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Parents of babies across the US are struggling to feed their children due to a baby-formula shortage.
The pain of the shortage is particularly felt among low-income families, such as Blacks and Latinos, who already suffer inequities in maternal and child health.
The shortage began during the COVID-19 pandemic in 2020, when America seemingly ran out of everything – from toilet paper to fresh produce.
In late February 2022, a baby formula recall, which caused two infant deaths, worsened the shortage.
In many states, including Texas and Tennessee, where infants depend on formula for more than half of their diet, formula is sold out in stores.
For parents such as Yury Navas, an immigrant Latina mother in Maryland, providing formula for her child is especially stressful.
Yury told AP News that she struggled to find the right formula for her nearly 3-month-old baby because other formulas caused vomiting, diarrhea, and discomfort.
But once she identified a formula appropriate for her baby’s needs, she struggled to find that specific formula in stores.
“It’s so hard to find this type,” she told AP News.
Because participating in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) isn’t feasible for everyone, such as Latinos who may have to forgo needed food, housing vouchers, and health care aid due to immigration fears, some parents have turned to social media and family/friends to help find baby formula.
Some advocacy groups, such as the El Jardin Birth and Family Resource Center in El Paso, Texas are doing everything they can to help mothers breastfeed during these difficult times.
“It is so sad. It shouldn’t be like this,” Capri Isidoro, another mother struggling to feed her baby, told AP News. “We need formula for our kid, and where is this formula going to come from?”
While feeding infants formula is sometimes necessary, the American Academy of Pediatrics recommends babies be fed nothing but breast milk for the first six months and for at least one year.
However, breastfeeding rates in the United States are some of the lowest of high-income countries, according to a UNICEF report.
Why Aren’t American Women Breastfeeding?
Given the vast benefits of breastfeeding, such as protection against disease, most women in the US recognize that breastfeeding is the best source of nutrition for most infants, according to the Surgeon General’s Call to Action to Support Breastfeeding.
Capri was no exception.
However, she felt a lack of breastfeeding support, like many mothers, in the hospital.
Capri planned on breastfeeding her 1-month-old baby, but the hospital gave her baby formula without consulting her.
Studies show that formula marketing decreases confidence in a mother’s ability to breastfeed, especially when supplied by healthcare providers or facilities.
Additionally, when hospitals feed infants formula it can increase the baby’s risk for diseases, such as obesity and diabetes, and make it difficult for mothers to produce enough breastmilk, according to the CDC.
It can even lead to babies refusing to breastfeed.
This very situation led Capri to seek help through a lactation consultant, an emotional and teary-eyed experience that highlighted the stress she was under trying to alleviate her baby’s hunger pains amid the baby formula shortage, she told AP News.
A Lack of Healthcare Support for Breastfeeding
Unfortunately, it’s common for US hospitals not to fully support breastfeeding.
In fact, the Centers for Disease Control and Prevention (CDC) states that hospitals should do more to help mothers start and continue breastfeeding.
“Hospitals that wait to start the first breastfeed, or separate babies from mothers, or routinely give formula to breastfeeding babies make it harder for mothers and babies to be able to breastfeed,” stated the CDC. “When hospitals support mothers to feed their babies only breast milk, it helps mothers to continue feeding only breast milk at home.”
Support for breastfeeding mothers also requires further instruction from healthcare providers.
According to the Surgeon General, information about breastfeeding and infant formula is rarely provided by women’s obstetricians during their prenatal visits, and many women rely on books, leaflets, and other written materials as their only source of information on breastfeeding.
However, these written materials are not as effective as having instructive role models, especially for low-income women or Latinas.
Breastfeeding is Not the Social Norm
Breastfeeding support can also be overshadowed by baby formula.
The Surgeon General stated that there is a societal preference for formula feeding in America, which stems from the widespread exposure to baby formula and the misconception that baby formula is equivalent to breast milk.
This misconception is even prevalent among some healthcare providers, potentially further discouraging mothers from breastfeeding.
The social norm for formula feeding has even infiltrated into immigrant families, such as a Latinas, with rates of breastfeeding decreasing with each generation in the US.
Further, preference for formula feeding is bolstered by women’s breasts being sexualized in American culture.
Americans are quick to celebrate women’s breasts in the media but quicker to judge a woman for publicly breastfeeding.
In fact, women only recently gained the right to publicly breastfeed in all 50 US states.
Women who do breastfeed in public are encouraged to cover up for modesty, an inconvenience that may require buying breastfeeding-friendly clothes, or modifying the current clothes in their closet.
And, if mothers are not modest enough while breastfeeding, they may be asked to stop or leave the public place, despite being protected by the law.
“Such situations make women feel embarrassed and fearful of being stigmatized by people around them when they breastfeed,” the Surgeon General stated. “Embarrassment remains a formidable barrier to breastfeeding in the United States and is closely related to disapproval of breastfeeding in public.”
Inadequate Accommodations in the Workplace
Just as mothers lack breastfeeding support in public, they often lack support in the workplace.
As part of the Affordable Care Act, employers must provide a private space (not a bathroom) and sufficient time for mothers to express milk.
However, many places of employment still lack these accommodations, especially businesses with fewer than 100 employees, according to the Surgeon General.
For low-income mothers, such as Latinas, who may work for an hourly wage, pay may be reduced if they take breaks to express breast milk to later feed their baby.
Lack of maternity leave can also be a significant barrier to breastfeeding.
While the Family Medical Leave Act requires US employers (with 50 or more employees) to allow mothers to take unpaid time off (up to 12 weeks) for the purpose of pregnancy or child-rearing, there is no requirement for employers to provide pay during maternity leave.
Thus, maternity leave can be unaffordable, especially for low-income mothers, such as Latinas.
However, going back to work impacts women’s ability to breastfeed, studies show.
“Women intending to return to work within a year after childbirth are less likely to initiate breastfeeding, and mothers who work full-time tend to breastfeed for shorter durations than do part-time or unemployed mothers,” the Surgeon General stated.
Unfortunately, because breastfeeding is not often supported in the workplace through proper accommodations, mothers find themselves sacrificing breastfeeding for financial responsibilities.
Mothers Need Equitable Breastfeeding Support
Each woman’s breastfeeding and motherhood journey is different, and there are potentially many more inequitable reasons a woman may not be able to breastfeed.
It is also important to recognize that some mothers simply cannot breastfeed due to complications, such as mastitis and inadequate milk production, and formula feeding does not mean that they love their baby any less.
While devastating to many, the formula shortage sheds light on perhaps a bigger issue – America has lost sight of maternal needs, including breastfeeding support.
The lack of breastfeeding support American mothers receive from healthcare providers, society, and the workplace is an injustice considering the selfless responsibility required to endure pregnancy, childbirth, and post partem healing.
More support is desperately needed to help ensure the health of generations to come.
“Policymakers and advocates should promote breastfeeding via formula marketing reduction, paid maternity leave, and break time or private places to express milk at work,” according to a research review by Dr. Amelie G. Ramirez, director of Salud America! at UT Health San Antonio. “Providers should use culturally tailored prenatal programs to promote breastfeeding, maternal healthy lifestyles, and proper infant feeding habits among Latinas.”
How Can You Make Systemic Changes for Latino Health Equity?
Download a Salud America! Health Equity Report Card!
The report card shows local rates of infant mortality, children in poverty, population receiving federal food aid, health insurance coverage, and more via maps and data visualizations, which you can compare to the rest of your state and to the country.
Email your Health Equity Report Card to community leaders and share it on social media.
Then use it to make the case to address health inequities where help is needed most!
Get your Health Equity Report Card!
Resources For Navigating the Baby Formula Shortage
The U.S. Department of Health and Human Services has put together an information webpage for families during the baby formula shortage.
Available in English and Spanish, the webpage includes tips on finding formula, safe formula substitutes, breastfeeding, and more.
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