AAP Voices Blog

Every day, families share with me that they are struggling to find formula to feed their infants. They are afraid of running out, they are worried about where they will find their next supply, they fear they will not be able to provide their infant with essential nutrition.

It can be very challenging to find the specific brand or type of formula that parents usually use. It also can be hard to find brands covered by the supplemental nutrition program WIC. In some areas, there is no option as the shelves are empty.

The decision to use formula depends on many important factors that both parents and pediatricians must consider. It may be the best option due to feeding challenges, metabolic diseases, allergies, and maternal medical problems. For others, formula use is influenced by historical and socio-economic factors.

The current shortage is also a racial justice issue and does not affect all families equally. National data from the CDC shows that 73.6% of Black infants compared to 85.5% of White infants are breastfed. Further, Black infants are nine times more likely than White infants to receive formula while in the newborn nursery. A 2015 study found that Black infants are less likely to initiate and maintain breastfeeding by 6 months of age compared to White peers.

The reason for this disparity in formula use is multi-factorial and rooted in both past and present structural racism. Historical factors include the forcing of slaves to serve as wet nurses and the targeted marketing of formula consumption to Black mothers.

Current socio-economic factors include decreased access to breastfeeding supports such as lactation services and hospital-based interpersonal racism that assumes that Black mothers will be less likely to breastfeed. Economic hardship also plays an important role as Black mothers cite the need to return to work as a reason for breastfeeding cessation.

“WIC program participants share confusion and frustration over which types/brands of formula are covered and which stores will accept their benefits.”

The formula shortage is also disproportionally affecting families who experience economic hardship and utilize the WIC program. WIC program participants share confusion and frustration over which types/brands of formula are covered and which stores will accept their benefits. The USDA has provided waivers that allow state WIC programs to expand coverage to additional brands/types of formula and retail locations. However, there are states that have not fully taken advantage of the waivers in many places and there are cans sitting on shelves that are not accessible to WIC participants.

One place that some families can find formula is online, but WIC benefits cannot be used to purchase formula in this way. Allowing the online purchase of formula using WIC benefits may eliminate barriers for those in most need. Economically vulnerable families cannot afford to spend the time and gas driving around trying to find formula. This benefits change would be in line with other programs such as SNAP in which families can use their benefits card to purchase food and formula online.

As pediatricians, we must advocate at community, state, and national level for the U.S. government to decrease barriers to obtaining formula with special attention to challenges experienced by Black families, families who experience economic hardship, and families who utilize the WIC program.

It is vital that families have access to a safe supply of formula as lapses in needed nutrition can lead to lifelong developmental consequences.

*The views expressed in this article are those of the author, and not necessarily those of the American Academy of Pediatrics.