Is my baby eating enough? That's a question we often receive from new parents, and one that's become ever more urgent during a nationwide formula shortage.
In February 2022, with pandemic-related supply chain issues already occurring, a reported bacteria outbreak closed a Michigan plant that makes baby formula and led to a nationwide recall of its products. As of mid-May, the plant had yet to reopen and stores in Pennsylvania, New Jersey and Delaware each had a more than 46 percent out-of-stock rate for formula, according to Datasembly, a group that monitors and reports retail data. The national average was 43 percent for the week ending May 8, 2022.
We spoke with Laura Carpenter, BSN, RN, IBCLC, lactation consultant for the Hospital of the University of Pennsylvania's Intensive Care Nursery, to learn the potential options and support available to current and soon-to-be parents.
Formula Shortage and Breastfeeding
Whether to use breastfeeding or formula is a deeply personal decision based on individual wants and needs. Parents must weigh their options and decide what is best for them, their baby and their family, and their needs may change over time.
According to the Centers for Disease Control and Prevention's (CDC) most recent Breastfeeding Report Card, more than 50 percent of babies receive at least some formula in their diet, meaning most families are affected in some way by the formula shortage.
Even if you originally chose to exclusively feed your baby formula, it is possible to switch to breastfeeding or a combination of breast milk and formula.
"In most cases you can breastfeed, even if you did not plan to breastfeed or start out with breastfeeding," Carpenter said. "It will just take time (weeks to months) to establish. Even if it comes in slowly, some milk is better than no milk in a crisis."
What to Do If You Want to Start Breastfeeding
"Our bodies make milk that is unique for our babies," Carpenter said. "Even if you are only able to bring in a partial supply, both you and your baby benefit. In this time of formula shortage, it may bring us back to relying on our bodies and learning that we can do it."
For parents who choose to breastfeed, it is often easiest to start right after birth, but it's possible to start later, too.
"Pregnant parents and recently delivered parents have the highest potential to succeed with proper support," Carpenter said, noting that hospitals have lactation consultants to help you get started and troubleshoot any issues. "If you are further out from delivery, you can do it too. Even non-birth parents and adoptive parents have successfully brought in a milk supply. It takes time and patience, so if you are considering this option, the time to start is now."
Carpenter noted that it is important to have realistic expectations. Parents who are further out from delivery may take weeks to months to bring in milk supply and it may be in lower volumes.
Here are the steps you can take if you'd like to start breastfeeding:
If you delivered your baby recently
If you delivered your baby recently, first see if the baby will latch. This is the best way to bring in a milk supply.
You'll need to give a bottle of formula after latch at first, but, as breastmilk supply increases, you will need less formula. There are lactation aids that allow formula to be given while baby is at the breast, too. Adding pumping can also help bring the supply in.
An International Board Certified Lactation Consultant (IBCLC) can help you get started with breastfeeding. Find an IBCLC near you at ILCA.org.
If you are farther out from delivery
If your baby will not latch or you are farther out from delivery, you can use pumping to build up a milk supply. Pump after every time your baby eats – typically eight times per day.
Nearly all insurance providers cover an electric breast pump and your obstetrician's office will write you a prescription for one. You'll then need to contact a durable medical equipment company affiliated with your insurance company to get the pump delivered to you. There are laws in place to support breastfeeding and pumping in public and at work.
If you are pregnant
If you are pregnant and had breastfeeding troubles in the past, seek a prenatal consult with an IBCLC. An IBCLC can help you troubleshoot past issues and give you strategies to try after delivery.
Even if you do not make a full milk supply, you can likely make a partial supply to help feed your baby.
What to Do If Breastfeeding is Not an Option
For some parents — including those who have had a mastectomy, are HIV positive, or are taking high-risk medications — breastfeeding is not an option because they should not or cannot safely produce breastmilk. For them, there may be options to feed their baby other than formula.
"Families that cannot breastfeed or have infants who use specialty formulas are in an even deeper crisis," Carpenter said, adding that they should talk to their health care provider about their specific options, including donor human milk (DHM). "Families may want to talk to their pediatrician to see if DHM would be an option for them. DHM is primarily used by hospitals, but infants at home can sometimes get it with medical prescription depending on their diagnosis."
The Human Milk Banking Association has several milk banks across the country. Learn more and find a milk bank near you.
If you are pumping and have more milk than your baby can use, you may consider donating to a milk bank. Your milk can help many other babies in need.
Breastfeeding and Lactation Support at Penn Medicine
If you are interested in breastfeeding your baby for the first time or want to restart lactation, Penn Medicine has various resources to help you:
- Our team of lactation consultants is available to help get you started with breastfeeding or answer any questions you may have.
- Your obstetrician can also help you get a prescription for a breast pump or medications to assist you in the breastfeeding process if you need them.
- The Hospital of the University of Pennsylvania's offers free lactation support by phone at 215-662-2361.
- Solutions for Women at Pennsylvania Hospital, which can be reached at 215-829-5046, has an outpatient clinic that accepts all insurances and can assist with restarting lactation, pumping, latching and breast pump rentals.
Additional Support and Resources