Getting through the formula shortage and how one nurse is making a difference

By Charlotte Stefanski, marketing associate, cstefanski@iuhealth.org

Since early spring, the United States has experienced a nationwide baby formula shortage, particularly of hypoallergenic varieties. The crisis has left store shelves empty and parents in need.

Two experts at IU Health North Hospital, Dr. Melissa Boling, a Riley pediatric hospitalist and medical director of the hospital’s newborn nursery, and Kathy Thomas, a registered nurse and lactation consultant with 35 years of experience, have offered advice for struggling families.

The two have outlined do’s and don’ts, community resources and how to help.

“You may hear people say, ‘Breastfeeding is free, natural, or easy,’” Boling said. “However, this does not take into consideration lactating parents’ time and effort that is put into breastfeeding.”

Dr. Melissa Boling

Both she and Thomas said there are a variety of medical factors that can prevent a mother from breastfeeding or producing enough milk, including breast development, a family history of infertility and even thyroid issues.

“I think women need to support women, and we can’t be judgmental, Thomas said. “What’s working for us may not work for another person. No two women are the same.”

Kathy Thomas

HOW TO BE PREPARED DURING THE SHORTAGE

For mothers that have been struggling with breastfeeding during the formula shortage, Boling and Thomas recommend connecting with a pediatrician or lactation consultant to help with milk supply.

One key element is stress, Thomas explained, and she knows the shortage has caused a lot, both for women who can’t produce breast milk, and those who can.

Many moms have tried to pump extra milk to store in case of an emergency but pumping too much can have a negative effect.

“What that can actually do is increase their milk so much that the baby is not happy at the breast. It’s almost like somebody turned on a water hose,” Thomas said. “Babies often get a belly ache, they can arch at the breast or they can cough, so it’s uncomfortable for them.”

Instead of trying to produce a freezer full of milk, mothers who are worried about their supply can add an extra pump or two a day to their schedule.

Stress can also halt milk production, so Thomas recommends taking time to do relaxation and breathing exercises to help milk flow.

“It greatly reduces cortisol, and on the other hand, it increases oxytocin, which is the love hormone, and love hormone is what helps bring milk down to the baby,” she said.

Mothers who have previously breastfed but stopped, whether it be because they didn’t like it or had issues, can also try to gain the ability back, especially if it’s only been a few months.

“It takes more effort. You have to pump every two to three hours to re-initiate milk supply,” Thomas said. “We have had more calls about that lately, and it is possible to do that.”

CHECK WITH YOUR PEDIATRICIAN FIRST

With many families struggling during the shortage, some might look to new or unconventional ways to feed their child.

When it comes to generic brands of popular formulas, Thomas advised it’s best to check with your pediatrician first, especially if your baby is sensitive to formulas.

Parents can also carefully compare the labels of name brands to their generic versions, ensuring ingredients and percentages are an exact match.

“Unfortunately, not all generic forms are created equally. Sometimes they have more fillers,” Thomas said. “That’s where you’ve got to really read labels before making a change.”

According to Boling, parents should avoid using any homemade formula recipes or diluting formula with more water than directed, both of which can cause various nutrient deficiencies.

She added that alternative forms of milk, like cow’s milk, plant-based milk, goat’s milk, evaporated milk or condensed milk, should not be given to infants younger than 12 months old, unless directed by a physician. Water should not be given to infants less than six months old, and juice and tea should be avoided until after 12 months.

And if you’re considering donor breast milk, Boling advises that parents should only receive milk from trusted organizations, like The Milk Bank.

“Currently, it is not recommended to participate in informal milk sharing,” Boling said. “Avoid purchasing human milk from those that you do not personally know such as on social media groups or online.”

COMMUNITY RESOURCES THAT CAN HELP

While shelves might be bare, there are plenty of community resources that have been a great help during the formula shortage.

For low-income households, both Boling and Thomas recommend reaching out to WIC with questions at the toll-free information line, 1.800.522.0874. Caregivers who are having trouble finding formula can also contact the Indiana Department of Health MCH MOMS Helpline at 1.844.MCH.MOMS for information.

And while formula might be sold out at stores in larger cities, Boling notes that smaller towns might have more items.

“If you cannot find formula, check smaller stores,” Boling said. “Try local social media groups online as well.”

IU Health North also has plenty of resources, and patients can always ask their pediatrician questions, make an appointment with a lactation consultant, or call the unit for any parenting advice at 317.688.2680.

The hospital has also partnered with The Milk Bank, an Indianapolis-based organization that receives human milk from carefully screened donors, and pasteurizes, freezes and distributes it throughout the country.

Thomas explained the hospital has an “express site,” and while the location does not accept donations, it has milk available for patients.

The milk is used in a variety of ways at the hospital, whether a new mom is struggling with breastfeeding or waiting for her milk to come in, or in emergency cases for babies in the neonatal intensive care unit (NICU).

Mothers leaving the hospital can purchase up to 40 ounces of milk without doctor’s prescription. Patients struggling during the formula shortage can also contact the hospital to purchase the milk or reach out to any other Milk Bank location.

Both Boling and Thomas encourage mothers with a larger supply to consider donating to The Milk Bank, which has seen a greater need for donors during this time.

Jenna Streit, advancement director of The Milk Bank, said there was a donation shortage, even before the formula shortage. This was due to an increase in demand both from families at home and hospitals.

“The need is continuous. We must approve 82 new donors every month to keep up,” Streit said. “It’s an incredible pace, and moms continue to meet the needs of babies across our communities.”

To learn more, visit themilkbank.org.

MOTHERS HELPING MOTHERS

Jayme Melton, a registered nurse (RN) at IU Health North, began donating her breast milk to The Milk Bank in February after having her first child, Jack, in August 2021.

Last fall and into the winter, she began researching milk donation, as she was a new mother and wanted to give back in some way. She came across The Milk Bank.

“Being postpartum, I can’t donate blood,” Melton explained.” So, I was looking at other ways to help and ventured down this path.”

She did a bit of research and found out they support several hospitals, including IU Health North’s Express Site.

Jayme Melton began donating her breastmilk to the Milk Bank in February.

From there, Melton said the donation process at themilkbank.org was simple. Those interested enter their contact information and answer a few questions. From there, a coordinator reached out to Melton to ask a few more in-depth questions to made sure she qualified.

Potential donors are then asked to provide a blood sample at a lab, which is covered by The Milk Bank. Once approved, the donor will receive a unique number and be able to donate. The whole application process takes about 30 days.

“Everybody’s breastfeeding journey is different. In my journey, I have been fortunate enough that I am able to produce a little bit more than what my little one needs daily,” Melton said. “I worked on a little bit of a freezer supply, but then I realized I wanted a way to give back to those mothers that may not be able to produce, or those ones that really need the milk.”

For Melton, it’s been a surprisingly touching experience. When she mentioned she was donating to one of her supervisors, she became emotional, as her first child received donor milk. Other team members told Melton they’ve seen how donated milk saved their NICU patients’ lives.

“To be able to make an impact in that way, it’s something I will never be able to really put into words, honestly,” Melton said. “It’s a privilege to be able to donate, and because I do produce a little bit more, this is the way that I have found the most rewarding for my journey to be able to give.”

While donations cannot yet be given to IU Health North’s Express Site, Melton donates to another local Indianapolis office. When she first started in February, she was donating 100 ounces at a time, or five to six days of milk.

It fit right into her schedule, allowing her to pump a few times at home, freeze the milk while she’s at work, use what she needs for her own child and then drop off her donation.

For those who are able to have a little extra supply like her, Melton highly encourages them to connect with The Milk Bank online. The experience has been a powerful one for her, and she added potential donors won’t regret it.

Melton is hoping to make one more donation before her son turns one. Since this winter, she’s been able to donate more than 250 ounces, and would like to donate one last 50 ounces.

“It has pushed me to continue my journey of breastfeeding and pumping,” Melton said. “I really can’t put into words how meaningful it has been to see the impact.”