Why US doctors don’t recommend homemade baby formula

With the United States in the midst of a baby formula shortage, parents across the country are increasingly worried about how they will feed their children.

Some are rationing food or driving to stores hours away only to find empty shelves. Others are heading online to look up homemade baby formula recipes that use anything from powdered goat’s milk to raw cow’s milk.

But paediatricians warn that do-it-yourself baby formulas carry significant health risks.

“Homemade formula is dangerous for babies,” said Dr Katie Lockwood, an attending physician at Children’s Hospital of Philadelphia Primary Care. “Regular formula is FDA-regulated and held to very high standards, the same way we treat medications. Making it at home is a lot riskier.”

Commercial infant formulas are designed to mimic human breast milk as closely as possible, and are carefully regulated to make sure they have the nutrients growing babies need — in a form their bodies can process.

“The nutrients in homemade formulas are inadequate in terms of the critical components babies need, especially protein and minerals,” said Dr Steven Abrams, a spokesperson for the American Academy of Paediatrics. The group has “strongly” advised against homemade formulas.

Such formulas can also contain an excess of minerals or nutrients, like salt, which a baby’s developing kidneys or liver may be unable to break down. Even the amount of water used in DIY recipes poses a potential risk.

“The big concern is the balance of the nutrients and the liquids that are added, because if those are not right, that can set up a situation where the baby might get too much water,” said Dr Suzette Oyeku, chief of academic general paediatrics at the Children’s Hospital at Montefiore, in New York City. That can cause a condition known as water intoxication, which can lead to dangerous complications like seizures in young babies.

In recent years, there have been a handful of case studies that speak to the potential dangers of going the do-it-yourself route. One 4-month-old baby went into cardiac arrest after being fed a homemade baby formula that included sea moss, hemp seeds and coconut water for a month.

Contamination is another concern. Parents making formula at home may also unwittingly introduce bacteria or other germs that can be especially dangerous for babies under 6 months whose immune systems are still developing, Lockwood said.

Stock of baby formula is low in part because of ongoing supply chain issues attributed to the pandemic, but the problem was exacerbated by the Food and Drug Administration’s closing an Abbott Nutrition facility in February after several children became sick with bacterial infections potentially related to its Similac, Alimentum and EleCare formulas.

Yet paediatricians say that commercial formulas remain safer than DIY options. The facility shutdown slowed formula production, but it was implemented to keep children safe, experts said. “It is a sign the system is working,” Oyeku added.

What can parents do instead?

The first call any parent or caregiver struggling to track down baby formula should make is to their child’s pediatrician. They may have formula samples on hand, or be able to help connect you with local charities or breast milk banks that can help.

As of the end of last week, 43% of baby formula products were out of stock nationwide, but Lockwood said the shortage has been coming in “waves.” Most parents should use whatever they can find on the shelves or online from well-known distributors and pharmacies, and not worry that switching formulas will harm their children.

It is safe for most babies to switch to any FDA-approved formula they can find, Abrams said, unless they have specific dietary needs. Babies who are on an extensively hydrolysed formula for allergies, for example, will need a comparable replacement, as will babies with specific medical needs. To address that need, the FDA is now allowing Abbott Nutrition to release “urgent, life-sustaining supplies” of certain specialty formulas on a case-by-case basis.

“A health care provider has to submit the form, but that is a response to this specific need,” Oyeku said.

In a pinch, babies over 6 months — with no known allergies — can have pasteurized whole-milk cow’s milk for a brief period until parents are able to find formula. While not ideal in large part because it does not provide sufficient iron, it’s preferable to offering them homemade formula or diluting store-bought formula with water, Abrams said.

If your situation is urgent, check with your child’s paediatrician. They can help come up with a plan for finding formula, and even serve as an emotional sounding board before parents turn to things like homemade recipes.

“Feeding your baby is such a vital part of what you do as a parent,” Lockwood said. “It can be really anxiety-provoking to feel like you’re not able to meet that basic need.”

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