A U.S. military aircraft arrived in Indianapolis Sunday night carrying 35 tons of baby formula from Germany. But it’s not destined for store shelves. Rather, the hypoallergenic formula will be distributed to areas of acute need to feed babies who cannot tolerate the protein in cow milk.

CNN reported that the shipment included 132 pallets of formula that had been trucked from Zurich, Switzerland, to Ramstein Air Base in Germany, where it was loaded on the C-17 cargo plane.

The Biden administration said that the formula from the first shipment would be sent to hospitals, doctors, home health care facilities and pharmacies in parts of the country with the greatest need.

The White House announced that a second flight of Operation Fly Formula will arrive later this week. It will contain 114 pallets of Gerber Good Start Extensive HA infant formula. The HA stands for hypoallergenic and will also be used for children who are allergic to cow milk protein.

The first shipment is the equivalent of a half-million 8-ounce bottles, according to the White House. Tom Vilsack, agriculture secretary, met the plane and in televised remarks noted the formula could feed 9,000 babies and 18,000 toddlers for a week.

The second shipment will be distributed from a Nestle facility in Pennsylvania, according to The New York Times. The article noted that the United States normally produces 98% of the formula used in the country, “with imports coming primarily from Mexico, Ireland and the Netherlands.”

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The Biden administration has promised that in addition to using military resources to bring formula in, it will use the Defense Production Act to bolster infant formula manufacturing in the United States. Sunday night, officials announced the first two authorizations using the act: Reckitt and Abbott Nutrition. The two companies can now receive in expedited fashion materials that are crucial to making formula.

CNN was told the formula flown in Sunday came from a plant that had already received FDA approval, so it would only require spot checks to make sure the product wasn’t damaged while being flown to the U.S. and that labeling is correct. An FDA inspector and Nestle will each be doing separate checks.

The making of a crisis

There were already some supply chain issues with manufacturing and distributing baby formula. But the formula shortage kicked off in February after Abbott Nutrition issued a voluntary recall of baby formula following the discovery that some infants had become sick and two died, possibly from baby formula. No evidence was found that the formula caused the illnesses, Deseret News reported last week. Then its Sturgis, Michigan, plant was closed after cronobacter sakazakii bacteria was found in the plant, though not in any product.

Abbott Nutrition has now reached an agreement with the Food and Drug Administration that should soon reopen that plant. In the meantime, it has been flying in some of its formula from Ireland.

The Deseret News previously reported that although it agreed to make improvements in its Sturgis plant, a statement from Abbott Nutrition said, “After a thorough review of all available data, there is no evidence to link our formulas to these infant illnesses.” Testing for the Centers for Disease Control and Prevention’s investigation did not link any of the illnesses to formula it produced.

The shortage has had serious consequences for some families who relied on formula to feed their babies. Two children who have a medical condition called short bowel syndrome were hospitalized in Tennessee after their formula became unavailable. Without special formula, they cannot absorb nutrition and replacements have not worked for them.

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And CNN noted that at least four babies were hospitalized at Medical University of South Carolina, as well. Three reportedly could not tolerate the formulas their parents tried due to the shortage. In the fourth case, the baby was fed a homemade mix and suffered “mineral imbalances.”

Desperate parents have been trying to make formula themselves, but pediatricians have discouraged that. “Homemade formula is dangerous for babies,” Dr. Katie Lockwood, an attending physician at Children’s Hospital of Philadelphia Primary Care, told The New York Times last week. “Regular formula is F.D.A.-regulated and held to very high standards, the same way we treat medications. Making it at home is a lot riskier.”

State of emergency

New York City mayor Eric Adams has declared a state of emergency over the infant formula shortage, which a news release promised would “empower the New York City Department of Consumer and Worker Protection to prevent price gouging for formula.”

“This emergency executive order will help us to crack down on any retailer looking to capitalize on this crisis by jacking up prices on this essential good. Our message to struggling mothers and families is simple: Our city will do everything in its power to assist you during the challenging period,” the mayor said in a news release.

The Wall Street Journal reported that, even amid the shortage, the Food and Drug Administration has been enforcing a ban on formula from Europe.

“European baby formulas are regulated by European regulatory authorities, and research has found that most meet FDA-required nutrient levels. They don’t meet FDA labeling and other requirements, however. Most don’t have formula-preparation instructions in English, specific labeling on iron content or instructions on how to store the product. The FDA also has concerns about European formulas requiring less water per scoop, the temperature conditions under which they are stored, and their lack of a system to notify U.S. consumers of recalls. Major European producers such as Hipp and Holle have not spent the time and money needed to comply with FDA regulations,” the article said.