Let’s Talk About the Baby Formula Shortage
As the nationwide baby formula shortage impacts our community, we want to make you aware of some great resources available to you as a support now, including this video interview with Senior Director of Women & Children Jackie Weaver, Pediatrician and Chair of Department of Pediatrics and Pediatric Hospitalists, Alison Ullman, and Lynchburg Pediatrics Pediatrician and Vice Chair of Department of Pediatrics, Kendra Simpson.
Centra Infant Feeding Specialist: 434.401.9344
Abbott Provides Infant Formula Update | Abbott Newsroom: https://www.abbott.com/.../abbott-update-on-powder...
Abbot Store: https://abbottstore.com/infant-and-child/similac.html
Healthy Children: https://www.healthychildren.org/.../Are-there-shortages...
ABM Statement on Shortage of Breastmilk Substitutes (bfmed.org)|Official American Academy of Pediatrics Recommendation: https://www.bfmed.org/statement-on-shortage-of-breastmilk...
Cami Smith:
Hello, everyone. Welcome to a little bit different version of Centra Scripts. We have Jackie Weaver, who is the Senior Director of Women and Children here at Centra Health. We have Dr. Ali Ullman, who is the Chair of Department of Pediatrics and Pediatric Hospitalist. Did I say that right, Dr. Ullman? Okay, wonderful. And then we have Dr. Kendra Simpson who is from Lynchburg Pediatrics, and she is the Vice Chair of the Department of Pediatrics.
Ladies, I'm so thankful to have you here and for you to bring your wealth of knowledge. I know you are all not like title, here's my title people, but it really speaks to the knowledge that you can offer on this topic. And so what we're going to be discussing today is this formula shortage, that is baby formula shortage, that is happening in our community.
Cami Smith:
Now we know that this is happening nationally. This is impacting women and families and babies really all over our country, but we want to talk about how it's impacting here in our Centra Health, our Lynchburg, and surrounding area, Bedford, Farmville communities, as well as how we can support each other and how your local pediatricians can support you as well.
Cami Smith:
So we have a few questions here. Would any of you like to just jump in first and maybe share a quick support or a quick, this is what I'm seeing and we can talk about how have you seen the formula shortage impact your specific community, but just share what you are seeing.
Dr. Kendra Simpson:
Sure. I can start. So again, because I work in an outpatient pediatric office, I'm taking care of infants from newborn all the way up until they go to college, so I have a lot of parents with babies on formula. And so I've been getting phone call, we've all been getting phone calls, my nurses have, about people who are not able to find the formula that they're used to. And so we are getting a lot of questions about, "Well, can I just switch formulas? If I can't find the right brand, can I use a different brand? Can I use the gentle versus the regular?" So that's the majority of the questions we've been getting. What becomes more difficult is the babies who are on specific formulas or who have problems with cows milk, so need a hypoallergenic formula, and they really do need specific formulas, that gets really tricky when they can't find those and figuring out substitutions and how to help them find the formula that they need. So that's what we've been doing a lot of in the last few weeks.
Cami Smith:
Yeah. And have you been dealing with those on a case by case basis? Because it's obviously going to be different for each baby as you're thinking about what their body needs?
Dr. Kendra Simpson:
Yeah. I mean, for most babies who are on regular formula, who don't have protein intolerances or other things that they've been diagnosed with, the answer is pretty simple. It's yes, your baby's going to be fine on any generic formula that's the equivalent of what you've been on. And so we tell them whatever brand you can find is fine. If you've got some of what's left, you can try mixing it so they have an easier time adjusting because the taste may be a little different, but it should still be just as nutritious, it will still nourish them, and they shouldn't have any trouble adjusting. So that's, a case by case basis would be the more complex babies, but for the vast majority of babies, they're going to be fine on any formula.
Cami Smith:
That is really wonderful things I'm sure for women and for parents to hear. Dr. Ullman, are you hearing some of the same questions?
Dr. Ali Ullman:
So that's an interesting question coming to me. Dr. Simpson and I are a really great pair because I am primarily inpatient in pediatric hospital medicine. So we both see newborns, but then I take care of kids admitted to the hospital, and she's the one, your go-to for your well children, keeping them away from me. So, I've been talking, as a department chair, to a lot of the community pediatricians trying to hear their experiences. But what's actually interesting on my end is how do we prevent harm? And so I worry about some of the things I'm hearing. We know when we don't educate well as pediatricians.
Dr. Ali Ullman:
I've had cases in the past where people will dilute, and there's food insecurities. We deal with that. I've been trained to counsel against that. Well guess what? Now we've got to put the message out there. We can't dilute formula. We can't change the mixing. We can't do home mixing. We don't get into all the details. Patient safety is one of my passions as these colleagues know. So to me thinking about the fact that babies may be getting formula that's mixed wrong, I think parents are trying to do the best they can, but electrolyte abnormalities, there are some case reports of, luckily not that I know of in Virginia, but of babies having serious problems and being hospitalized due to what it causes to their body when you're not giving them the exact right thing they need. They're just so fragile. So while I don't have the community experience Kendra does, it's about getting this message out there so that I'm not hearing so that she is their main point.
Dr. Kendra Simpson:
That we don't need you, hopefully.
Dr. Ali Ullman:
Yes, exactly. Exactly.
Cami Smith:
Yes. Yes. That sounds like such a great partnership and a great way to put it. I think what's super important to talk about here is more what not to do as opposed to what to do. And so could one of you speak to that. You mentioned not mixing formula properly and things like that. Can you just speak to some of the please don't dos for parents who, like you said, are just trying to do what's best for their baby, maybe not understanding the implications attached.
Dr. Ali Ullman:
Yeah. So it's very straightforward. We cannot change how we're mixing the powder. You always follow the instructions on the can. They may be different, so I'm not going to give specific instructions, but you must follow that. Changes to it are just like a pharmacist mixing your medicine wrong. For babies, formula is their medicine. Whether they formula feed or breastfeed, but for some babies, it's at the same level of importance. We never want to give babies just water. It's not a substitute. They have to have their sustenance, which is either breast milk or formula. What else? A few things.
Dr. Kendra Simpson:
I would also add you don't want to give just cow's milk or goat's milk. That's another thing people are asking. It is not equivalent. It's not a substitute for formula or breast milk. Cows' milk and goat milk don't have a lot of the nutrients babies need, particularly iron, they can get anemic, but also the protein level's a lot higher, and their bodies aren't ready to handle that. So especially if your baby's under six months, that's just a no. For babies older than six months, it might be like a temporary, hold them off for a week kind of thing, but it's never a transition or something that we would switch to. It would just be a holding place until we get the formula we need.
Cami Smith:
Yeah.
Jackie Weaver:
We are talking to parents about this at discharge, but please just remember, our community is so robust with resources and people that want to jump in and help and fill the space before you resort to unsafe measures. So we met with Abbott and confirmed that our WIC supply to parents that receive benefits through WIC is not interrupted. So please reach out if that's something that you're concerned about, reach out to your WIC office. And then certainly our local pediatrician's offices are excellent resources for finding formula, for connecting with reps to get special care formula or get formula for parents. We are here. We have infant feeding specialists with a warm line that parents are welcome to connect with if they have questions about formula preparation and how to do that safely. But before you resort to alternatives, please reach out to your community for help.
Cami Smith:
Jackie, that is such a great message. And so where would you specifically tell a parent? So call your pediatrician, who you've been going to, whoever you would call and make an appointment that's who you call and say, "I need help." And don't be afraid to just ask for help, so that's the message you want to communicate.
Jackie Weaver:
And I think the message is, we want to help. So everybody here is passionate about babies and that's what we love, and so we want to help. We don't want you to wait and struggle, not just during this time, but Dr. Simpson might get me for this message, but your pediatrician wants you to connect with them anytime. A parent intuition is your greatest gift, so if you're ever at home wondering and worrying, "What should I do or does this look normal for my baby? Where should we go?" Certainly connect with your pediatrician. I will volunteer the hospital. You can connect with us, and we're happy to connect you with a local pediatrician. If we have people traveling or people who haven't connected with a pediatrician, we are more than happy to help with that, but please connect with someone that you trust for your baby's care to help with these choices.
Cami Smith:
Yeah. And Dr. Ullman, I think you were going to say something before I started, I'll throw it over to you.
Dr. Ali Ullman:
Sure. I'm really good at hiding when I've got something to say next. If people are out there like me, and I get overwhelmed when there's a lot of new information, so we're sharing a lot of information, and so at some point we have really great sites we can share with parents too from the American Academy of Pediatrics. And we're so thankful for guidance. It is really about our community here and how can we support, but there are some key messages if you want to go back and hear some of this that are very friendly so we can share that link, too. And I guess.
Cami Smith:
Yes. So we will share the hospital number, Jackie, that you mentioned for people to get in touch with women and children, and we'll share some links that are just a quick read to have just in the back of your brain as you're processing this, just so you know that you're not walking through this alone. This is such an incredible community. We are very fortunate to have a great community here. Lynchburg, Farmville, Bedford, all very different communities, but all tight. And so reach out and know that you're not walking through this alone.
Cami Smith:
Now, Dr. Ullman you mentioned that you haven't heard of hospitalizations in Virginia, and I know that's a question that people have been hearing. The news can be a little scary to watch sometimes because you feel like this is all happening on your front doorstep, and it's just dire. So can you give us a snapshot of what is happening in the hospital related to this, if anything?
Dr. Ali Ullman:
So, luckily here in terms of patients and being admitted, not really seeing anything, which is great, that means we're the message out, and this is why we're doing that. Now in terms of affecting formulas and things in the hospital, my understanding is we've been pretty great, but I'm going to let Jackie Weaver take that over a little bit because she's more in the know.
Jackie Weaver:
Thank you. So our hospital has learned through COVID and through other supply chain issues that we are very skilled, and we have an entire team working and always looking at supply chain and always looking ahead at what we need and what we have in stock. We have great partners in our community formula representatives who make sure that we are able to stay in stock and that they're prioritizing our special care formula.
Jackie Weaver:
So we've not seen an interruption. Ready to feed also has not been interrupted by the actual supply issue. So ready to feed is coming off the shelves, and you might not see it because when there's not powder, parents can choose ready to feed. But ready to feed formulas are not affected by the issues with the supply chain right now. And so in the hospital, we haven't had a supply chain interruption, and that's why we can confidently say with partners like Dr. Simpson and then our warm line, if you're having trouble finding formula, we can work and let our resources help you because we do have robust resources who are constantly looking ahead for us, and we know that parents don't have that at home. They're their own little company at home trying to source and keep everything going for their family. So we're here to help Dr. Simpson, and our community pediatricians are here to help. And so please reach out, and we'll help you source what you can't find.
Cami Smith:
So a term that I've heard, that I'm not super familiar with myself that I wanted to bring to this team, is a milk bank. So what is a milk bank? And what type of resource is that for this particular situation? How do you access it? What are the dos and don'ts? So whoever wants to jump on that
Jackie Weaver:
I'll talk about a milk bank and then I'll turn it over to Dr. Simpson. So milk bank is a place where moms can donate unused breast milk or excess breast milk, and the milk bank actually processes the milk and checks it for things like bacteria. It's a bodily fluid, and so they check the milk for safety. The milk is then pasteurized, so heating process to help get rid of bacteria or anything like that that kind of tags along with pumping and storing breast milk, and then parents can go to the milk bank and purchase milk for use with their baby.
Jackie Weaver:
So at Centra, we do not have a milk bank. We do have an excellent partnership with Prolacta where moms can donate breast milk to Prolacta. They provide all the supplies for storage and turning in your breast milk, but what we receive back from Prolacta is given to our very low birth weight babies, so our tiniest and most vulnerable babies, in the form of human milk and human milk fortifier, and that helps those babies who have very specific, special risk with gut issues. So Centra does not have a milk bank for purchase, but there are milk banks online that moms and parents can access for purchase.
Cami Smith:
Okay.
Cami Smith:
And we can provide those resources?
Dr. Kendra Simpson:
Yeah. And that is a viable option for parents who are looking either moms who are breastfeeding and have been supplementing a little bit, but now can't find that supplement formula and are looking for other options or really anyone who wants to give their baby some breast milk. This is an option for them. I've had a lot of moms who are breastfeeding, who might have some extra milk, and they feel like they want to help. And so what I've been telling them is, don't just give it to your friend or your neighbor, but donate it to a milk bank where it can be processed and the bacteria removed, and then it can be given out safely to people who need it. And so that's what I would tell people. If you're looking for a resource like that, to go to the milk bank because then you know that the milk you get is going to be safe and healthy.
Cami Smith:
Yeah.
Dr. Ali Ullman:
Dr. Simpson, that's such a good point. And we spent a lot of time, especially Jackie, earlier and all of us talking about the community. Lynchburg is a place where people want to help each other, and as someone that's not originally from here, I love that. But I want to be very, very deliberate in saying we don't think of it this way, but breast milk, you wouldn't just go next door and be like, "Oh, you're anemic. Do you want some blood?" Sorry to be graphic, but breast milk is a body fluid. It can carry serious diseases. So if you're thinking about it, and you want to know more about these risks, talk to Dr. Simpson, talk to me, reach out to anyone. There are too many risks. So while you're trying to do the right thing, we have to do the right thing in a safe fashion that can't lead to serious problems down the road. So just thank you for doing the right thing, but we've got to.
Jackie Weaver:
Providers, I think, and can you speak too, you're certainly the experts, but I've seen lots of people sharing cans of formula also. I have a can of this, and I have half of it left, and it's been opened. So can I've seen that and just asking for advice about how to respond.
Dr. Kendra Simpson:
Yeah. I mean, what I tell people is it's like giving them a half eaten can of food. Once it's been opened, it can be contaminated. And so I would caution against doing that. Save it for your baby. But if you're done using it, and it's been opened, throw it away. The same if the formula's expired. We really can't recommend giving it because the nutrition isn't as good, it may not be safe for your baby at that point, and some of those nutrients start breaking down after the expiration date. So that's really hard to do and to say is to throw certain formula away if it's not good, but really it's not worth the risk. And we have other resources and ways to get you formula.
Cami Smith:
Yeah. That is such a great question and a great point, too, because as much as we are wanting to equip our community, equip our parents to do this, there's also some things that in a desperate situation, we don't really think about the other side of it. You're just trying to make it through. And so what are some other things that parents should be aware of in this situation? Like, maybe you do need to throw it away.
Dr. Ali Ullman:
I love the guidance we get from the American Academy of Pediatrics. I will say that. Because it really says, "Okay, here are some things that we wouldn't tell you to do normally, but in a pinch, urgent. And here are the ones that you might think about doing, but don't." So things like ordering from overseas, "Oh, Amazon, I see a million of these, and, oh, it's England. And they have an FDA that's similar to ours." They do. I mean, every place has regulatory things. Why then are we saying, well, don't order it online when Amazon is my life now? We don't know what happens.
Dr. Ali Ullman:
When it's coming from another country, it no longer goes through those regulatory processes. It's going to a vendor and then it doesn't have those same strict precautions. It's being shipped, we can't control the temperature. There's all these safety risks to it. So while it's super, "Oh my gosh, it's right there, and it's in stock." Just take a deep breath, calm that urge, and listen to these strategies we're offering for where to find it in the community because it's tempting, but just not safe.
Cami Smith:
Yeah.
Dr. Kendra Simpson:
As a caveat, I would say, definitely not ordering formula overseas, but ordering online can be safe especially if you're ordering from a known distributor. If you're ordering from the manufacturer themselves, or you're ordering from a trusted website, you're ordering from Target online, that's fine, and that may be a better way to ensure that you're getting what you need, and you don't have to worry about going to the store. Is it going to be in stock? Is it not? So ordering online from a trusted source is fine, but like Dr. Ullman was saying, you don't want to go online and order the formula from Switzerland that people are recommending because we can't tell you that that's safe.
Cami Smith:
Yes. So be aware of unknown vendors, do your homework, check reviews, look, and if you have been ordering online, stick with where you've been ordering online, but just do your homework. We're not going to be sharing formula that's already been opened, sharing breast milk that's not going through a milk bank, and then staying away from the imported variations of formula. There are out there.
Cami Smith:
And this is so great. It was so easy for me to receive that information from you all and just turn around and repeat it. And that's what I know that all of the hearts of this team right here is for that to be an easily digestible message for this community. And so I just so appreciate you all taking the time to come together so that we can do this. We are going to make some links available. Some of the links that we've messaged, phone numbers, websites, articles, some quick tips maybe for when you're at the grocery store, I know Dr. Simpson, you mentioned that. And so just be on the lookout from your trusted sources, and when you see a trusted source of information, then share that. Let's help be a source of spreading correct information to combat some of the misinformation that is really leading these parents astray right now and causing some pretty awful situations. So thank you ladies so much. Anything else quickly you wanted to say, or it's kind of burning in the back of your mind?
Jackie Weaver:
I just had to say good job parents. So we kind of heard the word unprecedented times a bazillion times over the last two years, and it feels a little stale, but parent are parenting and going through something other parents haven't had prior to you. And so COVID was the first scary when you're a parent or pregnant and have kids, and then now we've kind of doubled down with finding food for your baby, and so please know that we all see you, and you're not alone. And we think you're doing an amazing job because the thing that you're doing when you ask questions and when you're scouring websites at midnight, because we know that you are, you are showing how much you care, and you're showing what a great parent you are because you're trying to go ahead and you're trying to do the right thing and the safest thing. And we just want you to know, we see you, and we're proud of you, and we're standing beside you, and if you need anything we're here.
Cami Smith:
Yeah, absolutely.
Dr. Ali Ullman:
Couldn't have said it better.
Jackie Weaver:
Thanks.
Cami Smith:
Well, thank you so much, ladies. Have a good one.
Jackie Weaver:
Thank you.