By Lic. Pediatric Nutritionist Danielle Shea Tan & Lactation Educator-Counselor Moorea Malatt

We’ll keep this straight-forward and to the point because families need guidance immediately on how to feed their babies in the midst of the current infant formula shortage. We created the guidance below to help parents quickly identify and rank alternative formula options that are safe and not being as clearly offered or discussed as they should be in this time of crisis. And when all that is left on the market are brands you’ve never heard of, which ones are good?! 

**If you are currently supplementing your human milk with formula due to supply issues and have not tried getting support with supply; please consider contacting a lactation professional (IBCLC OR CLC) experienced in increasing supply.**

The American Academy of Pediatrics has delivered recommendations for families looking for formula. Unfortunately, if you’re at the end of your search for mainstream formula under 6 months, they have left very few options. Even over a few days, these recommendations have been changing to reflect more dire circumstances; but they have left us without details for how to rank the emergency alternatives or for ranking the options based on most optimal nutrition. 

The Academy of Breastfeeding Medicine has also provided their response but unfortunately their first and top recommendation is to “re-lactate,” which is unlikely to be feasible for the same reasons which led folks to need to or choose to formula-feed. Relactation is a full-time job and will still leave most folks needing to supplement with formula.

First, if you have been using a mainstream formula brand, don’t be afraid of using generic brands from big boxed stores like Costco, Walmart, Target or the generic brands at your pharmacy. These are the same product from Abbott, in different packaging! We have also heard that GoPuff app warehouses in many locations have formula on the shelves for delivery! If you are low-income, please call or go to your local WIC office to see if they can help you get formula!

You may be able to find shared human milk from Human Milk for Human Babies (find your area here) or Eats On Feets  or your neighbor (Donated milk only. NEVER purchase human milk as it may be fake or watered down for profit.) The sharing of human milk online is over a decade old and we bet you’ve seen very few scary stories in the news unless the milk was sold for profit. )

Peer-to-Peer Formula

Informal peer-to-peer formula sharing sites have popped up. They are at your own risk. Please make sure all formula cans shared are fully sealed and check the expiration dates. Free Formula.Exchange.  & Formula Exchange & formula through Proxi.

A few final notes before we dive into options: 

  • Please purchase any formula from a reputable website, retail store or directly from the manufacturer. Amazon has been having issues with quality.
  • Please review food allergen information for any products purchased as some of the formulas may contain soy, eggs, dairy, nuts or other.

 

Below we cover Under 9 mo & over + dairy options & sensitive/ non-dairy options:

If your baby is under 9 months and does well on DAIRY infant formula:

  • Shared human milk from Human Milk for Human Babies, Eats On Feets or your neighbor (Donated milk only. Never purchase human milk as it may be watered down for profit)
  • Our favorite formulas contain organic, real food ingredients, high quality oils and vitamins/minerals and leave out the corn syrup and hexane processed oils and fats:
    • Holle, HIPP, Kendamil and other trusted European brands 
    • Nature’s One Baby’s Only Toddler Formulas (These formulas meet all of the nutritional requirements for an infant formula per the Infant Formula Act and Amendments, but can only be recommended for infant use by Licensed Healthcare Professionals.)
      • Premium Dairy
      • Premium Dairy DHA/ARA
      • Gentle Whey
      • Gentle Whey DHA/ARA
      • Cholov Yisroel
    • Serenity A2 Whole Milk Toddler Formula (The press release indicates this meets the FDA nutritional requirements for infant formula, however I am waiting on confirmation per nutritional facts for 100 kcal.) 
    • Other toddler formulas may also be used as a supplement and for a short-term when infant formula is not available, however we urge you to work with a Licensed Pediatric Nutritionist to assess nutritional information and supplement with vitamins when needed.
       
  • We do not know how long this shortage will last. If you can afford it, you may want to order some formula from New Zealand, Australia, UK, or Germany- it will possibly take weeks to ship but will be helpful in case this formula shortage gets worse. Common European brands are Aptamil, and SML (you will usually find these in premixed aseptic packages). Reputable more organic powdered brands are Bugs, Bellamy’s, Nannycare. 
  • As a last resort and for a very short time, whole milk (we suggest organic or hormone-free, ideally) can be used, though there are health risks to consider. Drinking whole milk before age 1 is associated with increased risk of Anemia (low iron)  and Type 1 Diabetes,. Iron is critical for growth and development of infants – to reduce the risk of anemia you can work with a healthcare professional to supplement with infant iron drops or if your baby is eating solid foods you can serve iron-rich solid foods alongside Vitamin C-rich fruits and veggies to enhance absorption. 

 

A note on Homemade Infant Formula: 

  • Homemade baby formula is an Extreme Emergency-Only short-term option. While this is absolutely not supported by any medical associations, homemade formula recipes are available. For example, a formula recipe using evaporated milk as the base was developed in the early 1900s and was still used by intuit populations in Canada as recently as 2003. Unfortunately, literature demonstrates that children fed this formula are often deficient in iron, selenium and other critical nutrients., In this state of crisis, we urge you to work with a licensed healthcare professional to ensure you are following food safety guidelines and meeting the nutritional needs of your baby with any recipes. This option is the LAST option underneath the options above and below.

If your baby is under 9 months and is sensitive to dairy infant formula:

  • Our favorite formulas contain organic, real food ingredients, high quality oils and vitamins/minerals and leave out the corn syrup and hexane processed oils and fats:
    • Kendamil Goat Milk Formula (Stage 1 or 2) (European Brand) 
    • Jovie Goat Milk Stage 1 Formula or Stage 2 Formula depending on your baby’s age 
    • Nature’s One Baby’s Only Toddler Formulas (These formulas meet all of the nutritional requirements for an infant formula per the Infant Formula Act and Amendments, but can only be recommended for infant use by Licensed Healthcare Professionals.)
      • Dairy-based but more digestible
        • Gentle 
        • Gentle DHA/ARA
        • Sensitive DHA/ARA
      • Dairy-free options: 
        • Pea Protein 
        • Goat milk DHA/ARA 
    • Else Nutrition Toddler Formulas (These formulas may require some supplementation of nutrients including Vitamin C. See table for nutritionals below) 
      • Original Plant-Based Complete & Balanced Nutrition 
      • Omega Plant-Based Complete & Balanced Nutrition 
    • Danalac Goat Organic (European Brand – please use the correct stage of formula per your baby’s age) 
    • Kate Farms Pediatric Oral Supplement
    • Edensoy Organic unsweetened soy milk
  • Other good options that may include a couple of less than ideal ingredients include: 
  • Kabrita Goat formula (called Toddler formula to avoid violating the WHO code of marketing human milk substitutes so as not to undermine the promotion of lactation.) 
  • Gerber® Good Start® Soy Stage 2 Powder Infant & Toddler Formula (not organic, but milk-free and is already used for ages 9 mos+) (need to look into nutritionals to determine deficiencies)
  • You can also try using human milk, however finding dairy-free human milk would likely require working with a friend or finding an allergen-free nursing parent.

 

 

If your child of any age needs a specialized formula like Elecare/ Neocate and you can’t get it from your pediatrician:

Consider consulting a Licensed Pediatric Nutritionist who can help you create an alternative that is just right for your child’s needs. Only do this with licensed nutritional support or your pediatrician. For those on elemental formulas, we have heard anecdotally hat Alfamino may now be back in stock. 

Additional Options for Babies Over 9 Months: 

If your older baby is eating plenty of healthy table food at every meal and snack, there are several options to consider: 

  • Working with a Licensed Pediatric Nutritionist to create nutrient-dense, blenderized beverages may also be an option, but we only advise this if working with a professional. An older baby’s nutrient needs are still so specific, it is critical to ensure all nutrient requirements are being met. 
  • As a last resort and for a very short time, whole milk (we suggest organic or hormone-free, ideally) can be used, though there are health risks to consider. Drinking whole milk before age 1 is associated with increased risk of Anemia (low iron)  and Type 1 Diabetes,. Iron is critical for growth and development of infants – to reduce the risk of anemia you can serve iron-rich solid foods alongside Vitamin C-rich fruits and veggies to enhance absorption. 

If your baby is over 1 year: 

Babies under 1 year typically do not need infant formulas. A child who eats a variety of solid whole foods and will drink water can thrive without any milk or formula. 

When choosing drinks to replace formula for babies over 1 year of age, take time to read the ingredient label since some milk products and many plant-based beverages contain preservatives, emulsifiers and added sweeteners that are not valuable for growing babies. In addition, these beverages vary widely in their nutritional composition and should be assessed for value to a child’s diet.  

Healthy Alternatives to formula for your toddler over 1 year: 
  • Unsweetened plant-based milk alternatives containing two ingredients or less are best. The Cornucopia Institute’s Plant-Based Beverage Report and Scorecard can be used to narrow down the plethora of plant-based beverage choices available. Choose unsweetened products that received a score of 4 or 5 plants. Some of our favorite brands include: 
    • Malk
    • Edensoy
    • Three Trees
    • Elmhurst
  • Homemade hemp milk https://healthymamas.com/homemade-hemp-milk-in-60-seconds/ 
  • Meyenberg powdered goat milk, mixed properly by the directions. 
  • Organic grass-fed whole milk 
  • Nutrient-dense smoothies containing fruit, vegetables, nut butter and other whole foods! I have a few nutrient-dense smoothie recipes but it may make more sense to link an example from your blog if you have one
  • Make water readily available. We suggest open cups and some developmentally appropriate straw sippy cups. (Use code healthymamas to get 10% off)  
  • Any organic toddler formula (Although toddler formulas are an option for babies over 1 year, these formulas are currently desperately needed for older babies who still require very specific nutritional requirements. Many families are choosing to avoid toddler formula products so that stock is available for younger babies.) 

A note on cow’s milk: 

The medical community promotes drinking cow’s milk after 1 year of age due to the high needs of calcium and other minerals required during this life stage. Yet, plenty of children thrive without drinking cow’s milk. In fact, the Harvard School of Public Health specifies that “dairy requirements have not yet been determined and research is still developing.” 

If your baby or toddler is sensitive to dairy, you can support calcium needs by regularly including several calcium rich foods in your baby’s diet including: black beans, almonds, almond butter, broccoli, white beans, figs, chia seeds, tahini, sardines, okra, bok choy, collard greens, navy beans, tempeh, black strap molasses and nettles. For more calcium rich, dairy free ideas, read Danielle’s book, 52 Small Changes for the Family.

**We wants to remind you that If you are making a transition from exclusively body-feeding/breastfeeding to using formula at night, bed-sharing for sleep will become riskier and should be ended. 

If you have questions related to how feeding in relations to sleep, please fill out the form at the bottom of the About page***  

If you are experiencing anxiety and stress or sadness around this formula shortage, please reach out for FREE to Postpartum Support International. Special feeding coordinators are available.  Call or Text to 1800-944-4773

 

Chia, J. S. J., McRae, J. L., Kukuljan, S., Woodford, K., Elliott, R. B., Swinburn, B., & Dwyer, K. M. (2017). A1 beta-casein milk protein and other environmental pre-disposing factors for type 1 diabetes. Nutrition & Diabetes, 7(5), e274-e274.

Friel, J. K., Andrews, W. L., Simmons, B. S., L’Abbe, M. R., Mercer, C., MacDonald, A., & McCloy, U. R. (1997). Evaluation of full-term infants fed an evaporated milk formula. Acta Paediatrica, 86(5), 448-453. Accessed May 15, 2022 https://pubmed.ncbi.nlm.nih.gov/9183479/

Friel, J. K., Andrews, W. L., Edgecombe, C., McCloy, U. R., Belkhode, S. L., L’Abbe, M. R., … & McDonald, A. C. (1999). Eighteen-month follow-up of infants fed evaporated milk formula. Canadian journal of public health, 90(4), 240-243. Accessed May 15, 2022 https://link.springer.com/article/10.1007/BF03404124

Ziegler, E. E. (2011). Consumption of cow’s milk as a cause of iron deficiency in infants and toddlers. Nutrition reviews, 69(suppl_1), S37-S42.

Lamb, M. M., Miller, M., Seifert, J. A., Frederiksen, B., Kroehl, M., Rewers, M., & Norris, J. M. (2015). The effect of childhood cow’s milk intake and HLA-DR genotype on risk of islet autoimmunity and type 1 diabetes: The Diabetes Autoimmunity Study in the Young. Pediatric diabetes, 16(1), 31-38.

Harvard School for Public Health. Kid’s Healthy Eating Plate. Accessed May 17, 2022 https://www.hsph.harvard.edu/nutritionsource/kids-healthy-eating-plate