Fallout Continues from Infant Formula Crisis: 6 Key Takeaways

Where We Are Now: 6 Key Takeaways Impacting Parents

1.  Working moms’ attitudes about formula have shifted after the shortage. 
   Working moms took notice of the crisis--88% are somewhat to very concerned about the state of infant formula.¹
   
   In addition to reducing use of formula, another recent study found that 57% of new moms are changing their behavior due to the shortage – with 38% of new moms now planning to breastfeed for a longer period and 19% more motivated to use lactation support services.²
    
2. Food security concerns inspire efforts from employers to support breastfeeding.
   The shortage spurred conversations about how to create a healthier breastfeeding culture as a whole and how to give women more choices when returning to work. According to the Centers for Disease Control and Prevention, women who receive appropriate break time and private space for expressing milk are more than twice as likely to be breastfeeding at 6 months.³  Without employer support, women are especially vulnerable to falling short of reaching their breastfeeding goals. 
   
   What do new parents need the most to hit those goals? Solid lactation policies and open communication with their employer to map out a game plan that’s tailored to meet their individual needs.
    
3. The crisis brought more scrutiny of formula makers’ marketing tactics from WHO. 
   With parents scrambling to find formula, the World Health Organization (WHO) took a closer look at marketing tactics. Amid the shortage, WHO released a report asserting that the $55 billion formula industry breached the International Code of Marketing of Breast-Milk Substitutes adopted in 1981.
   
   The report analyzed 4 million social media posts about infant feeding and found that formula companies post as often as 90 times per day to reach 229 million users, which represents 3 times as many people reached by breastfeeding posts from non-commercial accounts. The posts were published between January to June 2021, reaching 2.47 billion people and generating more than 12 million likes, shares or comments.  The WHO report contends that companies use strategies that aren’t recognizable as advertising, such as online baby clubs, advisory services and influencers. WHO plans to release additional reports on tactics that breach the marketing code.
     
4. Powdered formula safety stays front and center. 
   Powdered formula offers a lot of convenience for busy parents, but the crisis has shined a light on its inherent challenges. After the recall, the CDC updated its website to include a warning that powdered infant formula is susceptible to contamination from Cronobacter.  While infections are rare, newborns or infants born prematurely or with weakened immune systems are more at risk.
   
   The CDC alert states that powdered formula is not sterile and might have germs in it and that the contamination can occur in the home or in manufacturing facilities.  In the home, Cronobacter can live on surfaces such as counters, sinks and in water. In a processing facility, the bacteria could result if the powder touches a contaminated surface or if an ingredient is contaminated.
    
5. More questions arise about the nutritional profiles of infant formula. 
   The formula crisis brought new conversations about formula ingredients and deciphering the dizzying array of types and marketing claims. American babies are now eating formula from Australia, New Zealand, Mexico, Singapore and Europe. With new formulas entering the market from overseas, the FDA has been keeping consumers informed of approved formulas on its website.  But since every country has different regulations and labeling requirements, it’s challenging for parents to compare and contrast ingredient profiles. 
   
   European brands, for example, ban the use of corn syrup and require formulas to have a higher amount of lactose. In the United States, nearly half of all formulas contain corn syrup and are marketed as lactose-free or lactose-reduced choices.⁴  A recently released study from The American Journal of Clinical Nutrition shows that corn syrup is metabolized differently and can alter the infant microbiome, as well as the eating habits of toddlers. The study tracked 15,000 infants in the WIC program who received corn syrup-based formulas and found a 10% increase in obesity at age 2 and a 7% increase at age 4 compared to infants who were fed lactose-based formula.⁵
    
6. A disrupted formula marketplace places more burdens on parents.
   The crisis created an opening for more competition in the $4 billion domestic market, which has primarily been dominated by 3 large companies.⁶  Two new companies, both direct-to-consumer models,  thrived during the shortage despite being much higher priced options marketed as organic, clean label certified brands. One of the companies is manufacturing formula itself, marking the first new formula plant approved by the FDA in 15 years.⁷ 
   
   And those imported formulas that entered the U.S. market during the formula crisis may be around permanently. The FDA announced that it’s considering allowing European formula imports in the long term to diversify the supply chain and head off potential future shortages. Lawmakers are pressing for more diversification and competition, which in turn places added pressure on the FDA to ensure that new products entering the market are safe. 
   
   But ultimately, for parents, this means more questions, not fewer, about the safety of choosing formula as their baby’s primary or sole food source.

¹ Breastfeeding in the News: Moms’ Thoughts on Breastfeeding in 2022, Survey of 2700+ Working Moms, Medela, September 2022
² Aeroflow Survey, July 2022
³ Nelson, How to Make the Full-Time Job of Breastfeeding Compatible with Work, Inc., 2019
⁴Szalinski, Why is Corn Syrup in So Many Infant Formulas, Undark, September 19, 2022
⁵ Anderson et al, Lactose-Reduced Infant Formula with Corn Syrup Solids and Obesity Risks, The American Journal of Clinical Nutrition, August 23, 2022
⁶Wiedeman, Milk Money, New York Magazine, August 30, 2022
⁷ Ibid