North Carolina families are navigating infant formula shortages and are often not sure where to turn for help. Here are suggestions for how to help families. We encourage families to take the following actions. 

Formula supplies

• Families and can contact manufacturers for help in finding formula
  • MyGerber Baby Expert
  • Abbott’s Consumer Hotline: call 1-800-986-8540 and urgent product request line
  • Reckitt’s (Mead Johnson) Customer Service line: call 1-800 BABY-123 (222-9123)
• If a family is unable to find their preferred cow's milk-based formula, a comparable other brand, including generic or store brand, smaller manufacturer, or organic options are generally fine. See a table of substitute formula options here.
• Families needing help with formula costs who have not applied for assistance are encouraged to learn more about WIC, or apply for FNS (formerly known as food stamps). 
• If you see a formula price that seems too high, report it to the North Carolina Department of Justice by filing a complaint or by calling 1-877-5-NO-SCAM.
• If your health care provider is writing WIC prescriptions, ask them to consider listing multiple formula options (i.e., formula equivalencies) on a single prescription. The WIC agency will work with families to accommodate multiple option prescriptions for specialized formula.

Breastfeeding

• Women who are pregnant are encouraged to consult with a health care provider about breastfeeding their infant.
• If you are using both breastmilk and formula, we encourage an appointment with your local lactation specialist to try and help increase their supply of breastmilk.
• If the parent recently breastfed then stopped, they may be able to induce re-lactation for some volume of breastmilk. Your local lactation specialist would be happy to discuss further with you. 
• There is the option for families to purchase human donor milk from the WakeMed Mother's Milk Bank, through partnerships with the Triangle Compounding Pharmacy in Cary and 501 Pharmacy in Chapel Hill. This option can be expensive, and a prescription is required and can be found here. 
• Informal breastmilk sharing is an option if you have a trusted source with excess available 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.

Alternative feeding

• If the infant is over 4 months old and can hold their head up well in a highchair, parents can start to introduce thin purees. Parents may also consider introducing meats, beans, egg yolks, avocado, banana, or other foods that have been pureed or mashed and mixed with water, formula, or breastmilk. The amount of solids taken at this age will not decrease their needs for breastmilk or formula by a lot, but it might help some.
• If the infant is close to 12 months old, parents can begin a transition from formula to whole cow's milk or use toddler formula temporarily. AAP counsels that families can feed infants older than 6 months cow’s milk for a brief period of time 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 well established recommendations on volume, follow the limits that infants 6-12 months should drink no more than 24 ounces a day. In this situation, it is important to ensure the infant is getting enough iron to prevent anemia.

Dangerous Practices to Avoid

• Do NOT make homemade infant formula. Homemade formula recipes can be very dangerous for babies since they have not been evaluated by the FDA and may lack nutrients vital to an infant’s growth. 
• Do NOT water down formula to stretch it out; it is not safe to do so. Always follow formula label instructions or those given to you by your health care provider.
• Do NOT buy formula from overseas, online auctions, or unknown individuals. Storage and shipping conditions may impact formula safety. The American Academy of Pediatrics discourages families from purchasing formula online that comes from outside the United States. These products are not regulated by the FDA, and there may be confusion over labeling. The FDA is exploring safe options for importing formula from other counties.
• Do NOT purchase breastmilk from an unknown source on the internet