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What’s next in the lingering baby formula shortage?

The government, manufacturers and friendly countries overseas are all making a dent in the crisis, but full recovery will still take several weeks.

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Illustration by Zoë Petersen, Deseret News

Feeding Jeremiah Heglund, who’s 5 months old, has been something of a team sport. 

Amid the crisis of a national infant formula shortage, the baby’s parents, Julie and Zachary Heglund of Vero Beach, Florida, have driven plenty of miles and made lots of social media posts asking friends and family to scour store shelves for elusive infant formula.

The impact of the shortage is huge. The Centers for Disease Control and Prevention 2020 Breastfeeding Report Card says that nearly 85% of new mothers attempt to breastfeed, but by six months, the number has dropped to under 60%. Just over a third breastfeed for a year.  And under half are able to breastfeed without supplementing with formula for three months.

U.S. Food and Drug Commissioner Robert Califf described for NPR’s “All Things Considered” what he calls measurable improvements in the monthlong crisis: “There’s more formula on the shelves, and the production now is exceeding the demand by a significant amount every week. So we’re on the road to recovery, but I don’t want anyone to think we are sitting back at this point. We’re still going 24/7, seven days a week to make sure that we stay on the road to recovery,” he said, adding full relief is likely several weeks away.

That sluggish recovery is not news to the Heglunds.

“Where we live, it’s still off and on with the formula stock,” said Julie Heglund, who said she couldn’t produce enough milk to breastfeed her only child and turned to formula soon after he was born.

She describes seeing shelves that are pretty full on one store visit and mostly empty on another.

“You have to drive around looking for formula,” she said. “He was on the sensitive formula because he was spitting up a ton at first. That was hard to find in stores. Friends and family all over the East Coast were searching for it and shipping it to us.”

It’s a crisis that’s stretched across the country. Lisa and Ryan Mersmann of American Fork, Utah, have found formula for Senna, also 5 months, by scouring Costco shelves and asking friends to do the same, and by stocking up every time they find some.

Even before their baby was born, her husband had seen stories about supply chain issues — the first problem in a series that would compound to create the formula shortage to come. So the Mersmanns stocked up early. But in late May, they were running out of formula and the shortage was dire nationwide, Lisa Mersmann said. 

“I was a little panicky,” she said, describing calling around to Costco stores, because the baby was used to the store’s signature Kirkland brand, and posting on social media asking others to check the shelves if they went to the warehouse store. “If you see it, buy it,” she’d write, promising to pick it up and pay for it.

“I was constantly refreshing the Costco website,” she added. And she’s still hunting, despite rumors the crisis is abating somewhat. She’s also still begging friends to keep their eyes peeled. Sometimes she gets a text that it’s available online. She stops whatever she’s doing to check.

The making of a crisis

Amid the supply chain problems, Abbott Nutrition, the largest U.S. baby formula manufacturer, issued a recall in February after several infants became sick and two died. Though the babies all used Abbott formula, the illnesses were never tied to the formula.

Shortly after, though, cronobacter sakazakii bacteria was found in Abbott’s Sturgis, Michigan, plant — though not in any of the product. That factory was closed for clean-up. When the requirements in a consent decree were satisfied weeks later, the factory reopened and restarted production.

Less than two weeks after that, a massive storm brought flooding and the plant was again closed temporarily for clean-up. It opened without fanfare on July 1 and has been producing formula ever since.

Government tackles the shortage

Califf said the Abbott Nutrition plant in Sturgis, Michigan, was supplying as much as 40% of America’s baby formula, so when it shut down over safety concerns, it created a big deficit that sent not only parents scrambling, but public officials, too.

The Biden administration has flown in foreign baby formula, using both commercial and military airlines and resources as part of “Operation Fly Formula.” In mid-July, the president announced the 17th mission. So far, the operation has brought the equivalent of 61 millon 8-ounce bottles of formula in from other countries, the announcement said

Among the hardest hit by the shortage have been parents of children who cannot tolerate regular formula and require specialty types. Those specialty formulas were prioritized among the shipments from overseas.

Califf said Abbott has been manufacturing its hypoallergenic special formula again. He told NPR, “For parents having trouble finding that special formula, you can just go to the (Health and Human Services) website, hhs.gov/formula and you can get the phone number for Abbott. Call directly; they’ll ship the formula to you.”

Other U.S. manufacturers have been running production lines around the clock, aided by the president’s use of the Defense Production Act to divert formula ingredients from other destinations as needed to prioritize formula manufacture.  

And Congress has taken steps to loosen the rules around formula and broaden access. Among other things, it passed the FORMULA Act sponsored by Utah Sen. Mike Lee, a Republican who said the title stands for “Fixing Our Regulatory Mayhem Upsetting Little Americans.” He called that one of his best titles recently during a subcommittee hearing.

Lee said the crisis highlights “systemic weaknesses in this vital supply chain.”

The bill lifts tariffs on the importation of baby formula for 90 days and reduces the costs retailers pay in trying to keep their shelves stocked during that time.

Said lead House sponsor Rep. Earl Blumenaur, D-Ore., in a written statement: “Suspending tariffs on the importation of infant formula and relieving parents of steep price increases is a critical step to ending the infant formula shortage.”

Helping WIC families

Federal officials had to change the rules so one vulnerable group of families — those using the Women, Infants and Children supplemental nutrition program — could navigate the shortage.

Zoe Neuberger, senior policy analyst at the Center on Budget and Policy Priorities, told NPR’s “News Hour” that WIC serves more than 40% of all babies born in the U.S. and buys at least half of the formula that gets consumed.

As NPR host Amna Nawaz explained, “Since 1989, states have sourced baby formula for their WIC programs through a competitive bidding process. The formula company with the lowest bid then becomes the sole provider of regular infant formula for WIC participants in that state.”

Only three manufacturers hold all those contacts — and Abbott has been the only provider for 35 states. The bidding system saves the program at least $1 billion a year.

But the rules have had to be suspended temporarily so that families that need formula can buy what they can find on store shelves,

According to CNN: “The (U.S. Department of Agriculture) has new powers through the Access to Baby Formula Act, which was signed into law in May. The agency recently announced that it would require state WIC programs to develop disaster plans in case of future baby formula supply disruptions.

And the department announced last week that it plans to extend the flexibility that has helped WIC families until the end of September, “covering the added cost of non-contract formula to make it financially feasible for states to allow WIC participants to purchase alternate sizes, forms, or brands of infant formula.”

The USDA letter explains how it will work: “In general, WIC state agencies have contracts with one of three manufacturers to provide formula to WIC infants who are partially or fully formula fed. Using the new authority provided by the Access to Baby Formula Act, USDA recommended in May that state agencies that contract with Reckitt Mead Johnson (RMJ) or Gerber seek contract flexibility to allow alternate formulas if the contracted size, form or brand of formula is unavailable.”

The future

Information Resources Inc., which tracks what’s on store shelves, says some shortage persists on store shelves, especially for powdered formula.

The shortage is now a mix of reality and perception, Califf told NPR. When manufacturers need to boost production — and that need has been well-acknowledged and is still dire — he said they set some products aside to concentrate on others. That might mean only making certain size containers or other adjustments. So people looking for sizes they used to get that have left empty spots on store shelves can impact how people perceive what’s happening and reinforce a shortage mindset.

“So that’s not to say that we’re where we need to be. It’s just to say that some of what you’re seeing is not just due to a shortage of formula. It’s just that type of formula is not being made,” he said.

The goal right now, according to the FDA chief, is to get to a place where production “far outstrips” the amount needed to feed U.S. babies. And he admits that will take a few more weeks.

Officials, including Califf, agree that resilience isn’t possible if one company dominates production. They note that fewer than a handful of companies prior to the formula crisis made 90% of the baby formula in the country.

Federal officials, including Califf, want to see more production facilities on U.S. soil. And they’re going to allow foreign formula producers who have passed U.S. requirements and who helped out during the shortage by shipping their formula here to continue to sell in U.S. stores.

The White House said among other efforts to ease the shortage, it’s cracked down on price-gouging. The FTC has launched an investigation into any deceptive, fraudulent or otherwise unfair business practices taking advantage of families during the formula shortage.

And the Department of Justice is urging state attorneys general to monitor and address price gouging, too, and to watch for predatory behavior.