3 Baby Steps to Disaster Readiness During the Formula Shortage

“This product is temporarily out of stock.”

Emergency managers are deeply concerned the infant formula crisis will increase the challenges families face this storm season.

According to a Bloomberg article, the national in-stock baby formula average fell from 77% to 70% this month. Eleven states report product availability below 60%, with Alaska at 51%. Wichita, one of 10 cities with less than 60% supply, reports 57% on-shelf stock.

How can agencies and managers prevent this year from becoming more deadly through elevated infant mortality? 

A master check-list for feeding babies during disasters

The US Centers for Disease Control (CDC) partnered with UNICEF/WHO Global Strategy for Infants and Children to develop the detailed Infant and Youth Child Feeding in Emergencies. The document is the basis for related policy and best practices. 

Key recommendations include:

• Ensuring infants and young children are regularly and adequately fed to protect their long-term health and that of their mothers.   
• Communicating with families, responders, and the media about the best practices for nourishing children during a crisis should be a top priority.
• Knowing local cultural feeding practices, the potential infectious disease environment, and mothers' concerns can ensure that neighbors work together for children's welfare.

Supporting breastfeeding families 

In Disaster Planning: Infant and Child Feeding, the CDC affirms:

"Breastfeeding remains the best infant feeding option in a natural disaster situation. Breast milk helps protect babies from diseases such as diarrhea and respiratory infections and provides the calories and nutrients babies need. This protection is vital during natural disasters when contaminated water and unsanitary environments can increase disease risk."

Managers can implement this recommendation by:

• Providing clean and private spaces in shelters for nursing babies and their mothers
• Prioritizing food and water for nursing mothers
• Enforcing the prohibition against unsolicited formula donations to mothers
• Communicating that not all babies need formula during the crisis

LaLeche League, the leading national breastfeeding advocacy organization, shares helpful information in their 8 Strategies for Breastfeeding During a Natural Disaster and multilingual handouts on Infant Feeding in Disasters. 

FEMA recently clarified that breastfeeding support equipment is eligible for Individual Needs Assistance. 

Supporting formula-fed babies

The CDC, UNICEF, and WHO strongly recommend "ready-to-use" baby formula during crises. Fortunately, most disaster relief organizations distribute this form, rarely powder, because the community water supplies are frequently disrupted or contaminated during disasters. Children become critically ill if bacteria-ladened water is used to reconstitute powdered formulas or clean feeding equipment. 

They suggest:

• If a ready-to-use infant formula is not available, it is best to use bottled water to prepare powdered formula when tap water is unsafe.
• If bottled water is not available, boil tap water for 1 minute and let it cool before mixing with the formula. Only use treated water to prepare formula if bottled or boiled water is unavailable.

Supporting babies facing both disasters and food-shortage

The US Department of Health and Human Services created Information for Families During the Formula Shortage, a list of resources and safe substitutions parents can try if they are absolutely unable to find product or sanitize equipment. 

For example, a consulted pediatrician may, in some extreme circumstances, suggest a short-term use of soy, whole-cow, or toddler formula for babies close to one year. Babies with no access to sanitized bottles may be offered sips of ready-to-use formula from a sterile, disposable cup.

Unfortunately, the crisis drives caregivers to “stretch” supplies with practices that can lead to malnutrition with dangerous long-term health consequences. 

Responders and volunteers can offer information if they observe these mistakes:

• Diluting formula
• Using expired formula
• Giving formula obtained from unreliable sources
• Making “homemade” formula
• Adding cereals or powdered milk to formula

Building a network of local support

Emergency managers are uniquely positioned to coordinate disaster support for families impacted by the formula crisis, especially in the aftermath of extreme weather events. Including local child nutrition advocates in all storm responses can ensure that food-insecure babies and their families are a key focus this season.