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14:07 PM

Do's and Don'ts of the Formula Shortage: Here's What Caregivers Should Know

A recall in February from Abbott Nutrition has placed extra pressure on the supply chain and some stores are limiting the amount a customer can purchase.

The formula shortage is hitting home for many families. On Monday, the American Academy of Pediatrics shared advice for parents and said parents should talk to their pediatricians.

A recall in February from Abbott Nutrition has placed extra pressure on the supply chain and some stores are limiting the amount a customer can purchase.

Here are some tips from the AAP, the U.S. Food and Drug Administration and our doctors.

Never dilute with water

Never dilute breast milk or formula with water. The extra water causes the sodium level in their blood to drop. Low sodium will lead to brain swelling which can cause poor feeding, lethargy, seizure and eventually death.

Do switch to a store brand

For most babies, it's OK to switch to store brands unless your baby is on a specific extensively hydrolyzed or amino acid based formula such as Elecare (no store brand exists), the AAP says. If you're unsure, talk with your pediatrician. Store brand formulas are equally regulated by the FDA, which has requirements for nutrients in infant formulas.

Don't make your own

The AAP and the Food and Drug Administration strongly advise against homemade formula because of serious health and safety concerns. “Although recipes for homemade formulas circulating on the internet may seem healthy or less expensive, they are not safe and do not meet your baby's nutritional needs," the AAP said. "Infant deaths have been reported from use of some homemade formulas.”

The FDA said it has “recently received adverse event reports of hospitalized infants suffering from hypocalcemia (low calcium)” that had been fed homemade infant formula.

In February, batches of three infant powdered formula brands were recalled because of possible bacterial infections. So far, four instances of infant illness have been reported to the Food and Drug Administration.

Do use breast milk

Breast milk is an option. Consider reaching out to a breast milk bank for support.

Don't substitute with alternative milk products

Be careful to avoid milk alternatives, like almond milk, oat milk and other plant-based milks. They are not recommended for infants under a year of age.

Don't buy from third parties

Consumers should also avoid purchasing imported formula or formula that has been diverted from normal distribution channels and relabeled, as it has the potential to be counterfeit, the FDA says. 

For example, if an infant formula is past the "use by" date, a counterfeit label may bear a false "use by" date to obscure the fact that the product may no longer contain the amounts of nutrients listed on the label and may otherwise not be of acceptable quality, the FDA says.

Do check with your trusted medical provider

Pediatricians often have samples or can connect with a formula brand representative for supplies if needed. Check with your local WIC office. They may also be able to help.

About Cook Children's

Cook Children’s Health Care System embraces an inspiring Promise – to improve the health of every child through the prevention and treatment of illness, disease and injury. Based in Fort Worth, Texas, we’re proud of our long and rich tradition of serving our community. Our not-for-profit organization is comprised of nine companies, including our Medical Center, Physician Network, Home Health company, Northeast Hospital, Pediatric Surgery Center, Health Plan, Health Services Inc., Child Study Center and Health Foundation. With more than 60 primary, specialty and urgent care locations throughout Texas, families can access our top-ranked specialty programs and network of services to meet the unique needs of their child. For 100 years, we’ve worked to improve the health of children from across our primary service area of Denton, Hood, Johnson, Parker, Tarrant and Wise counties. We combine the art of caring with leading technology and extraordinary collaboration to provide exceptional care for every child. This has earned Cook Children’s a strong, far-reaching reputation with patients traveling from around the country and the globe to receive life-saving pediatric care. For more information, visit