RICHMOND, Va. -- As families across Virginia and the U.S. continue to hunt for stocks of baby formula during a nationwide shortage, some are turning to alternative methods to help feed their children.
Online support groups and blogs can provide sources of information for parents to consider with no immediate end to the shortage in sight at this point in time. Still, local pediatricians said it is critical that families consult their child’s doctor before switching to alternative feeding methods.
In an effort to provide needed information from a trusted, local expert, CBS 6 spoke with Dr. Sean McKenna at the Children’s Hospital at VCU about what he is advising his families right now.
BURNS: What's it been like the past couple of weeks, as it gets harder for people to find baby formula? And what are you hearing from your families who may be using infant formula to feed their babies?
DR. MCKENNA: Yeah, so we in general pediatrics and the Children's Hospital of Richmond are definitely trying to be a resource for families when they have questions. We don't have a lot of solutions in terms of providing formulas for families, but we can offer advice.
So I've been hearing from a lot of families that it's just become nearly impossible. They're scouring all the different stores, they're looking online to see what they can find. And so we're working with families to try to help them identify what the other opportunities are to provide nutrition for infants, and there isn't a whole lot.
If you're a formula-fed infant, then you need your formula. What we are working with families on is the idea that you don't want to try to mix your own formula from some recipe you found online. You don't want to try to add any water or water down the formula that you have. That's one of the more dangerous things that we can do.
But what we can do, and this is my most frequent advice, is that you should and can use any formula you can get your hands on that's approved for infants. So, a lot of families have ended up through the course of the first couple of months working their way into some of the different formulas. That may be for sensitive stomachs or for a fussy baby kind of thing. And that's usually not necessary at all. So if you have a baby that's been feeding on cow's milk protein formula, you can switch over to soy formula. If you've been using the sensitive formulas, you can switch to the Target brand, the Walmart brand, whatever brand it is, you can find, as long as it's approved infant formula.
What does get a little bit trickier is if you have a baby who really does have a diagnosed milk protein allergy or something that requires a special formula, it can be pretty tricky to move away from those and to the regular formulas. If kids are old enough and you've reached out to your doctor while you're on that formula, and they're okay with a trial of a nonspecialized formula under their guidance, you certainly could try that.
I've also worked with some families just to emphasize that from an early age, we supplement infant formula nutrition with solid foods. I start at four months, the American Academy of Pediatrics recommends at six months. Typically beginning with purees, hopefully, mostly veggies and other foods from plants at the beginning. You can then just kind of move more to that in terms of the nutrition and try to bulk up that as a big part of your nutrition. Then use the formula afterward for what the baby's identifying as their thirst.
But especially in the first couple months, really the first four months, when that's the only nutrition we're offering, is infant formula, if you're formula feeding your baby, then you don't have as many alternatives, and you just have to keep looking for available resources.
It does sound like nationally, we're going to open up some of the International formulas, which tend to be very safe But, I would look for official FDA recommendations on that.
It is fine to order from trusted online resources, but I would be wary of auction sites and secondhand sites if you don't know them well or if people selling on their own. It is really much better to just buy infant formula that's approved and from an approved site.
We want to be really careful with this advice, but once you're closer to a year, I would say nine months or older, the nutrition that kids need from infant formula is not nearly as intense. So you can work around things a little bit. I've talked to some families where they said that they have some formula left, but they may end up giving a little bit of water to babies that are over nine months. I'm okay with that. Personally, I don't know that's necessarily sponsored by the American Academy of Pediatrics officially, but it is a way that we can make it through a couple of days or a week.
The AAP has sponsored the idea of whole milk cow's milk for kids over nine months, if necessary for a few days for the short term. They also were careful to point out that you don't want to use toddler formulas. Toddler formulas are specifically designed for toddlers and really in general are not necessary. I don't ever recommend any of my family's that they use toddler formula even for toddlers. You don't have to be giving dairy to kids older than a year; it's just a nice source of calcium. So whole milk is fine if you do want to give dairy or you can go with soy and alternatives like almond milk, but not again for kids under one year.
BURNS: So let's unpack some of those ideas for some specifics. When it comes to not diluting the formula, that seems like an important thing. I know a lot of people might say I’m running low; I want to stretch this out. That's what we do as adults, right? Why is that so dangerous for an infant, particularly the really young ones?
DR. MCKENNA: So when we dilute the infant formula, infants aren't able to sort of regulate their own salt intake. So if we as adults drink too much water, we'll get really hungry for salty foods. And we'll balance out the salt and fluid balance in our body that way, infants don't have that option. They're only getting one source of nutrition. You can end up with water intoxication. And that can be really serious. We've historically always taught all medical students and residents about the dangers of over diluting because we see these kids come in with what are called hyponatremic, low sodium seizures. and those can be very dangerous. So it's definitely one of the practices we absolutely want to speak out against and avoid.
BURNS: And what about sharing breastmilk with others, from people who don't need it anymore? What are some of the concerns? And why is that not a viable option, at least from the medical community's point of view?
DR. MCKENNA: So, donor breastmilk is certainly something that we're using more and more in very controlled circumstances through donor breast milk programs. So our partners down at Children’s Hospital of The King’s Daughters (Norfolk) have done a terrific job of putting together a donor breast milk program. And so, if you're able to reach out to them and find an official channel into donor breastmilk, that's really the only activity in that space, we can sanction as pediatricians. It’s not to say that all of it is dangerous. Families have, throughout history, shared breast milk, but it's not necessarily safe. It's just not something that we can provide any real guidance on. Especially if we can identify other alternatives, that's always going to be safer. So I would say work with your pediatrician to ask questions around that, or work directly with the donor breast milk programs that are available.
BURNS: I'm guessing because it can't be sanctioned, even though it has been happening forever, it’s probably because there's increased testing and that sort of thing?
DR. MCKENNA: Yeah, we’re very careful with the supplies that come through a milk bank. They're carefully tested and vetted and stored safely. We know that they've been stored safely; we know that they've been transported safely. If you're getting it from someone else, we just really can't offer any guidance there because you don't know for sure what you're getting your hands on.
BURNS: Every family is different, right? So they might have different ideas on when they're going to start solid foods versus not. But it sounds like if you have maybe an older infant that’s been relying on formula, your suggestion might be, if you're worried about the shortage, maybe it is time to do that next progression with nutrition. Safe assessment?
DR. MCKENNA: Yeah. So if you have some infant formula, and you're just trying to make it last a little bit longer, we don't dilute it. But, you can offer them more solid food nutrition. In that case, they'll need fewer calories from infant formula. We obviously have to use a liquid source to maintain hydration, and formula, if we’re not dealing with breast milk, is by far the best option we use for infants. I'm not saying to necessarily risk dehydration, but give them more nutrition from solid foods, and they may take less of the formula, and that'll help you make it last a little longer.
BURNS: If any family has questions, the best thing to do is reach out to someone like you immediately, especially to vet the information they’ve found. Is that right?
DR. MCKENNA: Yeah, we always encourage families to gather information wherever they can, but always to run things past their pediatrician when they're really feeling concerned, or even if they found information that they think will be helpful online. We're always happy to take a look at that with them and just say, yeah, this would be a well trusted source or this may not be the information you want to follow. So yeah, that's what we do in general pediatrics. We're here for families as a resource to help them when they have questions about their kids.
BURNS: The FDA has okayed importing infant formula from other countries. I’m guessing those should be safe for families once they reach shelves?
DR. MCKENNA: All of the infant formulas that I've seen from other countries, that are official and are sanctioned or that are not sort of off-market, are great. I've never had any concerns about families. A lot of my families that are from other countries will say, ‘hey, we're gonna use this formula from back home because we prefer this.” I've never had any concerns. Every every time I've looked them up, I've been really impressed that the nutrition is the same and the standards for production are impressive.
NOTE: This transcript was lightly edited for clarity and brevity. You can learn more about Dr. McKenna here.
