2022 US Infant Formula Shortages Crisis: Family Vulnerability and Lack of Lactation Support

Context of formula shortages

Recently, formula recalls occured in the US due to 3 cases of botulism linked to the consumption of Nara Organics brand infant formula .

In 2022, the United States experienced a major infant food insecurity crisis triggered by the closure of a major manufacturing plant (Abbott Nutrition) and global supply chain disruptions. This crisis revealed the fragility of nutrition systems in high-income countries heavily dependent on commercial milk formula (CMF). A scoping review analyzed the experiences of over 2,000 parents and caregivers, identifying four critical themes.

Key Identified Themes

1.  Feelings of Failure and Emotional Distress

    The inability to procure formula generated a profound sense of parental failure, anxiety, guilt, and shame, particularly among parents of newborns. The exhausting quest for product harmed the parent-infant bond and exposed vulnerable families (low income, minorities) to increased inequalities.

2.  Vulnerable Supply Chains

    Traditional purchasing methods became unpredictable. Parents resorted to creative, often risky solutions:

    *   Creation of online groups to track restocking.

    *   Unregulated informal markets leading to scams and price gouging.

    *   Reliance on family and friends for sourcing.

3.  Health-Risk Adaptations

    Faced with formula shortages, many families adopted potentially dangerous feeding practices to stretch their supplies:

    *   Diluting formula with water, animal milk, or breastmilk (rising from 2% to 29% of cases).

    *   Rationing feeds or introducing solid foods prematurely.

    *   Substitution with other formula types (e.g., "follow-on" formulas) or homemade formula preparation.

    *   Extensive use of informal breastmilk donations via social media, despite health warnings regarding the lack of quality control.

4.  Critical Lack of Support for Breastfeeding and Relactation

    Despite breastfeeding being a safe alternative, parents reported a glaring lack of support to initiate or reinitiate lactation (relactation).

       *Structural Barriers:** Absence of paid parental leave, reduced post-pandemic lactation services, and a lack of cultural and gender diversity in support services.

       *Social Pressure:** Societal expectations to "just breastfeed" exacerbated guilt for those unable to do so, without offering real alternative pathways.

Conclusion and Implications

The 2022 crisis demonstrated that cultural dependence on commercial formula creates a critical breaking point during emergencies. The United States, a high-income country, is not immune to risks associated with a fragile infant food system.

For lactation professionals and policymakers, this study highlights the urgent need to:

• Strengthen Emergency Preparedness: Integrate national action plans for infant nutrition during crises (stockouts, pandemics).

•  Improve Relactation Access: Train more professionals and make lactation support services more accessible and inclusive.

•   Secure Alternatives: Regulate and facilitate safe access to breastmilk donation banks while educating on the risks of informal networks.

• Reduce Formula Dependence: Promote public health policies that support breastfeeding as a national security norm, not just an option.

Synthesis based on the study by Jansch, E., Atchan, M., & Bazargan, M. (2026). Exploring the Experiences of Families Impacted by the 2022 Commercial Milk Formula (CMF) Food Insecurity Crisis in the United States of America: A Scoping Review. Journal of Human Lactation.