‘How Am I Going to Feed Her?’ Parents of Premature Babies Struggle Amid Formula Shortage

‘How Am I Going to Feed Her?’ Parents of Premature Babies Struggle Amid Formula Shortage

A Desperate Search: As the United States faces a baby formula shortage, some parents are rationing supplies, or driving for hours in search of them .
An Emotional Toll: The shortage is forcing many new mothers to push themselves harder to breastfeed , with some even looking for ways to start again after having stopped.
But many parents cannot or do not breastfeed. And it can be especially difficult to breastfeed if you are a mother who is admitted to the hospital with your own medical complications while your baby is in the NICU, or if your preterm infant cannot yet suck or swallow and has to be fed through a tube, explained Dr. Rashmin Savani, chief of neonatal-perinatal medicine at UT Southwestern Medical Center in Texas.
“Almost all preterm infants — especially those less than 35 weeks’ gestation at birth — require specialized formulas or supplemented breast milk for appropriate growth and development, particularly for long-term bone growth,” Dr. Savani said.
Many of those babies come home from the hospital still needing to be fed a specialized formula, and the ongoing shortage exacerbates how difficult that time of change can be for families still trying to find their footing.
“They have to transition from a technology-rich environment with multiple staff looking after their baby to a home environment without this level of scrutiny,” Dr. Savani said. NICU families must travel to and from numerous follow-up appointments, and many have to learn to manage with home medical devices, like feeding tubes — all while they are sleep deprived and adjusting to the rhythms of life with a new baby, he added.
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Parents of preterm babies already face many emotional and logistical challenges. Experts fear the formula shortage has only exacerbated their stress. Credit...Acacia Johnson for The New York Times
And now, parents have the added fear of depriving a vulnerable child of necessary nutrition — which they know could impact their growth and development, he said.
For moms like Anna Grymes, 38, the weight of it all feels relentless.
“You’re trying to bond with your baby and do all of the things that mothers feel pressure to do in the beginning. You are sleep deprived. Your hormones are racing through your body. And now you have this fear of: ‘How am I going to feed her?’” said Ms. Grymes, who gave birth in March at 35 weeks gestation. She now spends hours every day pumping milk and scouring store shelves for the specialized formula her daughter drinks.
None of this — not the NICU stay, not packing her baby up and racing to whatever store she hears just got a formula shipment in — is what she had in mind before she gave birth. Ms. Grymes, who is a single parent and works full-time, is tired. One day, she drove to five separate stores near her home in Jacksonville, Fla., and came up empty-handed — worrying all the while that she may have exposed her baby to the coronavirus while simply trying to track down her food.
Other mothers, like Shaquesha George, 33, have simply given up on finding specialized formula for the time being. Her baby was born seven weeks early and has a cow’s milk allergy that causes upset stomach. Ms. George adores her daughter and adores motherhood, but her first few months as a parent have been punctuated by moments of profound stress — like in February when she heard about the baby formula recall and realized her daughter was drinking from an affected can of Similac Alimentum.
Navigating the Baby Formula Shortage in the U.S.
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A growing problem. A nationwide shortage of baby formula  — triggered in part by supply-chain issues and worsened by a recall  by the baby food manufacturer Abbott Nutrition — has left parents confused and concerned. Here are some ways to manage this uncertainty:
Checking your supplies. Abbott Nutrition has recalled several lots of its Similac, Alimentum and EleCare formulas  after at least four babies became sick with bacterial infections. To find out whether a formula in your home may be affected by the recall, check the lot number  on the Abbott website. If you learn that you fed your child a recalled product, contact your pediatrician.
Finding formula. If your baby’s formula was not affected by the recall, but is still not available, you can try calling local stores  to ask when they expect to get it back in stock. You may also be able to buy it online. If your baby is on special formula, reach out to your doctor’s office: They might have samples in stock.
Picking a new formula. If you typically use a name-brand formula , look for its generic version. Alternatively, seek a new formula that matches the ingredients listed in your usual one. If your baby is on a special formula for health reasons, check with your pediatrician before switching.
Transitioning to a new product. Ideally, you will want to switch your child gradually . Start by mixing three quarters of your usual formula with one quarter of the new one and gradually phase out the old product. If you can’t transition gradually because you’ve run out of your usual formula, that’s OK, although you might notice more gassiness or fussiness during the transition.
What not to do. If you can’t find your baby’s usual formula, don’t make your own — homemade formulas are often nutritionally inadequate and at risk of contamination. Don’t try to “stretch” your formula by adding extra water, and don’t buy it from unvetted online marketplaces  like Craigslist. For a baby less than 1 year old, don’t use toddler formula.
“I completely freaked out,” said Ms. George, who rushed her daughter to the hospital near her home in Louisville, Ky.
Months later, despite diligent efforts, she has been unable to consistently find Enfamil Nutrimagen, the hypoallergenic formula their pediatrician recommended. So she gives her daughter a cow’s milk-based option. The pediatrician said it is fine for now, but after all that her baby has been through in her first months, Ms. George hates to watch her squirm in pain as she tries to process the dairy.
“As a mom, you want to make sure your child is able to eat. It’s hard when it’s really out of your hands as far as getting formula,” Ms. George said. “It’s very emotionally draining.”
In the absence of meaningful support, or a clear sense of when this will all end, parents have done what they can, establishing formula exchanges and local online groups that help them swap and locate cans.
Experts say that parents should also lean heavily on their children’s pediatricians . But sometimes, pediatric practices aren’t able to come up with extra supplies either. There have been reports of families who have run out of formula heading to the emergency room for help. Fortunately, Dr. Yap offered reassurance that “hospital supply is not in jeopardy at this time.”
But as specialized formula remains scarce on store shelves and online, some frustrated parents are turning to measures they never anticipated.
Mary Chappell, 19, gave birth to her daughter at 33 weeks, and has been unable to find the specialized formula she was prescribed anywhere near her home in Joplin, Mo. She has driven two hours in either direction — to Branson and Kansas City — but “we weren’t able to find anything anywhere,” Ms. Chappell said.
Instead, she has had to give her baby a combination of a standard formula that left her with a cracked and bleeding face rash, and about 200 ounces of donated breast milk from a mother on an informal sharing site.
The American Academy of Pediatrics and the Food and Drug Administration advise against informal milk swaps because of the potential risk for introducing babies’ systems to bacteria, drugs or even life-threatening infections, like H.I.V.
But Ms. Chappell — who has broken down in tears in grocery stores multiple times — does not see what other choice she has. Her baby, who has already been through so much, must eat.
“It feels like a never-ending battle,” she said. “She was in the NICU for 26 days, and that was really scary. Now there’s the formula shortage, and it’s terrifying.”
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