Above Photo: Enfamil formula on store shelves. ParentingPatch, CC BY-SA 3.0 , via Wikimedia Commons.
Families in the US are struggling with the effects of an infant formula shortage caused by over-reliance on commercial milk formula producers.
And the absence of support for breastfeeding and human milk banks.
Baby formula supplies in the United States are still fluctuating, a full year after the closure of one of Abbott Nutrition’s factories in February 2022. At the beginning of this year, forecasts by the Food and Drug Administration (FDA) and industry rivals predicted that stocks could reach pre-shortage levels in spring 2023. Yet, while the situation has improved in comparison to May or June 2022, many parents and caregivers continue to report difficulties in finding the right type of infant formula—or any type of formula at all.
According to the US Census Bureau Household Pulse Survey, 1.9 million households reported problems in finding infant formula in January 2023. This was already an increase in comparison to November and December 2022, when 1.5 and 1.7 million households, respectively, said they experienced difficulties in purchasing baby formula.
Then, on February 20, Reckitt—which was able to take hold of approximately 50% of the overall US infant formula market since Abbott ran into trouble—announced a voluntary recall of 145,000 cans of its baby formula Enfamil due to suspicion of cronobacter contamination. Company officials claim this will not affect the overall availability of formula since a limited amount of product was under doubt of contamination, but the news only added to the commercial milk formula industry’s bad track record.
Experts say proper budgets, not slogans, will improve breastfeeding rates
Only days before news of the Reckitt recall reached the media, dairy giant Lactalis was indicted in France following a 2017 series of salmonella infections among children who were fed their formula. Years and miles apart, the cases illustrate how the commercial milk formula industry still manages to avoid attempts of more significant regulation.
Several reports published over the past months, including one by Third World Network and the United Nations University, and the most recent Lancet series on breastfeeding, reiterate that commercial milk formula producers rely on aggressive marketing strategies to reach health workers and families. They have also been investing into lobbying to keep governments in line. Between 2007 and 2018, the biggest infant formula producers in the US, including Abbott and Reckitt, spent USD 55.1 million USD on lobbying the government. Almost 80% of this amount—USD 43.8 million—was spent by Abbott.
While companies’ lobbying budgets remain higher than the funds allocated by the government for breastfeeding support, it should not come as a surprise if relying on infant formula remains a standard in child nutrition in the US. And judging from the response of health and food authorities until now, there will not be a significant shift in policy or a more significant revision of the relationship with the commercial milk formula industry.
The FDA’s evaluation of the response to the shortage, including recommendations for the future, fails to identify the dependence on the infant formula industry as a risk factor. Both the FDA and mainstream analysts are focused on finding technical solutions that would allow things to go back to where they were before February 2022—either by keeping lower import tariffs for infant formula or investing more in cronobacter monitoring.
On the other hand, health and nutrition experts are warning that merely restructuring the commercial milk formula market will not be enough to avoid similar problems in the future. Instead of expanding existing partnerships with the industry, they see a better chance in building women-centered, culturally appropriate health systems, and expansions of workplace rights such as mandatory paid maternal leave, to increase breastfeeding rates.
Barring adequate budgets and fiscal policies, campaigns to promote breastfeeding will remain superficial, Phillip Baker and his co-researchers pointed out in one of the recent Lancet studies. “Without substantive societal investments to enable breastfeeding, women’s choices are open to manipulation by exploitative commercial milk formula marketing,” the researchers warn.