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This story has been updated. It was originally published on February 18, 2022.

Brooke Pimental is a foster mom in West Chester, Ohio, who tried six types of formula before landing on one that worked for her 5-week old foster daughter. That persistence helped rid the child of painful gas and diarrhea—until the ongoing formula shortage left her scrambling. 

“She has a very sensitive system, and we didn’t want to change things up once we found what worked for her,” Pimental says. She first encountered supply chain issues toward the end of December 2021, when it took her three stops to find the correct formula. Recently, she had the same problem again, and finally found what she needed by paying double the usual price at a drugstore.

“I would have to continue paying whatever it costs to feed her and keep her comfortable. However, it does put a lot of financial strain on a family,” she says, adding that government services will only cover one type of formula, and it’s not her foster daughter’s type. Parents around the country echo Pimental’s struggle in online chat groups, using virtual support systems to help each other locate the formula they need. In some cases, though, people are attempting solutions that could be dangerous—even deadly—to their child.

Don’t panic. You can still feed your baby.

Most of us have been annoyed, at minimum, and in some cases, substantially inconvenienced by the supply shortage pervading many industries. Baby formula is no exception, but it can feel downright terrifying not to know where your child’s specific formula type will come from when the last can runs out. Making matters worse, the current shortage has been exacerbated by a massive formula recall. Not only have some families had to throw out hard-to-find formula that may be contaminated, but the Abbott Nutrition plant that made the recalled formula shut down, further squeezing US supply. Fortunately, as communities and the government scramble to respond, there is good news on the horizon. 

For one thing, 98 percent of the formula American babies drink is produced in the US and highly regulated by the Food and Drug Administration, so it’s less likely to be blocked by problems with international shipping. There just might be a delay between its manufacture and when it makes it into your baby’s bottle. Of course, it doesn’t help that the Abbott facility is one of those domestic manufacturers. It has, however, reached an agreement with the FDA to work toward reopening and estimates the factory could be back up and running within one or two weeks after the agency signs off on the plan.

Still, “The Great Resignation” likely means delays in transporting and restocking, and supply issues may persist due to stockpiling behaviors. Availability may vary from city to city, but help is hopefully on the way: President Joe Biden has invoked the Defense Production Act in an effort to get formula ingredients to manufacturers, and the FDA has suggested it’s open to more formula imports.

Until the shortage is officially resolved, there are still a lot of options for parents, says Daniel Ganjian, a pediatrician at Providence Saint John’s Health Center. If your baby is over 6 months old, you can also increase the amount of baby food and age-appropriate foods they are eating, but you shouldn’t replace formula with food completely, he says.

Think beyond the grocery shelves

Creative sourcing can help you find formula outside of your typical grocery or baby superstore. At smaller stores, like local drugstores, managers may know when the next shipment of a certain product is due to arrive, so be sure to ask, Ganjian says.

[Related: What the FDA is doing about the US baby formula shortage]

Like everything from baby swings to hand-me-down clothes, social media is a top-notch resource for finding cans of formula other parents might be willing to swap or resell. But be careful about these products, warns the Infant Nutrition Council of America: “Purchasing infant formula from individuals, such as at flea markets, on e-commerce websites, or on internet auction sites, is not recommended. These products may have been improperly stored or shipped, which can negatively affect the quality of the formula.” The Council advises parents who do this to watch for any signs of tampering and to check the expiration date.

Asking your pediatrician for samples is also totally acceptable and encouraged. “We are still stocked,” Ganjian says, and your doctor should be able to provide similar samples so you can test out other brands before switching. In a pinch, consider checking hospitals and emergency rooms, too. And if your family is experiencing a food shortage emergency, including formula, call 211 to access community resources or visit Feeding America’s website to find nearby food banks. 

If it hasn’t been too long, consider giving breastfeeding a(nother) go

Breast milk is a nutritious and free alternative to formula, if it’s available. The American Academy of Pediatrics, Centers for Disease Control and Prevention, and numerous other health organizations recommend it as the “optimal” baby feeding option, but stress that no parent should use that endorsement to keep their baby from getting enough milk. Also, parents who can’t or don’t want to breastfeed shouldn’t feel overly pressured to do so, even during a formula shortage, because that can harm their mental health.  

Ganjian, who believes “breast is best” as long as a mother is able to produce enough, says parents who might still be able to breastfeed, either because they’ve recently given birth or have only stopped recently, might consider working with a lactation consultant to restart breastfeeding as a healthy formula alternative. However, if it’s been months since you stopped breastfeeding or producing milk, that might not work, he explains.

“It depends on how motivated moms are,” he says, referring to the natural challenges inherent to increasing milk supply. “I’ve seen moms who have [decreased] a lot in their milk production but then decide, ‘You know what, I really want to go back to breastfeeding,’ and they pick up the pump and they work with their lactation consultants.”

Parents who are able to breastfeed but need to supplement with formula might also be able to use that combination strategy so they don’t have to find their hard-to-locate formula as often. Additionally, if you can’t or prefer not to breastfeed, but still want to consider breast milk as an option, look to breast milk donation centers (relatedly, consider donating if you have a surplus of milk).

You can also ask a trusted friend if you can buy or use their breast milk. Anita Patel, a pediatric critical care doctor at Children’s National Hospital, explains you should only consider this option if you are confident your friend is truthfully sharing crucial information with you, including any medications they’re taking or lifestyle habits that could impact the milk quality.

A formula change might not be as bad as you think, in most cases 

It might seem that the formula your baby has been using is the only type that will work, but aside from some specific circumstances, that isn’t usually the case, Ganjian says. He explains there are three main types of formula—milk-based, soy-based, and hypoallergenic—and that it’s best to switch to the same type if you need to change brands.

Parents should also avoid attributing spit-up or perceived stomach discomfort as allergies without confirmation from a doctor, and Ganjian hopes parents won’t assume switching will be a problem. “Ninety-five percent of the time when kids do switch formula…[they] don’t have any sort of symptoms,” he says, and parents should know within two days if their child won’t tolerate the new type. “Speak to your pediatrician to make sure [any symptoms] are because of the switch and not because the child is coming down with a virus.” You don’t have to gradually switch, either, he says, “unless the baby doesn’t like the new one.” In that case, you should introduce the change slowly, mixing the old and new formulas together.

Toddler formula can be a last-ditch substitute for infant formula. But Patel says you should never attempt this without talking to your pediatrician first, as toddler formulas don’t have to adhere to the same strict regulatory standards as infant formulas do.

Be extremely careful with cow’s milk

In a perfect world, you wouldn’t give your children cow’s milk until they’re 12 months old, as it puts them at risk of intestinal bleeding, Ganjian says.

Given the formula shortage, however, the American Academy of Pediatrics has said parents can consider cow’s milk as a short-term stopgap (one week, maximum) for children at least 6 months old. And anyone thinking about doing so should absolutely talk to their pediatrician before or immediately after the switch, so they can help monitor the child’s health, Patel says.

Infants younger than 6 months should not drink cow’s milk at all because their gastrointestinal tracts are generally not mature enough to handle the stuff, Patel says. That maturity starts to develop after the half-year milestone, and Canada actually recommends considering a switch when a kid is between 9 and 12 months old, she explains.

“There is nothing magic that happens the day before or day after your child’s first birthday,” Patel says. “We have these guidelines because we know the average time when children both tolerate milk and when they should be relying on solid foods more to meet their nutritional needs.”

Cow’s milk also doesn’t provide infants with enough iron, so they may need to get the crucial nutrient elsewhere—another reason Patel emphasizes communication with a doctor.

Don’t make your own formula or dilute the formula you have 

While it might seem like a desperate time, no formula shortage should result in making your own at home or diluting formula. This is one problem you cannot and should not DIY your way out of. These alternatives are dangerous for your baby, Ganjian says. “The reason you don’t want to make your own formula is because the baby’s kidneys aren’t fully mature and they cannot process high levels of minerals, protein, calcium, [and] phosphorus, so you want a formula that is FDA-approved,” he says, explaining that the agency checks formula’s electrolyte content to ensure immature kidneys can fully process it.

[Related: Improving your baby’s bone health starts in the womb]

If you make your own, you don’t know its contents with full accuracy, and diluting formula can cause seizures, he says. Homemade formula recipes touted online as reputable and “dietician created or approved” can still contain harmful ingredients.

Patel issues the same warning, coupled with first-hand experience with the effects. “I can’t tell you how many children I have admitted to the ICU with lethargy, seizures, malnutrition, or worse—permanent brain damage—from inappropriate mixing or purposeful dilution of formula,” she says. So seriously, don’t trust your favorite mommy blogger’s recipe.

Update, May 22, 2022: This story has been updated to add more information about the various solutions and bring the facts up to date with the current formula shortage situation.

Update, March 4, 2022: This story has been updated to further emphasize why parents should not replace formula with cow’s milk.

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