Challenges in Supply, Market Competition, and Regulation of Infant Formula in the United States (2024)
Chapter: Appendix J: Special Supplemental Nutrition Program for Women, Infants, and Children Participants' Experiences During the Formula Shortage
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Appendix J
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Suggested Citation:
"Appendix J: Special Supplemental Nutrition Program for Women, Infants, and Children Participants' Experiences During the Formula Shortage." National Academies of Sciences, Engineering, and Medicine. 2024. Challenges in Supply, Market Competition, and Regulation of Infant Formula in the United States. Washington, DC: The National Academies Press.
doi: 10.17226/27765.
Appendix J
Special Supplemental Nutrition Program for Women, Infants, and Children Participants’ Experiences During the Formula Shortage
The committee conducted a survey using convenience sampling of WIC participants. These experiences were collected via e-mail (a convenience sample). All 50 state WIC agencies were contacted via e-mail asking to survey participants to “describe their experiences during the shortages.” The experiences are below in Table J-1. All de-identified comments from participants are saved in the project’s Public Access File.
Suggested Citation:
"Appendix J: Special Supplemental Nutrition Program for Women, Infants, and Children Participants' Experiences During the Formula Shortage." National Academies of Sciences, Engineering, and Medicine. 2024. Challenges in Supply, Market Competition, and Regulation of Infant Formula in the United States. Washington, DC: The National Academies Press.
doi: 10.17226/27765.
TABLE J-1 WIC Participants’ Experiences During the Formula Shortage1
| Theme | Written Statement |
|---|---|
| Mental Health Impact on Mothers and Caregivers | “Tough. Defeating. Scary. Not knowing if there would be enough formula to feed your baby is such a scary experience as a mom or any parent.” |
| Most caregivers described their experience of searching for infant formula during the shortage as uniquely stressful. First-time mothers and those with infants on specialty formulas were particularly affected while breastfeeding moms less so. Families resorted to several strategies for obtaining formula such as driving long distances, enlisting friends or relatives in the search for supplies, joining support groups that provided tips on where supplies might be found, and by purchasing online. Some expressed anger and indignation that the shortage happened. | “Scary, nightmare, nerve racking, nauseating.” |
| “It was very scary as a first-time mom.” | |
| “The experience was daunting. Disheartening and scary. For myself as a mother having a NICU preemie and low supply, knowing that there was a shortage and not being able to find resources to feed his sensitive belly was a struggle I wish on no one. It was sleepless nights, it was tons of vomit and tears, it was long travel with empty gas tanks to stores that ended up nowhere and not having the type he needed. It was online orders only to have them cancelled last minute, it was long lines and fights, it was trusting other caregivers only to allow your baby to survive, it was beyond horrible. For myself as a new mom finding out about the shortage shortly after I had just made a bottle for my baby with an infected can minutes from feeding it to him that could have landed him in critical condition it brought up emotions that no parent or caregiver should ever have to encounter. It will be a memory forever engrained in my head and my heart.” | |
| “My kiddo needed Alimentum. The shortage as well as restrictions when there was some on the shelf (2 per person) made for a constant state of anxiety and stress with regards to feeding my child because there was no other option for feeding. WIC restrictions for brand and size made it further challenging. I had to beg my pediatrician for samples to feed my baby because no one else could do anything to help.” | |
| “My son and I had a very awful experience, as soon as he was born we had issues with formula. We would spend days searching for formula. His formula was a special kind because he was allergic to milk. Multiple family members, friends and acquaintances would search in multiple different towns and even out of state for this formula. When it was finally found the stores would only allow 1-2 cans to be purchased which would only last a couple days at the most. It was honestly an awful and traumatic experience for my son and I. Everyday I would cry wondering if I was going to be able to feed my baby.” |
Suggested Citation:
"Appendix J: Special Supplemental Nutrition Program for Women, Infants, and Children Participants' Experiences During the Formula Shortage." National Academies of Sciences, Engineering, and Medicine. 2024. Challenges in Supply, Market Competition, and Regulation of Infant Formula in the United States. Washington, DC: The National Academies Press.
doi: 10.17226/27765.
| Theme | Written Statement |
|---|---|
| “It was beyond stressful. I would have to drive all around - - checking stores for my baby’s formula, constantly calling her pediatricians office for samples. Not knowing if we were going to have enough until the next store got another shipment and having a baby on a special formula so I couldn’t just give her any kind. It was the worst experience and this country should be ashamed of themselves for the suffering they caused innocent babies.” | |
| “It was awful. My child was on Puramino. My parents, my siblings, my friends and even coworkers were searching for formula. It’s extremely disheartening when America can’t provide or make their most vulnerable and the future of this country the priority. No mother should have to go through wondering how they are going to feed their baby ever again. The emotional/mental toll it took on me on top of being post-partum is unfathomable. Just not acceptable I can say WIC was absolutely AMAZING in assisting.” | |
| “I was fortunate enough to be able to breastfeed, so I was not personally affected.” | |
| “It was a bit scary when I was pregnant watching it unfold and then being in the thick of it with a newborn, there wasn’t any formula in any stores around me, so I decided to breastfeed and thankfully it went amazing for me. I know many women who couldn’t breastfeed though and I was donating my spare milk to whoever I could because people could not find formula.” | |
| “I felt bad for families that needed it, I breastfed so I wasn’t dealing with it myself. But there should never be a shortage of food, especially for babies.” | |
| “I been very stressed about this situation. I traveled to hundreds of stores. Feeling like a bad parent by not be able to give my child what he needs to survive.” | |
| “During the infant formula shortage, my family and I had to drive to multiple stores across several counties to find formula. We also utilized social media for information on product availability. We attempted to even purchase formula from Canada via Amazon. We would also use slightly more water than the directions suggested.” |
_________________________
1 Origin of the data set: Convenience samples; most responses from the Northeast; identifying information has been omitted, including regional origin.
2 The written statements selected convey frequently expressed views and are organized by themes. The statements are exactly as written and have not been edited.
Suggested Citation:
"Appendix J: Special Supplemental Nutrition Program for Women, Infants, and Children Participants' Experiences During the Formula Shortage." National Academies of Sciences, Engineering, and Medicine. 2024. Challenges in Supply, Market Competition, and Regulation of Infant Formula in the United States. Washington, DC: The National Academies Press.
doi: 10.17226/27765.
| Theme | Written Statement |
|---|---|
| “I joined CT formula groups to purchase formula, take samples, and most importantly see when others posted that stores were stocked again. On Amazon and Walmart, you could purchase a few more than stores would allow…. For about 8+ months, it seemed like “formula searching” was a full-time job. It felt like it would never end.” | |
| “It was a horrific experience that something my newborn child needed for survival was not available. He was allergic to milk and had to get the hypoallergenic formula…. It was a needed item that should never have been allowed to be compromised. The fact that only one facility in the entire country produced something that is vital for life is disturbing. Why are there not more than one place that produces something that could place lives in jeopardy if not available? No one company should have a monopoly over a vital resource like that. … The government needs to ensure that corporations do not have a monopoly over an essential resource that can have detrimental consequences if they do not supply it. There should have been a greater oversight of baby formula back in 2022. It demonstrated a lack of consideration for one of our most vulnerable populations in our society, our children.” | |
| Economic Burden on WIC-Participating Families Commonly reported costs associated with the shortage include transportation costs, time away from work, out-of-pocket purchases of non-WIC-allowable infant formula, and inability to use WIC benefits. The shortage was an economic shock that affected many families adversely. |
“With how the economy is today, that [monthly cost of formula without WIC] is almost half my rent and double the cost of my car payment.” |
| “It really took all of my savings, and I haven’t recovered from it, but my baby is happy and healthy and thank God we no longer use formula.” | |
| “Had to purchase formula in different sizes that were not WIC approved from stores that did not necessarily take WIC and pay for it because I did not have enough or was nervous I would run out. Additionally, the purchase limits from stores was very inconvenient as I have twins and the 3 can limit in many stores made it that I constantly had to be running to stores all the time…..” | |
| “Desperation. Paid for overprice formula online through eBay and Amazon. Spending money on formula instead of my rent because all the prices were jacked up due to the shortage.” | |
| “Extremely difficult financially. Having such a new baby and not being able to find formula resulted in me having to pay for formula out of pocket. I rarely had the money to afford it and always had to ask family for assistance. It was a really rough time for my family and I.” |
Suggested Citation:
"Appendix J: Special Supplemental Nutrition Program for Women, Infants, and Children Participants' Experiences During the Formula Shortage." National Academies of Sciences, Engineering, and Medicine. 2024. Challenges in Supply, Market Competition, and Regulation of Infant Formula in the United States. Washington, DC: The National Academies Press.
doi: 10.17226/27765.
| Theme | Written Statement |
|---|---|
| “It was terrible, I had to leave work mid shift if I got notifications that my son’s formula was available in the area. Barely used WIC because I mostly had to purchase online, sometimes in other states to have family ship to me.” | |
| “It was a very difficult time. I had to drive to other towns to find formula. I had to choose between feeding myself or putting gas in my car so that I can drive around to stores looking for the formula.” | |
| Infant Nutrition and Health Repercussions Not having enough formula or lacking the certainty that some could be obtained timely led to several remedial strategies that may have important repercussions for infant nutrition and health. Caregivers reported being stressed by the cries of their hungry baby and reacted by diluting formula, reducing the amount provided and speeding the transition to solids and cow’s milk. Caregivers also reported gastrointestinal discomfort brought on by the frequent switching of brands. |
“It was rough, my baby didn’t stop crying when there was no milk to give him.” |
| “I rationed him from 8 oz to 5 oz, that made him fussy, more hungry and start to develop fever.” | |
| “Half of the time we weren’t even able to use our WIC benefits for formula because the stores just didn’t have it ever! My child started eating purees and baby cereal because he was hungry and there wasn’t any formula.” | |
| “I had to switch my infant to milk almost 6 months sooner than recommended because her brand was impossible to find....” | |
| “My WIC benefits were limiting me to what was available. If Nutramigen formula was found it was never in the approved size or can. This I had to start my daughter with solids at 3.5 months old to compensate for the lack of formula.” | |
| “It was really hard to find my son’s formula in every store that I went and I had to constantly change his formula to different formulas because there wasn’t the one he was drinking and it ended up messing up my son’s stomach and made it hard for him to poop, it was really frustrating.” | |
| “Since she attended daycare, we had to ensure a supply at home and also daycare - and we tried as hard as possible to stay with one or 2 brands consistently, but ended up using whatever was available some months. I tried to prepare by mixing in the new formula with the old 75/25 and then 50/50 before going straight to the new one to try and avoid stomach complications. We had many upset stomachs, lots of passing gas, spitting up, and very watery stools as we constantly had to switch brands and ingredients, though similar, vary significantly.” | |
| “At some moments when I couldn’t find formula, I would give my baby evaporated cans like the old times.” |
NOTE: All comments received are saved to the project’s Public Access File: https://www8.nationalacademies.org/pa/managerequest.aspx?key=HMD-FNB-23-04 (accessed April 22, 2024).
Suggested Citation:
"Appendix J: Special Supplemental Nutrition Program for Women, Infants, and Children Participants' Experiences During the Formula Shortage." National Academies of Sciences, Engineering, and Medicine. 2024. Challenges in Supply, Market Competition, and Regulation of Infant Formula in the United States. Washington, DC: The National Academies Press.
doi: 10.17226/27765.
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Suggested Citation:
"Appendix J: Special Supplemental Nutrition Program for Women, Infants, and Children Participants' Experiences During the Formula Shortage." National Academies of Sciences, Engineering, and Medicine. 2024. Challenges in Supply, Market Competition, and Regulation of Infant Formula in the United States. Washington, DC: The National Academies Press.
doi: 10.17226/27765.
Suggested Citation:
"Appendix J: Special Supplemental Nutrition Program for Women, Infants, and Children Participants' Experiences During the Formula Shortage." National Academies of Sciences, Engineering, and Medicine. 2024. Challenges in Supply, Market Competition, and Regulation of Infant Formula in the United States. Washington, DC: The National Academies Press.
doi: 10.17226/27765.
Suggested Citation:
"Appendix J: Special Supplemental Nutrition Program for Women, Infants, and Children Participants' Experiences During the Formula Shortage." National Academies of Sciences, Engineering, and Medicine. 2024. Challenges in Supply, Market Competition, and Regulation of Infant Formula in the United States. Washington, DC: The National Academies Press.
doi: 10.17226/27765.
Suggested Citation:
"Appendix J: Special Supplemental Nutrition Program for Women, Infants, and Children Participants' Experiences During the Formula Shortage." National Academies of Sciences, Engineering, and Medicine. 2024. Challenges in Supply, Market Competition, and Regulation of Infant Formula in the United States. Washington, DC: The National Academies Press.
doi: 10.17226/27765.
Suggested Citation:
"Appendix J: Special Supplemental Nutrition Program for Women, Infants, and Children Participants' Experiences During the Formula Shortage." National Academies of Sciences, Engineering, and Medicine. 2024. Challenges in Supply, Market Competition, and Regulation of Infant Formula in the United States. Washington, DC: The National Academies Press.
doi: 10.17226/27765.
Suggested Citation:
"Appendix J: Special Supplemental Nutrition Program for Women, Infants, and Children Participants' Experiences During the Formula Shortage." National Academies of Sciences, Engineering, and Medicine. 2024. Challenges in Supply, Market Competition, and Regulation of Infant Formula in the United States. Washington, DC: The National Academies Press.
doi: 10.17226/27765.
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