Formula shortage: practical steps when your usual formula is unavailable
Discovering that your baby's usual formula is out of stock - at your usual pharmacy, then at three more, then online - is genuinely frightening. Infants depend entirely on formula or breast milk for their nutrition, and there is no easy workaround in the way there is when adult food runs short. This guide brings together the most current guidance from the American Academy of Pediatrics (AAP) and the Food and Drug Administration (FDA) to help you identify what is safe, what is not, and where to find supply.
The most important message first: for healthy, full-term babies on standard formula, switching brands is safe. Store-brand formulas and name-brand formulas meet the same FDA nutritional requirements. You do not need to call your doctor before making that switch.
Why formula shortages happen
Formula supply disruptions are more likely than many parents realise, for several structural reasons.
Manufacturing concentration. The infant formula market in the United States is dominated by a small number of large manufacturers. Four companies - Abbott Nutrition, Mead Johnson, Nestle, and Perrigo - account for the vast majority of formula sold domestically. When a single large facility is disrupted, the effect ripples across a significant share of national supply. The 2022 shortage was triggered largely by a voluntary recall and temporary closure of Abbott's Sturgis, Michigan facility following contamination concerns, combined with supply chain disruptions that were already straining inventory.
Recalls. Safety recalls are an important consumer protection, but a recall of a major brand pulls large volumes of product from shelves simultaneously. Parents who relied on the recalled brand suddenly compete for alternatives.
Supply chain fragility. Formula ingredients - including specialised whey proteins, vegetable oils, vitamins, and minerals - are sourced globally. Disruptions to shipping, ingredient availability, or packaging supply can all cause downstream shortfalls.
Panic buying. Once news of a shortage breaks, stockpiling by worried parents can empty shelves faster than the underlying supply reduction would cause on its own, creating a feedback loop.
Understanding these causes does not solve an immediate shortage, but it does help to know that shortages, when they occur, are usually temporary - and that regulators and manufacturers have tools (emergency imports, expedited production, import waivers) to accelerate recovery.
What is safe when your formula is unavailable
The following options are considered safe by the AAP and FDA for healthy, full-term infants, with the caveats noted.
Switching formula brands
For healthy, full-term babies on a standard cow's milk-based formula, switching to a different brand of standard cow's milk formula is safe and does not require a call to your paediatrician. All infant formulas sold in the United States must meet the nutritional standards set out in the Infant Formula Act and enforced by the FDA. Whether the tin says Similac, Enfamil, Gerber, or a store own-brand, the core nutritional profile is required to meet the same benchmarks.
Some babies notice a taste difference or have a brief period of adjustment when switching brands, which may manifest as slightly different stool consistency or increased gas. This is normal and typically resolves within a few days.
Store-brand and generic formulas
Store-brand formulas sold under supermarket and pharmacy own-labels are not inferior to name brands. They meet the same FDA nutritional standards and are often manufactured by the same contract manufacturers that produce name-brand products. Cost savings of 30 to 40 percent compared with name brands are common without any reduction in quality or safety.
If you have been buying name-brand formula purely out of habit or because it was what the hospital sent you home with, a store-brand equivalent is a fully valid alternative in any circumstance, shortage or not.
Switching within the same category
Formula is broadly organised into categories: standard cow's milk, partially hydrolyzed (for easier digestion), extensively hydrolyzed (for cow's milk protein allergy), elemental or amino acid-based (for severe allergies or medical conditions), and soy-based.
For a healthy baby on standard cow's milk formula, switching to another brand within that standard cow's milk category is safe without medical consultation. Moving between types within the same tier - for example from one partially hydrolyzed formula to another - is also generally safe, though checking with your paediatrician is reasonable if you are uncertain.
If your baby is on a partially hydrolyzed formula because of mild gassiness or perceived fussiness (not a confirmed allergy), temporarily switching to a standard cow's milk formula during a shortage is unlikely to cause harm. Monitor your baby and switch back when your preferred formula is available.
If your baby is on specialty formula
If your baby has been prescribed an extensively hydrolyzed, elemental, amino acid-based, or preterm formula for a medical reason - including cow's milk protein allergy, multiple food protein intolerance, malabsorption, or prematurity - do not switch without speaking to your paediatrician or specialist first. These formulas are not interchangeable with standard formulas for babies who depend on them medically, and an inappropriate switch can cause a serious reaction or nutritional deficit.
In a genuine shortage of specialty formula, your paediatrician or specialist can help you identify the closest safe alternative, contact the manufacturer for emergency supply, or refer you to WIC or a hospital social worker who may have access to additional resources.
For babies over 6 months: temporary cow's milk
The AAP standard guidance is that whole cow's milk is not appropriate as a primary nutrition source for babies under 12 months because it lacks sufficient iron, vitamin E, and essential fatty acids, and its high protein and sodium levels can stress infant kidneys. However, in a genuine formula shortage, the AAP has said that whole cow's milk may be used as a temporary supplement for babies aged 6 months and older - meaning it can partially replace formula for a short period while you locate an adequate supply, but should not entirely replace formula or breast milk.
If your baby is over 6 months old and already eating solid foods, prioritise iron-rich foods (iron-fortified cereals, pureed meat, lentils) during any period of cow's milk supplementation, since cow's milk is low in iron. Return to formula or breast milk as the primary fluid as soon as you can.
Cow's milk is not appropriate in any quantity as a primary drink for babies under 6 months.
What is not safe
The following approaches are dangerous and should not be attempted under any circumstances, including during a shortage.
Diluting formula
Adding extra water to formula - to stretch the supply further - dilutes the concentration of sodium in what the baby drinks. This causes hyponatremia (dangerously low blood sodium levels), which in infants can cause seizures, brain swelling, coma, and death. Hyponatremia from over-diluted formula is a medical emergency. Always prepare formula exactly according to the label instructions, using the precise ratio of powder or concentrate to water specified.
If cost or supply is a concern, the answer is to find alternative sources of formula (see below), not to dilute what you have.
Homemade infant formula
During shortage periods, recipes for homemade infant formula circulate widely on social media and parenting forums. These recipes - which often involve raw cow's milk or goat's milk, corn syrup, and added vitamins - are not safe. They have caused infant deaths and serious illness.
The problem is not simply that the recipes are nutritionally incomplete, though they are. It is that infant nutrition requirements are exceptionally precise. Too much or too little of certain minerals, the wrong ratio of proteins, absent or incorrect fat-soluble vitamins, or inadequate iron can all cause irreversible harm in a growing infant. Home cooks and even well-meaning chemists cannot replicate the manufacturing controls, nutritional testing, and consistency that commercial formula production requires.
The FDA and AAP both advise unequivocally against all homemade infant formula, and this advice holds even if a professional-seeming recipe claims to be evidence-based or inspired by historical practice.
Toddler formula for infants
Toddler formula (also called growing-up milk or transition formula) is marketed for children aged 12 months and older. Its nutritional profile is designed for that age group and it is not equivalent to infant formula. Using toddler formula for infants under 12 months is not recommended; it may provide inadequate protein of the right type, insufficient iron, and an inappropriate balance of macronutrients for an infant's developmental stage.
Plant-based milks
Oat milk, almond milk, rice milk, and other plant-based beverages are not suitable as a formula substitute for infants at any age. They do not provide adequate protein, fat, or the full range of vitamins and minerals an infant requires. They are not regulated as infant nutrition and should not be used as a primary or supplementary food source for babies under 12 months.
Where to find formula during a shortage
When the obvious first sources are empty, here is where to look next.
- Independent and smaller grocery stores. Large chain supermarkets and big-box stores are the first to empty during a shortage. Smaller independent grocery stores and ethnic food markets often stock brands not carried by major chains and may have inventory remaining.
- Pharmacies. Independent pharmacies sometimes receive shipments separately from supermarket supply chains. Call ahead rather than making multiple trips.
- WIC offices. If you are enrolled in WIC, your office can help you identify alternative brands that are WIC-approved, which may include brands that are still in stock. WIC offices are also sometimes able to issue vouchers for alternative products during documented shortages.
- Manufacturer direct contact. Major formula manufacturers have customer service lines and sometimes maintain lists of retailers with current stock. Some have offered direct shipping to families during shortage periods.
- Online retailers. Amazon, Walmart.com, Target.com, and specialist baby retailers sometimes have stock that bricks-and-mortar stores have exhausted, though prices should be watched - price gouging during shortages is illegal but does occur.
- Community groups and local mutual aid. Local parenting Facebook groups, Nextdoor, and Buy Nothing groups sometimes facilitate formula sharing between families. This is generally safe for sealed, in-date, standard formula from a familiar brand - apply the same common sense you would apply to any food received from a neighbour.
- Your paediatrician's office. Paediatric practices often keep sample supplies of formula donated by manufacturers. Call your baby's doctor and explain the situation; they may be able to provide enough to bridge a few days.
How to compare formula labels when switching
If you need to switch brands and want to verify that a new formula is comparable to your usual one, here is what to look for on the label.
Type classification. The label will indicate whether the formula is cow's milk-based, soy-based, partially hydrolyzed, or extensively hydrolyzed. Match this to your baby's current formula type first.
Age range. Make sure the formula is labelled for infants (0-12 months), not for toddlers.
Iron fortification. The AAP recommends iron-fortified formula for all formula-fed infants. The label should state "with iron" or indicate that the formula meets the iron content requirements for infant formula. Low-iron formulas are rarely indicated and are not recommended for most infants.
DHA and ARA. Most modern infant formulas include DHA (docosahexaenoic acid) and ARA (arachidonic acid), fatty acids associated with brain and eye development. These are optional under FDA rules but are present in the majority of mainstream formulas. If your current formula includes them, switching to one that also includes them is a reasonable goal, though a brief gap is not harmful.
Preparation instructions. Always follow the preparation instructions on the label of the formula you are using, not the instructions from your previous formula. Scoop sizes, water ratios, and preparation steps can differ between brands even within the same category.
Checking formula safety: recalls and alerts
Before buying formula you are unfamiliar with - especially from an online third-party seller - check the FDA's recall database at fda.gov/recalls-market-withdrawals-safety-alerts. Search for the brand name and look for any active recalls or alerts. Formula subject to an active recall should not be purchased or used.
Also check the expiry date before any purchase. Formula has a finite shelf life; expired formula may have degraded nutritional content. Do not use formula past its use-by date.
If you are considering purchasing formula that was originally intended for sale in another country - including formula available on some international retail sites - be aware that formulations, labelling, and nutritional standards vary internationally. FDA-regulated domestic formula is the safest option. If you do use imported formula in an emergency, check with your paediatrician.
A reassuring word for parents
It is worth restating clearly: for healthy, full-term babies on standard cow's milk formula, brand loyalty is a preference, not a medical necessity. The FDA's regulatory framework for infant formula exists precisely so that parents can rely on the fact that any compliant product on the shelf will meet their baby's nutritional needs. A baby who moves from one standard formula to another for a few weeks will be fine.
The situations where extra care is needed are specific and identifiable: premature babies, babies with confirmed allergies or metabolic conditions, and babies on specialty formulas. If your baby is in one of those groups, you already have a relationship with a paediatrician who can guide you. If your baby is healthy and full-term, the range of safe options is broader than many parents realise during a stressful shortage event.
Frequently asked questions
Can I switch formula brands if my usual one is unavailable?
For healthy full-term babies, switching to another standard cow's milk-based formula is generally safe without consulting a doctor first. Store-brand and name-brand formulas meet the same FDA nutritional requirements. If your baby is on a specialty formula (soy-based for medical reasons, extensively hydrolyzed, or amino acid-based), call your pediatrician before switching.
Is it safe to dilute formula to make it last longer?
No. Diluting formula is dangerous and can cause hyponatremia (low sodium), seizures, and in severe cases death. Always prepare formula according to the label instructions. If cost is a concern, contact WIC or a local food bank for help.
What about homemade infant formula recipes?
Homemade infant formula is not safe. Recipes circulating online and on social media do not provide the correct balance of nutrients for a growing infant and have caused serious illness and deaths. The FDA and AAP advise against all homemade formulas.
My baby is 7 months old and I cannot find formula. Can I use cow's milk?
For babies aged 6-12 months, the AAP says whole cow's milk may be used as a temporary supplement in a shortage, but should not replace all formula or breast milk. Cow's milk lacks sufficient iron and other nutrients for this age group. Contact your pediatrician for guidance specific to your baby.