Formula hard to find

Nikki Thobe, Coldwater, is a nurse at Mercer County Community Hospital and has felt firsthand the effects of the nationwide baby formula shortage.

She has four-month-old twins and pumps breast milk for them, rather than nursing the babies directly.

"I am exclusively pumping for them, but … knowing that there's not any formula available is stressing me out to feeling like I have to continue pumping even if maybe I wouldn't have because I have a four-year-old, a two-year-old and then the four-month-old twins," she said. "The formula shortage is making me feel pressure(d) to where I don't have a choice."

The issue is two-fold. She's feeling pressured to pump because of the formula shortage and because the stress reduces her milk supply, she said.

Many moms and parents are feeling backed into a corner.

Valarie Knapke, Coldwater, said in a Facebook post she has a six-month-old daughter who drinks Similac Alimentum, which was involved in an initial recall of baby formula.

Ongoing supply disruptions due to the COVID-19 pandemic and a recent safety recall for formula have left many pharmacy and supermarket shelves bare.

The problems began last year as the pandemic led to disruptions in labor, transportation and raw materials. Inventory was further squeezed by parents stockpiling formula during lockdowns. Then in February, Abbott Nutrition recalled several major brands of powdered formula and shut down its Sturgis, Michigan, factory over contamination concerns when federal officials began investigating four babies who suffered bacterial infections after consuming formula from the facility. Two died.

"My husband and I have fortunately been able to find the liquid on Similac's website and for the past two months on Amazon," Knapke said. "I was told frequently to switch to Nutremigen, which is what our first child was on. Nutremigen is only 93% hydrolyzed (and) Alimentum is 100% hydrolyzed."

Hydrolyzed formulas contain milk protein that has already been broken down into smaller pieces, making it easier for babies to digest, according to Enfamil's website.

"My youngest daughter's milk sensitivity is triggered by Nutremigen. All off-brands are based on Nutremigen. I know there are parents who are in worse shape than we are, but I was nearly sick when I had to send in my 12 cans of stocked powdered formula (due to the recall) and had nothing on hand."
  A lot of parents are scared.

Deanna Schlarman, St. Marys, program director at Mercer County Women, Infants & Children office in Celina, said the shortage is distressing.

She said WIC advocates for breastfeeding but can provide participants with iron-fortified formula.

While Ohio's WIC program contracts for formula with Mead Johnson and not Abbott, the company experiencing the shortage, the Ohio Department of Health has applied for USDA waivers to potentially extend more flexibilities to families purchasing infant formula using WIC benefits, according to an ODH news release.

"At the local level, WIC staff are working closely with impacted participants to help them locate the appropriate formula, including contacting physicians and retail outlets to problem solve and identify additional options," the ODH release reads. "Many participants in the WIC program have medically complex needs and are on prescription formula. WIC works with dietitians and healthcare providers to find the best solution to keep these infants healthy."

Jessica Bergman, St. Marys, has been a certified nurse midwife at Mercer Health for
2 1/2 years. She said many of her pregnant clients are nervous about the formula shortage.

"It's scary that you don't know if you're going to be able to get the formula," she said.

Bergman said the majority of people's stress stems from finding the right kind of formula. She also noted it's not always easy to switch formulas, because some infants cannot tolerate certain types.

"There's just so many different types and it can take people months to find the right kind of formula that their babies can tolerate. It's not as easy as just picking up any formula available on the shelf," Bergman said. "If there's only one brand in stock, but if your baby's never had it, you don't know if your baby's going to get constipated or gassy or keep it all down."

Megan Core, St. Henry, a physician of internal medicine and pediatrics at Mercer Health, said the majority of babies will do fine with various types of formula, but some babies are more sensitive and need a specific type.

She urged parents to stick with formula.

"Even if you get a different type of formula, it's still really important for infants under 12 months of age to have formula truly as their exclusive drink," Core said. "We really do not recommend going to whole milk or soy milk or other types of milk at an earlier age because it just simply does not have the nutrients that babies need."

Core recommended parents having a hard time finding the type of formula their baby needs to try a different off-brand rather than switching to milk at an earlier age. If parents are having difficulty finding formula they should contact their doctor, she said.

Thobe said many women formula feed instead of breastfeed for a variety of reasons.

"We've had a lot of moms who have had unsuccessful breastfeeding journeys with previous children and so they just go straight to formula to avoid that stress," she said. "A lot of moms just feel more comfortable (with) formula because they can visually see how much the babies are getting."
  It takes a mom who pumps her own breastmilk a few days to accumulate enough milk for her baby in the beginning, Thobe noted. Nursing stimulates the production of more breastmilk when compared to pumping, she said.

"If a lot of moms (are) choosing to just pump, then they'll use formula as a backup if they don't pump enough," Thobe said.

Bergman said infant formula is important because not all women can nurse.

"Sometimes, breastfeeding just doesn't work out," she said. "Sometimes, personal preference - breastfeeding can take a lot of time. Not everyone's comfortable with that, not everyone is able to do that and people like to have their partners participate a little bit more in the feeding."

For families impacted by the infant formula shortage, ODH doesn't recommend diluting formula or making homemade formula.

A military plane carrying enough specialty infant formula for more than half a million baby bottles arrived Sunday in Indianapolis, the first of several flights expected from Europe aimed at relieving the shortage. President Joe Biden authorized the use of Air Force planes for the effort, dubbed "Operation Fly Formula," because no commercial flights were available.

The White House has said 132 pallets of Nestle Health Science Alfamino Infant and Alfamino Junior formula was to leave Ramstein Air Base in Germany for the U.S. Another 114 pallets of Gerber Good Start Extensive HA formula were expected to arrive in the coming days. Altogether, about 1.5 million 8-ounce bottles of the three formulas, which are for children with cow's milk protein allergies, are expected to arrive this week.

Indianapolis was chosen because it is a Nestle distribution hub. The formula will be offloaded into FedEx semit-trailers and taken to a Nestle distribution center about a mile away where the company will do a standard quality control check before distributing the formula to hospitals, pharmacies and doctor's offices, according to a Biden administration official on site.

U.S. regulators and the manufacturer, Abbott Nutrition, hope to have its Michigan plant reopened next week, but it will take about two months before product is ready for delivery. The Food and Drug Administration this week eased importation requirements for baby formula to try to ease the supply crunch.

- The Associated Press contributed to this story.