Millions of babies in the United States depend on formula, which is the only recommended source of nutrition for infants who are not exclusively breastfed.

Here’s a look at what’s behind the problem and what parents can do:

Ongoing supply disruptions have combined with a recent safety recall to reduce supplies.

The problems began last year when the COVID-19 pandemic led to disruptions in labour, transport and raw materials – economy-wide problems that did not spare the formula industry. Inventory was further reduced by parents stocking up during COVID-19 closures.

Then, in February, Abbott Nutrition recalled several major brands of powdered formula and closed its plant in Sturgis, Michigan, when federal officials began investigating four babies who suffered bacterial infections after consuming milk powder. formula milk from the establishment.

Abbott is one of the few companies to produce the vast majority of the formula supply in the United States, so their recall wiped out much of the market.

Most formulas are made from cow’s milk protein that has been modified to be easier to digest and fortified with additional nutrients needed for growth and development. The Food and Drug Administration sets specific nutritional requirements, including minimum amounts of protein, fat, calcium, and a number of vitamins. Formula manufacturers achieve these levels by adding various sugars, oils, and minerals.

The formulas are designed to mimic breast milk, although studies have repeatedly shown better health outcomes for breastfed babies.

WHY CAN’T ALL MOTHERS RELY ON BREAST MILK?

Health professionals recommend exclusively breastfeeding babies until they are 6 months old. But federal figures show that only 1 in 4 people rely solely on breast milk at this age.

Mothers face a number of long-term breastfeeding challenges, including returning to work and finding the time and equipment to express breast milk. About 60% of mothers stop breastfeeding sooner than they planned, according to Centers for the Control and Prevention of Disasters.

State and federal laws have been enacted to encourage breastfeeding in requiring break time and accommodation for mothers of infants.

Breastfeeding rates have always been lower among black babies than among other groups. About three-quarters of black babies are breastfed in infancy, below the national average of 84%, according to the CDC.

WHAT SHOULD PARENTS DO IF THEY HAVE TROUBLE FINDING A PREPARED FORMULA?

Talk to your pediatrician or call a local food bank to see if they can help you find some options. Experts also recommend checking with smaller stores and pharmacies, which may still have supplies when larger stores run out.

Most regular infant formulas contain the same basic ingredients and nutrients. Parents should therefore not hesitate to buy another brand if they have trouble finding one.

Some infants need special formulas due to allergies, digestive issues, and other medical conditions. Parents should talk to their doctor if they can’t find these products, which manufacturers typically distribute through pharmacies and clinics.

Families eligible for WIC — a federal program similar to food stamps that serves mothers and children — can also contact their local agency.

Health officials also warn against purchasing formula through social media websites or outside of conventional retailers, as they may be counterfeit.

WHY ARE PARENTS TOLD NOT TO USE ONLINE FORMULA RECIPES?

Many make-it-yourself formula recipes are made with cow’s milk and granulated sugar which can be difficult for young babies to digest. They also lack the specific vitamins and proteins found in breast milk and FDA-approved formulas that are needed for basic nutrition.

“Especially for small babies, many of these formulas and blends found online don’t even contain the most basic nutrient blends that babies need to survive,” said pediatrician Dr. Steven Abrams. at the University of Texas, Austin.

Abrams also stressed that parents should never dilute infant formula.

WHEN IS SUPPLY LIKELY TO IMPROVE?

Health regulators recently announced several measures to boost supply, including allowing faster importation of foreign-made infant formula.

The FDA is working with Abbott to correct the violations that triggered the closure of its Michigan plant, which produces Similac, EleCare and several other leading powder formulas.

The Chicago-based company said this week that, pending FDA approval, it could restart manufacturing at its plant within two weeks. After that, it would take another six to eight weeks for new products to hit store shelves.

The company says its products have not been directly linked to bacterial infections in children, pointing out that genetic samples taken from its factory did not match those found in several infants who fell ill.

But even then, experts warn that many industry-wide problems will continue to limit supplies.

“It’s going to be a problem and it’s not going to go away for at least a period of months,” Abrams said.

Follow Matthew Perrone on Twitter: @AP_FDAwriter

The Associated Press Health and Science Department is supported by the Howard Hughes Medical Institute Department of Science Education. The AP is solely responsible for all content.