A decline in breastfeeding rates during the pandemic likely contributed to the ongoing infant formula shortage, health experts say—and the shortage is expected to continue through July as the country slowly increases its supply and production of formula.

Decline in breastfeeding contributes to baby formula shortage

Over the last few months, supply chain and staffing problems have contributed to a growing shortage of infant formula—a situation that was further exacerbated by a recall of several formulas produced by Abbott Nutrition, which makes up almost 50% of the market.

Currently, many parents are trying to stretch their dwindling formula supplies as they search for more formula or test alternative options.

"[U]nlike other food recalls, shortages in the infant formula supply affects a major — or even exclusive — source of nutrition for babies," said Brian Dittmeier, senior director of public policy at the National WIC Association, adding that insufficient nutrition "could have long-term health implications."

According to the Wall Street Journal, the current increased demand for formula was driven partially by a significant decline in breastfeeding rates during the pandemic.

Research from Demographic Intelligence found that the share of breast-fed one-year-olds declined from roughly 34% in 2020 to roughly 14% in 2022, reversing decades of growth. In addition, Diane Spatz, a professor of perinatal nursing at the University of Pennsylvania and a nurse scientist at Children's Hospital of Philadelphia, said this recent decline in breastfeeding was particularly steep among people of color and lower-income families.

During the pandemic, many new mothers were unable to get the care and help they needed to successfully breastfeed because of Covid-19 restrictions, experts said. For example, many mothers had shorter hospital stays and were discharged before their baby latched successfully or their milk came in. Parents also had less support and in-person assistance from doulas and peer-support groups, as well as from family and friends, as people reduced contact to avoid exposing newborns to the coronavirus.

According to Spatz, parents who want to breastfeed their babies need a strong support network, especially in the first few days after birth since it's a critical time for mothers to establish their milk supply.

"It takes a village," she said, but during the pandemic, "all the in-person, peer-to-peer support went away."

Formula shortage could last until July, officials say

So far, the Biden administration has implemented several measures to increase both supply and production of infant formula in the United States.

For example, President Joe Biden last month invoked the Defense Production Act, which requires suppliers to "direct needed resources to infant formula manufacturers before any other customer who may have ordered that good."

In addition, the administration launched "Operation Fly Formula," which will import 1.5 million 8-ounce bottles of three Nestlé S.A infant formulas that are currently in short supply in the United States. So far, two shipments of formula have arrived in Indianapolis and Virginia.

On Wednesday, Biden met virtually with industry representatives from Bubs Australia, Reckitt, Gerber, Perrigo Company, and ByHeart "to receive updates on their progress in ramping up the supply of formula in the U.S.," according to a White House official.

According to FDA Commissioner Robert Califf, the United States has so far made good progress in increasing its current supply. "We have made tremendous progress, including notable steps in just the past week, which will allow us to immediately begin bringing specialty and infant formula products into the U.S. as quickly as possible," he said. "It is our goal to ensure that hospitals, specialty pharmacies and retail store shelves will begin seeing adequate supplies again in the coming weeks."

However, Califf noted that the formula shortage is likely to continue until July as both supply and production slowly increase. "It's going to be gradual improvement up to probably somewhere around two months until the shelves are replete again," he said.

By then, Califf said he expects manufacturers to be producing a surplus of formula, and the federal government will consider if it wants to "maintain that surplus as a government activity for the foreseeable future."

"The big question that, I think, is going to have to be addressed is, do we create a stockpile as a backup in case something doesn't work in the future," he said. Currently, the United States maintains strategic stockpiles of certain supplies, including petroleum and antibiotics, in case of shortages or other emergencies. (Maloney, Wall Street Journal, 5/29; Chalfant, The Hill, 6/1; Scribner, Axios, 5/26; Whyte, Wall Street Journal, 5/26; Shutt, Virginia Mercury, 5/31)