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Families across the U.S. are scrambling to feed their babies as formula becomes less and less available.
According to CNN, a February recall of three brands of formula and ongoing supply-chain issues have contributed to shortages that have left store shelves empty. In response, White House press secretary Jen Psaki says the FDA is doing everything it can to shore up production to meet the demand, CNN reports.
But for the time being, some families are left with few options for getting their babies the nutrients they need.
Gabby Orr, a reporter at CNN, is one of them. “The baby formula shortage is getting unreal,” she tweeted. “No grocery store near us has the brand we use, it is temporarily out of stock on Amazon Prime and the generic version that is ‘available’ on Amazon has a 1–2 month lead time.” Other parents told POLITICO that they are “panicking” over the shortage.
The problem may contribute to pre-existing pressures on women to shift to breast milk. But Northeastern experts say it would be a mistake to assume that breast milk is always a viable alternative to using formula, and the current crisis may make purchasing it riskier than ever.
“The pressure to breastfeed has always been an issue,” says Jamie Ladge, associate professor in the Management and Organizational Development Group of the D’Amore-McKim School of Business. The Centers for Disease Control and Prevention recommends that infants be breastfed for the first six months of life, and the pressure—by doctors, relatives, or others—to choose this option can already be stifling for some parents. When asked whether the formula shortage could change this, Ladge says, “I do suspect this would exacerbate the pressure.”
But breastfeeding is far from being a quick fix for the formula shortage for many families. “It’s not always that simple to just say, ‘go breastfeed,’ particularly for those who may not be able to or who had to stop for whatever reason, or for those who never started because they were relying on formula,” Ladge says.
In addition to biological barriers, breastfeeding comes with a host of hidden costs which can include nursing clothes, lactation consultants, and pumps, plus indirect costs like time off work and the additional cost of food (the CDC recommends that breastfeeding mothers consume an additional 330 to 400 calories per day). Some of these can be covered by insurance, but some cannot.
For those who cannot breastfeed but are looking to use breast milk, the breast-milk market might be a tempting option. Breast milk can be purchased on Craigslist or on specialty sites such as Only the Breast. These sites allow buyers to purchase excess milk that others have frozen.
The problem with this, according to Nikos Passas, professor of criminology and criminal justice at Northeastern, is that the breast-milk market is “largely unregulated,” leaving parents vulnerable to the risks associated with buying milk online.
These risks include health concerns for the baby. For one, buyers may not be aware that the breast milk they purchase may not be suitable for their baby. “A newborn’s breast milk is not appropriate for an older baby,” Passas says.
Then there are concerns about the seller and the quality of the milk. Families are highly encouraged to consult with their healthcare provider before using someone else’s milk, he says, and to make sure the donor has been screened for health issues, as diseases such as HIV and some drugs can be transmitted to a baby. There are other risks to purchasing from strangers as well, as sellers may use incorrect or unsanitary equipment, or may not store the milk in accordance with guidelines. For strong standards on breast-milk storage, Passas cites the Human Milk Banking Association of North America, which publishes detailed guidelines on who can donate milk and how it should be processed and stored.
Plus, there is no guarantee that a seller who claims they are a healthy non-smoker is telling the truth, and they could even be selling something other than human breast milk (Passas cites a case where breast milk purchased online was mixed with cow milk). When you purchase milk online from random sellers, “You do not know what you’re getting.” Unfortunately, some of these dangers apply to secondhand formula as well.
Despite the risks, Passas estimates that the breast-milk market may see a boom during the current formula shortage. “Whenever you have an asymmetry between demand and supply, you have problems,” he says. “This is what drives illegal markets.”
And until the shortage is resolved, desperation may drive families to them.
For Ladge, it’s an added stressor that the parents of the country didn’t need. “Just add that to the mix of what working parents have had to contend with in the caregiving crisis over the past couple years,” she says. “Becoming a parent, and a working one at that, has never been more difficult.”
Jessica Taylor Price, Northeastern University