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    The current baby formula shortage has created a lot of stress and concern for our families. 

    To help provide the most up-to-date information and resources available, we put together this article which includes information and recommendations from the American Academy of Pediatrics (AAP) and the NC Department of Health and Human Services. We hope you will find the information helpful to you and know that we are here to help in any way that we can. 

    1. Help is available. The NC Department of Health and Human Services recommends that pregnant women consult with their health care provider about breastfeeding their infant. If a family is using both breastmilk and formula, we recommend women work with a lactation specialist to increase their breastmilk supply. 
    2. Breastfeed if you can. The formula shortage has caused many parents to reconsider breastfeeding or offer breastfeeding as a supplement to formula. It is possible to restart lactation depending on how old your baby is. Relactation works best if you had your baby within the last three months or if your milk supply has been low or nonexistent. You can read tips on how to restart lactation here. 
    3. Donor breastmilk is available. Families can purchase human donor milk from WakeMed Mother’s Milk Bank through partnerships with the Triangle Compounding Pharmacy in Cary and 501 Pharmacy in Chapel Hill if you have the means. The outpatient price is $110 for 500mL, the minimum volume one can order. The price decreases slightly as volume increases. A prescription is required. 
    4. Breastmilk sharing is an option. Informal breastmilk sharing is an option if the family has a trusted source with excess breastmilk to donate. This breastmilk will not be pasteurized and tested like human donor milk from the Milk Bank. Purchasing breastmilk from an unknown source on the internet is not recommended. 
    5. Alternative feeding for infants 
      1. Over four months: If an infant is over four months and can hold their head up well in a highchair, parents can start to introduce purees. Parents may also consider introducing meats, legumes (lentils, beans), egg yolks, avocado, banana, or other foods that have been pureed or mashed and mixed with water, formula, or breastmilk. The number of solids taken at this age will not decrease their needs for breastmilk or formula by a lot, but it might help some. Pediatrician, Dr. Nanda recommends introducing one ingredient at a time and to watch for three to five days for an allergic reaction. She also suggests offering the ingredient 10-12 times before giving up on it if your baby is resistant to the flavor. 
      2. Close to 12 months: Parents can begin to transition from formula to whole cow’s milk or use toddler formula temporarily. AAP counsels that families can feed infants older than six months, cow’s milk for a brief period until the shortage is better. Although not ideal and should not become routine, it is a better option than diluting formula or making homemade formula. Although there are no established recommendations on volume, follow the limits that infants 6-12 months should drink no more than 24 ounces a day. It is crucial to ensure the infant gets enough iron to prevent anemia in this situation. C
    6. Do not substitute baby formula. Toddler formula is not recommended for infants. According to the American Academy of Pediatrics (AAP), in emergencies, when no alternatives are available, toddler formula can be used safely for a few days for babies who are close to a year of age.
    7. Don’t over-dilute baby formula. The AAP recommends that parents follow label instructions or the instructions provided by their pediatric provider. Watering down baby formula is dangerous because it causes nutritional imbalances and can lead to serious health problems.
    8. Do not make your baby formula? Some parents are tempted to make their formula. Don’t. The AAP strongly advises against homemade formulas. And although recipes are circulating online that may seem healthy or inexpensive, they are not safe and do not meet your baby’s nutritional needs. Infant deaths have been reported from the use of some homemade formulas.
    9. Do not buy formula from overseas, online auctions, or from unknown individuals. Storage and shipping conditions may impact formula safety. The AAP discourages families from purchasing formula online outside the US. The FDA does not regulate these products, and there may be confusion over labeling. The FDA is exploring safe options for importing formula from other counties. 

    What Families Can Do About the Baby Formula Shortage

    • Families can contact manufacturers for help in finding formula:
    • If a family cannot find their preferred cow’s milk-based formula, comparable other brands, including generic or store brands, smaller manufacturers, or organic options, are generally acceptable. See the table here for substitute formula options. 
    • Families needing help with formula costs who have not applied for assistance are encouraged to learn more about WIC here or apply for FNS (formerly known as food stamps) here.
    • If you see a formula price that seems too high, report it to the North Carolina Department of Justice by filing a complaint here or calling 1-977-5-NO-SCAM.

    Other Baby Formula Resources Available:

    What other resources are available? 

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