Four months into the formula crisis, we’re still putting a bandage on a big bleed


In mid-February, a major infant formula recall and factory shutdown took place, preventing millions of families from safely feeding their babies. Texans felt this shortage keenly because the contract for infant formula for the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) was held by the company that had the recall and shutdown of the factory. The shortage has led families to use homemade formulas that do not meet the nutritional needs of infants.

After a slow start to response, the federal government implemented a short-term partial resolution using largely imported formulas. Unnecessary and inaccurate political blame on both sides for the shortages, rather than understanding their systematic causes for decades, has not put the formula back on the shelves. At the same time, importing formulas using special temporary Food and Drug Administration rules led to no meaningful long-term solution and only slightly improved the situation in Texas and other states where the shortage was severe.

In other words, we continue to put a band-aid on a big bleed and continue to force families – especially low-income ones – to suffer.

These families can’t order formula online through WIC, and often they can’t easily find the formula they need in stores without spending the time and gas to do a thorough search. We can do better.

The FDA should use its rule-making processes, in conjunction with Congress and the White House, to allow foreign infant formula manufacturers to continuously market in the United States without the need for undue additional research or documentation and unnecessary. The current special allowance that makes formula brands appear on store shelves expires in November.

A permanent change in FDA rules, including acceptance of international guidelines and oversight of overseas factories, must be implemented quickly. The factories and formulas used in Europe, Australia and New Zealand, for example, are already tightly regulated. We don’t need any additional layers of regulations in the United States other than ensuring safe means of transportation to the United States. In fact, the FDA recently announced a plan for this, but gave no details or guarantees that the agency will make it simple or feasible for companies to stay in the country.

More of us need to realize that the severe shortage of specialty formulas that Americans face for babies with allergies and other special needs has affected multiple countries and therefore requires a global solution. For example, it is currently affecting Canada, which has urged families to limit the purchase of these products. We must prioritize the production of these formulas, which are needed for around 5% of all infants, as well as financial incentives to make this happen.

We also need to begin a long-term reassessment of contracts and other WIC program processes. WIC programs, like the one in Texas, are run with inadequate technology and rules that prevent online shopping and severely limit plan choices for nearly half of families. This system is to be overhauled by the United States Department of Agriculture under the supervision of Congress, including a complete modernization of the computer systems that allow families to make purchases.

I am a pediatrician who cares for high risk infants and conducts research on food insecurity and infant nutrition. Simply put, we need to align our support for breastfeeding women and families with what most other countries are doing. This includes increased paid leave after birth, increased support for lactation counseling and breast pumps for workers trying to successfully return to work while feeding their babies. Our society has made life difficult for families wishing to breastfeed.

If we don’t make changes now and imagine that the eventual reopening of a factory will fix everything, then we will undoubtedly find ourselves in the same situation or in a worse situation soon due to ongoing supply problems and the near certainty that another factory problem will develop somewhere yet. Let’s get pediatricians, dietitians, and others to join policy makers in creating long-term solutions to this long-standing problem now, instead of healing a clearly gaping wound.

Dr. Steven Abrams is a professor of pediatrics at the Dell Medical School at the University of Texas at Austin.

A version of this op-ed appeared in the San Antonio Express News and the Austin American Statesman.


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