Families in America should never have to scrounge for baby formula. The United States needs a diverse and resilient supply of infant formula. Boosting the ability of smaller companies to compete in this market against the three large formula makers — Abbott, Mead Johnson, and Nestlé Gerber — could help make shortages a thing of the past.
We come at this issue from different perspectives. One of us (M.G.) scrambled to find formula for her twin grandsons, who were born nearly three months early in February 2022. The other (R.D.), the ranking member of the U.S. House of Representatives’ Appropriations Committee, has long been focused on bolstering food safety in the United States.
Here’s the background: In February 2022, Abbott recalled three brands of its baby formula after four babies became sick with bacterial infections after consuming the company’s formula. When a Food and Drug Administration inspection uncovered traces of a potentially deadly bacteria in Abbott’s main production plant in Sturgis, Mich., the company shut down the plant, which at the time produced more than 40% of U.S. formula. The shutdown caused cascading supply chain problems, creating a severe shortage of baby formula that lasted more than a year.
When my (M.G.’s) grandsons were finally brought home from the neonatal intensive care unit in May 2022, my son and daughter-in-law were told to continue the feeding protocol that had sustained them in the hospital, supplementing mother’s milk with Similac NeoSure, made by Abbott, or Enfamil NeuroPro, made by Mead Johnson. In Minnesota, where my grandsons lived, the out-of-stock rate — the percentage of empty shelves for an item — was 88.5%. (The average out-of-stock rate in the U.S. is typically about 8%). Ten states fared even worse, with out-of-stock rates in excess of 90%.
I jumped into action. The metro area where I live, Kansas City, had one of the lowest out-of-stock rates for formula in the country, though it still exceeded 50%. But my visits to several grocery and big box stores proved futile. In store after store the shelves dedicated to infant formula were pathetically bare. Some had a meager supply of one or two brands of formula for healthy babies or toddlers, usually with a handwritten sign specifying a limit of one or two cans per customer. No one had any of the specialty brands made for premature infants like ours or for babies with other special needs, such as those who were lactose intolerant, those with acid reflux, or infants with other special dietary needs.
I turned to the internet and eventually found an online distributor in New York that carried one of the formulas my family needed in bulk. I texted the information to my son who gratefully ordered a case to be delivered directly to their home. Just to be sure, I bought another case to keep at our house. Eventually, the boys needed that, too.
In the same time frame, I (R.D) was hearing stories like Martha’s from my constituents. Since I was first elected to Congress in 1990, I have put working families at the center of my legislative agenda. Parents in these families work hard, often at more than one job, to provide for their children, and did not have the time or resources to track down formula in the next town or state. I worked to get safe, nutritious infant formula back on the shelves because I knew how much families were struggling.
In May 2022, I held a roundtable discussion with mothers and grandparents in my district. They told me how impossible it was to find infant formula. Some mothers were adding cereal to their milk to ensure their babies received the nutrients they needed. One working mother who had depended on infant formula to feed her children realized she had been using recalled product and had to throw it all out.
To ensure that families will have the formula they need to feed their babies, I introduced a number of infant formula bills to improve food safety and avoid another shortage, including the Keep Infant Formula Safe and on the Shelves Act which made infection with Cronobacter — the bacteria that contaminated Abbott’s Similac product — a reportable disease nationwide.
But there were two issues at the heart of the 2022 crisis: food safety and supply. For far too long, only a few giants have dominated the infant formula market, with three companies controlling nearly 97% of the market. That’s why in March 2004 I introduced the Infant Formula Made in America Act with my colleague, Sen. Bob Casey (D-Pa.). This bill is intended to create a more resilient domestic market for infant formula so Americans never again face the dire shortages that sent frantic parents scrambling to feed their babies just two years ago.
This bill would provide tax credits for infant formula manufactures with less than $750 million a year in annual sales, providing a boost these smaller companies need to compete against Abbott, Mead Johnson, and Nestlé Gerber. These credits would give smaller companies incentives to expand their manufacturing operations and increase their output, providing more production alternatives, and thus greater diversity, to the highly concentrated formula market.
Diversifying formula manufacturing capacity across more firms and more factories will help prevent major market disruptions should one company need to shut down operations due to safety, sanitation, or other issues.
Having a safe and reliable supply of infant formula is an issue that affects millions of American families. More than half of the 3.7 million babies born in the U.S. each year will be fed formula, either as a supplement or as their exclusive source of nutrition. Until the U.S. addresses the extreme concentration in the infant formula industry, the country is just one plant closure away from empty shelves that send panicked parents searching far and wide for the sustenance their babies need. Passing the Infant Formula Made in America Act of 2024 will be an important step in that direction.
Martha Gershun is a nonprofit consultant, writer, and community volunteer living in Fairway, Kan. Rosa DeLauro has been the Democratic U.S. representative for Connecticut’s 3rd congressional district since 1991.