An infant formula shortage that began several months ago is reaching crisis proportions in the United States, as a combination of supply chain problems and a major recall are making it difficult or impossible for many parents to secure the product.

The shortage has prompted retailers to limit the amount of formula that individuals can buy, in order to deter hoarding. It has also placed enormous strain on social services programs such as the federal Special Supplemental Nutrition Program for Women, Infants, and Children, known by the acronym WIC.

“The unprecedented scope of this infant formula recall has serious consequences for babies and new parents,” Brian Dittmeier, senior director of public policy at the National WIC Association, said in a statement provided to VOA. “Assurances from manufacturers that production has ramped up have not yet translated to new product on the shelf. Each day that this crisis continues, parents grow more anxious and desperate to find what they need to feed their infants.”

Some health departments said that they had, with a few exceptions, been able to keep formula in stock for WIC recipients.

In an email exchange with VOA, a District of Columbia health department spokesperson said, “Since the beginning of the national infant formula shortage, DC Health has been working with its WIC formula vendor, local retail stores, and its WIC grantees … to ensure all families receiving DC WIC benefits have continuous access to infant formula. While there have been spot shortages of infant formula in some stores, DC Health and its WIC grantee partners are assisting DC WIC families, and currently these families are able to purchase a range of infant formulas using their WIC benefits.”

A crisis with multiple causes

The baby formula supply started to become unsteady in the second half of 2021, according to Datasembly, a firm that tracks sales at grocery and retail stores. In the first half of last year, out-of-stock rates for infant formula held steady, between 2% and 8%, the company found. As the year went on, however, the rates began climbing, ending the year at over 15%.

The growing scarcity in the U.S. was primarily attributed to various supply chain woes caused by the coronavirus pandemic. Rates climbed sharply in February, after Abbott, one of the three companies that produce virtually all infant formula in the U.S., announced a voluntary recall of its products after discovering dangerous bacteria in one of its manufacturing plants.

The Abbott plant was shut down, and as of Thursday, it still had not received permission to begin production again.

By the beginning of April, Datasembly was reporting out-of-stock rates above 30%. At the end of last week, the rate had leaped to 43%.

Few import options

When U.S. domestic production of crucial goods is disrupted, market participants’ natural reaction is to import foreign-made goods to satisfy demand. But with infant formula, it’s not that simple.

Food and Drug Administration rules covering infant formula are so strict that almost all foreign-made formula cannot be legally sold in the U.S. That includes formula that meets standards for sale in the European Union and in developed countries such as Canada and Mexico.

Abbott, which has an FDA-certified manufacturing facility in Ireland, has been air-shipping formula from the country daily, but the volume has not been meeting the need.

Increasing production difficult

Converting other food-manufacturing facilities to produce infant formula is not feasible because it poses an unacceptable health risk, the FDA said in a statement.

“It’s important to understand that only facilities experienced in and already making essentially complete nutrition products are in the position to produce infant formula product that would not pose significant health risks to consumers,” the agency said.

The FDA is aware that parents nationwide are struggling, Commissioner Robert M. Califf said in a statement.

“We are doing everything in our power to ensure there is adequate product available where and when they need it,” he said. “Ensuring the availability of safe, sole-source nutrition products like infant formula is of the utmost importance to the FDA. Our teams have been working tirelessly to address and alleviate supply issues and will continue doing everything within our authority to ensure the production of safe infant formula products.”

White House announces actions

On Thursday, the White House announced the administration of President Joe Biden was taking several steps to alleviate the crisis.

The administration said it would work with states to loosen the rules WIC participants follow when buying formula. The program usually requires them to use WIC funds to buy specific kinds of formula, and in packages of a specific volume. Easing those rules will help reduce the stress on many families, the administration said.

The White House said it would ask the Federal Trade Commission to “crack down” on any businesses taking advantage of the shortage to raise prices to “unfair” levels.

Finally, the administration said that in the coming days, the FDA would announce steps to make it easier to import infant formula from other countries.

Congress gets involved

In Congress, Representative Frank Pallone, a Democrat who chairs the House Energy and Commerce Committee, said Wednesday that his committee would investigate the formula shortage this month.

“The focus of this hearing will be on better understanding the causes of the shortage, what has been done to increase production and supply thus far, and what more still needs to be done to ensure access to safe formula across the nation,” Pallone said.

While Pallone praised the Biden administration’s actions, the top Republican on the committee, Representative Cathy McMorris Rodgers of Washington state, criticized the White House for its slow response.

“We are asking the questions. We’ve been raising the alarm to President Biden for months,” she said. “We’ve been seeing the empty shelves. We’ve been seeing the rising cost on families.”

She added, “On behalf of every parent and caregiver who is unsure as to whether they will be able to feed their children, we need answers and we need accountability.”

Structural problems

Some people involved in the WIC program question the wisdom of allowing a system to persist in which only a few companies supply something as vital as infant formula. They also question the tactics of infant formula manufacturers, who provide free samples to new mothers, which many see as discouraging breastfeeding.

“As a country, we must take a hard look at how we got to this moment,” said Dittmeier of the National WIC Association.

“The infant formula industry is highly concentrated, with only three companies bidding for contracts in the WIC space,” he said. “For decades, this small number of manufacturers have been allowed to target new parents in hospitals and other settings, undermining public health efforts to promote breastfeeding.

“These tactics are abetted by policies that do not support new mothers in sustaining breastfeeding, including the more than 9 million women who work in jobs that do not have statutory protections for nursing or pumping.”

He added, “Every day, we hear from parents who are hurt, angry, anxious and scared. The lives of their infants are on the line. It is time for answers and accountability as we all work to improve the supply and ease the worries of parents enduring this national crisis.”