill the gaps, but Strope said it’s hard to see an end to the shortage until the Sturgis plant is operational again.
Abbott CEO Robert Ford said in an opinion piece the Sturgis plant plans to reopen at full capacity the first week in June.
”By the end of June, we will be supplying more formula to Americans than we were in January before the recall,” Ford wrote.
However, he also said in the same paragraph it would take 6-8 weeks from the start of production for formula to reach the shelves.
That’s another couple of months when moms like Cathey, have to worry about where to find formula.
An ongoing community effort is the best way to support mothers and babies during this time.
From the frontlines of the issue, as both a mom and WIC coordinator, Strope suggested the following ways to help:
Jessica Hurd is one of the many moms donating extra breast milk to those who can use it.
She’s been breastfeeding for almost five years now, with just short breaks between each of her three kids. Her youngest is just 6 months old and still feeding, but Hurd said she over produces milk and ended up with a freezer full of breast milk.
As she heard about the formula shortage affecting families this past month, she decided to reach out on a Facebook group about donating her milk.
“I’m not going to use it, so why not give it to someone that needs it?” Hurd said.
Within an hour of listing that she had breast milk to donate, Hurd had countless inquiries and was able to donate about 700 ounces of milk.
The moms she was able to donate to were grateful, she said. One gave her farm fresh eggs and others offered to replace her breast milk bags.
“I’m not doing it to get anything back,” Hurd said. “I like to think that if I was in that same position, they would donate to me.
While Facebook groups have helped some people find food, social media conversations around the shortages are filled with comments suggesting mothers just breastfeed, and offering recipes for homemade formula.
But what works for one baby doesn’t necessarily work for every baby.
Alyson, Cathey’s 4-month-old baby, was born with a heart condition and struggles to gain weight needed for early development, so she needs a high density formula. To make matters worse, Alyson is allergic to milk.
Even Cathey’s breast milk gave the baby a rash and caused projectile vomiting.
“(Formula) is almost more like liquid gold to me than breast milk because I can’t make more of this,” Cathey said. “When it’s not on the shelf, how do I feed my baby?”
Alyson is healthy, but because of her heart condition at birth, she is still only in the 25th percentile for growth. Cathey’s pediatrician told her to mix Alyson’s formula at a higher powder-to-water ratio to help the baby gain weight. This means a can of formula, which goes for about $35, only feeds Alyson for a few days.
“So I can’t supplement with anything,” Cathey said. She is frequently left in situations saying, “I have one can left, and that’s two days worth of food for her. I have to find something in these two days.”
She tried to breastfeed, but it wasn’t what her baby needed.
“I just have to remind myself that these people that are leaving these comments, they just don’t understand because they haven’t had to walk in these shoes,” Cathey said.
Another local mother is experiencing a similar problem.
Em Moreno feeds her 3-month-old baby a special formula that she now scrambles to find on Kansas grocery shelves.
“I thought (it) may be easier to find because it’s only for premature babies, but we have friends and family looking all over,” Moreno said.
When he was born, her baby was in the natal intensive care unit for more than a week. He was jaundiced and his weight hovered at around four pounds, until physicians gave him formula, Moreno explained.
“He grew around two ounces a night and finally got to come home after 11 days,” she said.
The new mother said she never expected for this to happen. She chose to formula feed her child because her mom and grandmother did the same.
She just wants her baby to be healthy.
Maternal health care experts say the stigma that comes with making the choice to formula feed is underscored the day a child is born. When a person gives birth, nurses come in who may or may not be well versed in lactation care.
Rather than educate and empower the parents, the choice might be made for them, one advocate says. Like clockwork, maternity ward staff come in and rattle off the 10-step Baby-Friendly Hospital Initiative launched by WHO and UNICEF.
No. 6 states: “Do not provide breastfed newborns any food or fluids other than breast milk, unless medically indicated.”
This raises concerns for parents like Moreno.
“Lots of people think ‘breast is best’ and it’s easy to get breast milk but that is just not true for a lot of babies,” she said. “My baby needs a special amount of calories to grow.”
Now her child is a healthy five pound baby as she struggles to find the specified formula recommended by her pediatrician. In recent weeks, she and her family hit every Walmart, Dillons, Sam’s Club and CVS within an hour radius, “and nothing.”
Finally a friend in South Dakota located four cans — the only four left in that store — and shipped them to her. Another family friend sent her a few more, so she’ll have enough for maybe 70 days.
Although her doctor provided a different formula, she’s worried it isn’t the one her child needs.
“I don’t know what will happen after that,” Moreno said.
Netta Thompson, chief operations officer and breastfeeding/lactation educator at Uzazi Village, said it all boils down to this: “Ultimately, my thing is, feed your baby.”
Thompson said the shortages happening now remind her of the early part of the pandemic.
“The stress of going to the store, and what you need is not there. And so then you have to really think about, ‘How am I going to take care of my family?’”
Added stress also can impact how mothers are able to care for their children, newborn or not. With those considerations in mind, Uzazi Village is doing what it can to provide community support.
The nonprofit organization is a leader in maternal care for parents of color, a needed resource for those who distrust hospitals and medical clinics. Thompson said the organization has seen less formula donations as of late, which poses a dilemma.
Staff asked whether they should go to big-box stores to purchase formula. They ultimately decided not to.
“Because we’d be taking it away from families who need it,” she said.
Though Uzazi Village is a hub in the community for its free offerings, such as family education, diaper depots, lactation consultations, pantry and closet, organizations like these rely on donations and funding to get by. The lack of investment in maternal health care organizations — and parental care in general — has been magnified by the current shortage, Thompson says.
She added: “It really breaks my heart that families here in the U.S. have to be concerned with how they’re going to feed their babies.”
While Thompson states that breastfeeding is the optimal way to feed infants, this just isn’t an option for every parent. She feels the issue is multifaceted, one being that the formula industry in the U.S. should be held to a higher standard.
In the 1950s, formula was hailed as the premium choice. But more recent research has shown otherwise depending on the brand.
“We also need to kind of understand a little bit about infant anatomy. When babies are born, they have a virgin gut, meaning that some whey molecules — the whey that is in formula — (makes) it a little bit harder for some of our babies to be able to process than mom’s milk,” she said.
Second, understanding complexities of other factors is key, she said.
A brief trigger warning for readers. This explanation may be unsettling for some.
Some women who have been sexually assaulted are unable to feed at the breast, Thompson explained. Then there are also women who require medication that are unsafe to pass on to the infant through feeding.
“We haven’t even talked about babies with Down syndrome or a cleft palate,” she added.
The list goes on.
Still, parents are being shamed, on social media and elsewhere. Thompson said another piece to understanding the puzzle is the historical implications of racism and discrimination in medical settings.
It has sown distrust.
“Many medical providers still believe that a lot of these families are on welfare, and so they’re not going to breastfeed anyways, they’re gonna go ahead and just give the baby formula,” she said. “So they don’t put in as much effort when it comes to educating the mom about breastfeeding.”
The history points to discriminatory practices that used enslaved Black, immigrant or poor women to feed wealthy mothers’ babies, also called “wet nurses.” This meant the needs of kids from lower-income and marginalized backgrounds went unmet.
Then when infant formula was popularized in the late 1920s, the industry further cemented the widening racial disparities as it connects to food access, health and maternal health care.
“This (shortage) does point to a larger issue of just our maternity care here in the U.S.,” Thompson said.
Segregation, racism in the medical field and economic drivers made it harder for lower-wage workers, who were largely Hispanic or Latinx and Black, to access fair parental leave. This included a workplace that provided an avenue for breastfeeding such as nursing rooms, time to pump and other lactation support.
According to a report by the Association of Women’s Health, Obstetric and Neonatal Nurses, early initiation and support was lacking in communities of color.
This shortage further underscored the issue.
A PBS report found that the demographic of parents hit hardest by the shortages were largely parents of color.
Thompson’s hope is that hubs like Uzazi Village can work to close those gaps in Kansas City and provide what parents need. The community support has no doubt been vital to these mothers.
“It does boil down to education. It does boil down to having better maternity leave for moms and giving them a fighting chance,” she said. “Giving them the opportunity to be able to do what they want to do.”
But it doesn’t change the fact that many of them still face another month or two filled with fear.
“There’s a lot of frustration as a parent that in (the) first world country that we live in, this should not be a problem,” Cathey said. “It’s very frustrating.”
Vicky Diaz-Camacho covers community affairs for Kansas City PBS. Cami Koons covers rural affairs for Kansas City PBS in cooperation with Report for America. The work of our Report for America corps members is made possible, in part, through the generous support of the Ewing Marion Kauffman Foundation.
This article has been updated for clarification.