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Formula Shortage: Health Literacy’s Role in the Access to Infant Nutrition

Amanda Baethke
Director of Corporate Development, Aeroflow Healthcare

The baby formula shortage that began in February 2022 wreaked havoc across the nation leaving parents and infants in dire need of supply. The crisis raised questions about the regulation of formula and prompted calls for broader reliance on breastmilk and to increase support and health information for breastfeeding parents. 

Health literacy plays an imperative role in times of crisis and can be the one thing separating a new parent from being able to feed their baby. 

The formula shortage crisis began with the shutdown of the Sturgis, Michigan, Abbott plant – one of the largest manufacturing facilities of the leading formula brand, Similac. Following an investigation by the U.S. Food and Drug Administration (FDA), the Centers for Disease Control and Prevention (CDC) reported that the contaminated formula may have been tied to the deaths of two infants and the hospitalization of two other infants with bacterial infections. 

Since the Abbott plant was shut down and recalls began, formula availability continued to worsen in the United States, and an overall shortage caused parents to begin turning to breast milk banks for sources of nutrition. However, milk banks were already seeing a 22% increase in demand for donated human milk with more than 9.2 million ounces of milk distributed in 2021. Add a formula shortage to this already high demand, and milk banks have been struggling to keep up. 

Other parents turned to the internet to search for recipes to make homemade baby formula – promoting the American Academy of Pediatrics to put out advisories to parents about the dangers of homemade baby formula

There are significant racial disparities in breastfeeding rates; limited or inadequate health literacy is a factor associated with early cessation of exclusive breastfeeding

Historically, the formula push onto Black women was only exacerbated by the formula shortage. After comparing maternity facilities in areas with more than 12.2% Black residents to areas with less than 12.2%, the CDC concluded the facilities with the larger minority population did not implement recommended practices related to early initiation of breastfeeding and limited use of breastfeeding supplements. This left families, especially those from minority populations, grappling with a short formula supply without tools, resources, and information to overcome the problem. 

Black women, particularly those with a low income, return to work earlier than women in other racial/ethnic groups and are more likely to experience challenges to breastfeeding or expressing milk, according to the CDC. This means they are in even dire need of formula or donations found at a milk bank; vulnerable families are hit hardest. 

We must address the gaps and barriers to equitable infant nutrition access and overall healthcare. 

  • Advocate for increased access to virtual lactation education and support programs covered through insurance. 
  • Integrate the “teach-back method” to check understanding (asking patients in their own words to state what they need to know or do about their health). 
  • Use simple terminology to avoid confusion and misunderstanding when speaking with patients.
  • Offer assistance in filling out complicated forms to ensure all information is recorded accurately in the patient’s medical record.
  • Create health literacy workshops before open enrollment periods to ensure all employees understand what plans are available to them to fit their health needs. 

Health literacy can no longer be ignored. We must work together to break the barriers and improve maternal and child health outcomes.  


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Aeroflow Healthcare was founded in Asheville, NC, in 2001 as a home oxygen provider and has since grown to become a nationwide provider of durable medical equipment. Patients and physicians nationwide are choosing Aeroflow as their provider for breast pumps, maternity compression, incontinence supplies, urological supplies, diagnostic sleep testing, CPAP equipment and supplies, nebulizers, and mobility equipment. Aeroflow’s mission is to provide innovative home healthcare solutions that allows one to spend more time in your home while lowering healthcare costs and improving overall quality of life.

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