The Formula Shortage: Expert Guidance

On European and Homemade Formula

Disclaimer: This is not medical advice, please consult your doctor in person before messing around with anything you feed your babies!

I don’t know how long this baby formula shortage is going to last, but I do know many of my families are getting very, very worried. If you are a breastfeeding mom, and things are going well, now is not the time to wean. In fact, if things are going very well, I would suggest prayerfully considering donating milk to your local milk bank. If your baby is on formula and that formula is running out, it’s time to discuss alternatives. Which brings me to the FDA and the American Academy of Pediatrics.     

            Like many Canadian expatriates, I have long suffered under the cruel heel of the American Food and Drug Administration. I refer, of course, to Kinder Eggs, the delicious chocolate confection – with toy included! – that was a staple of my happy childhood. Widely beloved in much of the world, they are banned in America. I have had them ripped from my toddler arms by border guards – yes, literally stealing candy from a baby. Nothing will ever shake my conviction that they ate my egg themselves the moment we drove away. Fellow expat Mark Steyn has written about the FDA-approved war on deliciousness at length:

My kids asked the CBP seizure squad if they could eat the chocolate in front of the border guards while the border guards held on to the toys to prevent any choking hazard — and then, having safely consumed the chocolate, take the toys home as a separate item. This request was denied, and, indeed, my ten-year-old was told that by proposing it he was obstructing a federal official in the course of his duties.

            As for the AAP, well, you know how I feel about them.

            What better resource for frantic, formula-searching families could there be than an AAP explainer on how to deal with the formula shortage, featuring plenty of FDA guidance? Let’s take a look.

            Snark aside, it is in many ways a helpful resource, and I do recommend reading it. Much of its advice is clearly sound. Do not feed water to your little babies! However, given recent developments, and the possibly severe and prolonged nature of this current shortage, it is worth taking a closer look at two pieces of advice the AAP provides.

            First, the question of imported formula. You know, all those sickly Swedish, German, and Dutch babies, wasting away on their second-rate baby formulas, probably full of Soviet-era mattress lint and discarded Yugo car parts. Or, to be more precise, baby formula that contains fewer trace pesticides and meets arguably higher nutritional standards than FDA-labeled formulas. The AAP’s advice to moms and dads worried their baby might starve to death? “Do not import formula from overseas, since imported formula is not FDA-reviewed.”

            Just a reminder: a key reason we currently have this shortage is because the formula that was FDA-reviewed was so contaminated and killed so many babies it had to be recalled. Reports are that the FDA was first alerted to these safety issues in October, did not inspect the plant until late January, and did not recall the formula until February. So we are facing a formula shortage brought to us by the recall of tainted, FDA-reviewed formula, but the AAP and the FDA are saying not to import European formula because… it has not been FDA reviewed. It doesn’t have the “Reviewed and Tainted” seal of approval! Go ahead, pull the other one.

            The AAP expert writing the above advice, by the way, clearly understands its flaws. Please follow the link for his complete thoughts, but here are the damning quotes, with my italics: “They’re not hugely different, because babies are babies whether in the United States or Europe […] But they’re slightly different and so the FDA is concerned about labeling […] So the problem becomes not so much that these formulas are dangerous, they’re not…” Clearly, in his own words, these formulas are not moonshine laced with fentanyl, they are only slightly different from our Reviewed/Tainted ones (hopefully the main difference is less tainting) and they are not dangerous to babies. In a normal situation, I completely understand where the expert is coming from, you just don’t want to get involved with the complexities of international food inspections and cross-border complications, I get it. But this is not a normal situation. This is, by all accounts, a growing emergency. And “it’s safe and healthy for European babies but not for yours” is not a good enough reason to give parents when they are worried their child is going to starve. When the choice is local formula or foreign formula, go local, rah-rah. But when the choice is foreign formula or seeing how long you can stretch the Pedialyte before all your baby’s rolls disappear, please, AAP, have a heart.

            Second, the question of homemade formula. From the guidance, with their emphasis: “The AAP strongly advises against homemade formula. 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.” Believe me, I’m all about that. I cannot tell you to make your own formula, not even in an emergency. Let me be clear: I have zero nutritional training and do not know where to start when it comes to advising a family on what to put in a homemade formula. To have that kind of nutritional know-how, you’d have to be some kind of world-renowned infant nutritional expert. Just spitballing here, but maybe something like past chair of the National Committee on Nutrition for the AAP, or even a member of the Dietary Advisory Committee at the Department of Agriculture. Wait a sec… the doctor writing these guidelines just happens to be precisely such a nutritional expert - what a coincidence! Who better to advise the rest of us about which internet formula recipes are dangerous and which might just work, for a short-term emergency? But no, he uses all his knowledge to give the same advice that decidedly unknowledgeable me would give: I don’t know, they’re probably all unsafe, stay away!

            But wait. If homemade baby formula is so outrageously dangerous it cannot even be spoken of, how did babies survive before all our baby food was made in FDA-inspected, tainted factories? Here is an absolutely fascinating history of the development of baby formula. The whole thing is well worth reading, but let me direct your attention to the following lines:

By the 1940s and through the 1960s, most infants who were not breastfed received evaporated milk formula, as well as vitamins and iron supplements. It is estimated that, in 1960, 80% of bottle-fed infants in the US were being fed with an evaporated milk formula.

Evaporated milk formula helped us win the Cold War, but is it really safe?

            Again, I have to emphasize, in normal times, I understand the AAP’s position. The question is, are these normal times? Remember when the experts told us not to wear masks, then said we had to wear masks, resulting in endless mask arguments and the end of many people’s trust in experts? Well, what happens if this supply chain crisis/recall/formula shortage gets worse, and evaporated milk formulas are the only available option for many families? Will the AAP be forced to memory-hole their anti-homemade stance and put out a statement saying, “actually, homemade formulas can be totally safe, we used them successfully for decades”? What will happen to already plummeting trust in public health experts in such an emergency, when we need to be able to trust them the most?

            This is no small point. We are moving daily closer to a world in which influential institutions and government entities can cancel doctors – can fine them, strip them of their licenses, end their careers – for the crime of spreading ‘unapproved’ information. Yet what is and is not approved seems to have no firm basis in objective truth, science, or history, and seems based merely on whims and the temporary messaging motives of those in charge. You will notice at no point, for example, do I ever advise you to use European formula, and I want to be clear I do not recommend it; in not entirely unrelated news, I’m legitimately scared I could lose my license if I did – European formula is not AAP-recommended or FDA-reviewed, and so advising its use could easily be labelled ‘disinformation’ and lead to disciplinary consequences. Isn’t life under the Ministry of Truth just grand?

            To summarize, it is not time to panic. However, it never hurts to be prepared, and I wish our experts would be straight with us. Again, I do not know how safe non-FDA formula is, I strongly advise you not to experiment with any of it, it may very well hurt your baby. However, faced with the possibility of a severe, lasting, nationwide formula shortage, it would be nice if the FDA and the AAP gave us a little more guidance besides telling us all the things we are not to do. For, faced with a true shortage, and if the donor milk banks run dry, there seem only to be the following options:

1.     Use the formula all those chubby French babies are using.

2.     Use the formula the Greatest Generation used a few years before they stormed the beaches of Normandy and won us our freedom.

3.     Watch your baby starve.

According to the AAP, options 1 and 2 are verboten, end of discussion. All I can say is I hope the factories get back to running full speed and we never have to find out for ourselves. So, thanks, AAP! Helpful and honest as always.