Switching baby formulas can help parents through the formula shortage

May 17 • 2022
Baby formula shortage

How to keep your baby safe during the infant formula shortage


Q&A with Dr. Christian Nunez

The infant formula shortage is a crisis affecting many families. While the reasons for the shortage are complex and include a recall from a major manufacturer, what’s most important right now is getting families through this crisis.

We discussed options parents have with Dr. Christian Nunez, pediatric hospitalist with the Spence and Becky Wilson Baptist Children’s Hospital.

Let’s start with why formula is so essential. What does it do for babies?  

It’s important because it provides the nutrition infants need for their high metabolic demand. The neonatal timeframe is a period of rapid growth and development. In the first few weeks and months of life, the proportionate drastic change in the baby’s weight isn’t seen again until puberty.

Formula is designed to not only fulfill babies’ caloric requirements, but to maintain their electrolytes. That’s why we consider formula to be so important if breast milk isn’t available or an option. Families can consult with a pediatrician to select what is appropriate for their child.

Why is it important not to water down formula?

If you water down formula too much, it’s going to be essentially useless. It won’t have the calories to support growth, and you run the risk of seizures and kidney damage.

It’s very important for the formula to be mixed properly. If too much water is added, there can be serious electrolyte abnormalities — most notably with sodium. If sodium drops in the blood too quickly, it can cause seizures. And babies’ kidneys aren’t fully developed until close to a year and can’t handle that much water.  

Is it appropriate to offer infants cow’s milk or plant-based milk?

The type of proteins in cow’s milk and even plant-based milk can be harmful to infants under 1 year old. The proteins can affect their kidneys, which are not fully developed enough to handle the high protein load, and can also affect the intestinal tract, potentially causing intestinal bleeding.

It is best to stick with infant formulas or breastmilk, which is safer and has the correct amount of nutrients needed for that stage of development. The American Academy of Pediatrics offers other tips on infants’ dietary needs.

Are you seeing patients and parents affected by the shortage?

Personally, I’m not, but I do know it’s very prevalent today. The question we get a lot is, “Should we switch formulas? Is it safe?”

What I generally say is that if it’s a standard infant formula, 19 or 20 kilocalories per ounce, and most brands are, it should be sufficient for an infant. All the different name brands are just brands. They are comparable. What’s important is that they are mixed correctly to prevent abnormalities.  

What alternatives do parents have during the shortage?

They can switch formulas. Some parents worry that switching formulas can cause stomach upset, and that can happen when you introduce something new to the diet. It can affect the intestinal tract slightly. So, it can take about five to seven days for the baby to adjust. Parents should avoid frequent switching without giving the baby enough time to adjust. Give it a week after switching. If there are still issues, consult with a pediatrician.

Some other symptoms that may come up with switching formulas include gas, irritability, spit up, diarrhea or change in color of stools. Ask a pediatrician about gas drops to help with symptoms.

What I recommend to families, especially parents of newborns I see in the nursery, is to start breastfeeding from birth if possible. Breast milk supplies nutrients that can’t be produced in formula. It also has antibodies from the mother. Studies have also shown that breastfed babies are less likely to develop asthma, eczema, allergies, frequent stomach infections, and they have increased cognitive development.

The Spence and Becky Wilson Baptist Children’s Hospital is one of the leading pediatric hospitals in Memphis and includes a pediatric emergency room, advanced pediatric intensive care unit, spacious inpatient rooms and outpatient diagnostics and surgeries. Find a physician by visiting our Find a Doctor page.