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    Why the US has a baby formula shortage — and who is most at risk

    America is enduring its worst baby formula shortage in decades.

    Why baby formula is in short supply — and who is most at risk

    America is enduring its worst baby formula shortage in decades.

    By Dylan [email protected]@vox.com May 12, 2022, 2:50pm EDT

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    Paul Hennessy/SOPA Images/LightRocket via Getty Images

    Baby formula has been running low all over the United States, threatening the health of infants and other people who depend on it for their sustenance.

    Experts say this is the worst formula shortage in decades. It’s also the latest example of how the US health system’s failures consistently fall hardest on people with complex medical conditions and people who are socioeconomically disadvantaged.

    The shortage can be traced back to a contamination problem at an Abbott factory that produces much of the Similac formula, as well as several other brands, for the US market, Abbott voluntarily shut down the factory in February, amid consumer complaints about contaminated formula that was linked to two infant deaths. As of mid-May, it’s still not up and running again. As Politico reported this week, it’s not exactly clear why Abbott and the FDA have failed to come to an agreement that would allow the plant to resume producing formula and help alleviate the shortage.

    That factory’s prolonged shutdown, combined with general supply-chain problems for the formula ingredients and packaging, have led to formula stock drying up fast. Nationwide, about 40 percent of the most popular baby formula brands were out of stock as of April 24, according to the Wall Street Journal, much higher than the 10 percent average in normal times. Some parts of the country, like the San Antonio metropolitan area, are seeing more than half of their normal supply out of stock. Panic buying amid news of the shortage has already caused some major chains to limit the number of formula containers that any one person can buy. Public officials are already worried about the possibility of price gouging.

    As long as supplies are limited, some people may struggle to feed their children or themselves. It is people of color and people living in poverty, along with the people who must take special formulas for medical reasons, who will be most exposed to the health and economic consequences of a prolonged formula shortage.

    “Certainly, the families who have fewer resources, have fewer options, who aren’t able to pay premium prices are going to be more at risk,” said Ann Kellams, a University of Virginia faculty pediatrician and board president of the Academy of Breastfeeding Medicine.

    Why a baby formula shortage is so serious, briefly explained

    Most families rely on infant formula to one degree or another. Nearly one in five babies receive formula within their first two days of life, according to the CDC. By three months, less than half of babies are exclusively breastfeeding, meaning they are taking at least some formula as a supplement.

    But all families are not equally reliant on formulas. According to CDC survey data, people living in poverty are most likely to report that they’ve supplemented with formula in the first three months of their baby’s life. Black, Hispanic, Asian, and American Indian parents are all more likely to say that they used formula within three months than white parents.

    And for some people, formula isn’t a choice but a necessity. Sometimes an infant struggles with breastfeeding and needs formula to continue gaining weight. But allergies or immune conditions can also necessitate using formula, including into childhood and adulthood. As Politico noted in its report, about 2,000 Americans have a metabolic disorder so severe that amino acid formula is their only means of survival.

    Changing formulas is definitely possible, but can still be tricky with infants because of digestive issues — and can be difficult if a person’s dietary needs are especially strict. During natural disasters, when formula can become even more scarce, the CDC urges breastfeeding mothers who also use formula to consider breastfeeding more.

    But for some people, that is not going to be possible, either because they can’t breastfeed or pump more or because they need specialty formula. And experts strongly discourage people from trying to make their own formula at home, giving the severe risks — including death — if a nonprofessional doesn’t get the formula right.

    That leaves many families with few options available to them, prompting them to wonder how they will feed a loved one who depends on out-of-stock specialty formula to survive.

    Some are taking drastic measures, with the New York Times reporting parents have been rationing formula or watering it down, both of which can be harmful to kids. Some experts recommend checking with your pediatrician for samples, but that is another way in which the US health system disadvantages certain people: People in poverty and people of color are also less likely to have a regular source of health care.

    The US policy failures are colliding in the formula shortage

    Source : www.vox.com

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    What’s Behind America’s Shocking Baby

    Bacteria, a virus, a trade policy—and a lesson

    IDEAS

    What’s Behind America’s Shocking Baby-Formula Shortage?

    Bacteria, a virus, a trade policy—and a lesson

    By Derek Thompson

    The Atlantic MAY 12, 2022

    About the author: Derek Thompson is a staff writer at The Atlantic and the author of the Work in Progress newsletter.

    Sign up for Derek’s newsletter here.

    America’s baby-formula shortage has gone from curious inconvenience to full-blown national crisis.

    In many states, including Texas and Tennessee, more than half of formula is sold out in stores. Nationwide, 40 percent of formula is out of stock—a twentyfold increase since the first half of 2021. As parents have started to stockpile formula, retailers such as Walgreens, CVS, and Target have all moved to limit purchases.

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    The everything shortage isn’t new. But rationing essentials for desperate parents? That’s a twisted turn in the story of American scarcity.

    Three factors are driving the U.S. baby-formula shortage: bacteria, a virus, and a trade policy.

    First, the bacteria. After the recent deaths of at least two infants from a rare infection, the Food and Drug Administration investigated Abbott, a major producer of infant formula, and discovered traces of the pathogen in a Michigan plant. As a result, the FDA recalled several brands of formula, and parents were advised to not buy or use some formula tied to the plant.

    Derek Thompson: America is running out of everything

    Recalls are common. Thousands of drugs and products are recalled every year, and they don’t create a meltdown at pharmacies or require CVS to instate Soviet-style rationing of essentials. So something else is going on here.

    That brings us to the second cause: the virus. The pandemic has snarled all sorts of supply chains, but I can’t think of a market it’s yanked around more than infant formula. “During the spring of 2020, formula sales rocketed upwards as people stockpiled formula just like they stockpiled toilet paper,” Lyman Stone, the director of research at the consulting firm Demographic Intelligence, told me. Then, as “families worked through their stockpiles, sales fell a lot. This oscillation made planning for production extremely difficult. It was complicated to get an idea of the actual market size.” Meanwhile, Stone’s research has found that an uptick in births in early 2022 has corresponded with a “very dramatic decline in rates of breastfeeding” among new mothers, which pushed up demand for formula once again.

    In brief: Demand for formula surged as parents hoarded in 2020; then demand fell, leading suppliers to cut back production through 2021; and now, with more new mothers demanding more formula in 2022, orders are surging faster than supply is recovering.

    Finally, the third factor: America’s regulatory and trade policy. And while that might not sound as interesting to most people as bacteria and viruses, it might be the most important part of the story.

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    FDA regulation of formula is so stringent that most of the stuff that comes out of Europe is illegal to buy here due to technicalities like labeling requirements. Nevertheless, one study found that many European formulas meet the FDA nutritional guidelines—and, in some ways, might even be better than American formula, because the European Union bans certain sugars, such as corn syrup, and requires formulas to have a higher share of lactose.

    Some parents who don’t care about the FDA’s imprimatur try to circumvent regulations by ordering formula from Europe through third-party vendors. But U.S. customs agents have been known to seize shipments at the border.

    U.S. policy also restricts the importation of formula that meet FDA requirements. At high volumes, the tax on formula imports can exceed 17 percent. And under President Donald Trump, the U.S. entered into a new North American trade agreement that actively discourages formula imports from our largest trading partner, Canada.

    America’s formula policy warps the industry in one more way. The Department of Agriculture has a special group called WIC—short for Special Supplemental Nutrition Program for Women, Infants, and Children—that provides a variety of services to pregnant and breastfeeding women and their young children. It is also the largest purchaser of infant formula in the United States, awarding contracts to a small number of approved formula companies.  As a result, the U.S. baby formula industry is minuscule, by design. A 2011 analysis by USDA reported that three companies accounted for practically all U.S. formula sales: Abbott, Mead Johnson, and Gerber.

    Read: Americans have no idea what the supply chain really is

    The Biden administration is focused on expanding domestic manufacturing of formula to meet families’ needs. But the bigger problem is our trade policy. “The U.S. is a captive market for domestic dairy producers like Abbott, and during times of crisis, the lack of alternative supplies becomes a pretty big problem,” Scott Lincicome, the director of general economics and trade for the Cato Institute, a libertarian think tank, told me.

    Source : www.theatlantic.com

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