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How the formula shortage widens racial disparities for breastfeeding mothers

While it could take weeks or even months to alleviate the nation-wide baby formula shortage, women of color and low-income families will bear the brunt of the crisis.
Image: Shot of a mother feeding her adorable infant daughter at home
Hiraman / Getty Images

Mississippi resident, Michelle White, did not know how she was going to feed her 5-month-old son last week.

The formula her son uses, Enfamil Gentlease, has been missing from the shelves of her local Kroger and Walmart for weeks, she told Know Your Value. By state law, they are the only two stores where she can use her federal benefits to purchase formula. She, like thousands of other parents, depends on the federally subsidized nutrition program for low-income women, infants and children, known as WIC.

But the state of Mississippi does not allow parents to substitute brands under the program, so White, a single mother of two, has had to pay out-of-pocket for any generic formula she can find for the last six weeks.

Image: Michelle White's five-month-old son, Kyler.
Michelle White's five-month-old son, Kyler.Courtesy Michelle White

It's not an easy cost for the 32-year-old, who runs a cleaning service in Olive Branch, Miss., and delivers with Doordash part-time.

Setting aside $20 for each can of formula every two days amounts to spending less on groceries and contributing less to her electric bill. "It takes away from the pot on something else," White explained.

With more than 40 percent of all baby formulas out of stock nationwide, it's been nearly impossible for millions of parents to buy formula. Had it not been for the generosity of people she found through Facebook groups donating sample cans of formula, she is sure her son would have gone hungry.

"I have people literally sending me formula from Canada, Florida, California, New Jersey and Texas as we speak," White said. "If it hadn't been for the world coming together, I honestly don't know that I would have made it through."

Among those grappling with the formula shortage, low-income families – the majority of whom are Black and Hispanic – are suffering the most. Sixty-five percent of all baby formula in the U.S. is purchased through WIC. Half of the infants who receive WIC benefits rely on formula from Abbott, which includes Similac, Alimentum, and EleCare.

The status of federal intervention

Last week, President Biden announced a shipment of 78,000 tons of baby formula arrived in the U.S. from Germany as part of an effort to address the shortage. The supply is equipped to feed 9,000 babies and 18,000 toddlers with allergies to milk protein for up to one week, according to the Secretary of Agriculture. A second shipment also arrived this week, carrying 100,000 pounds of baby formula from Germany to Washington, D.C.

Separately, President Biden invoked the Defense Production Act to speed up formula production from "priority" manufacturers, Reckitt and Abbott Nutrition, the company whose recall jumpstarted the nationwide shortage. Biden also signed a bill into law this month to expand access to the WIC program for parents buying formula.

Monopoly capitalism feeds the formula shortage

But the more significant issue behind the shortage is the consolidation of the formula market, according to Kelly Davis, co-founder and CEO of Kinshift, a healthcare consulting firm focused on anti-racism and Executive Director of New Voices for Reproductive Justice.

Just four companies – Abbott, Reckitt, Nestlé and Perrigo – account for 89 percent of the baby formula market in the U.S.

"Can you think about what the country would look like if four companies made a product like flour? We'd be in crisis," Davis told Know Your Value. "If WIC is aiding and abetting these kinds of monopolies that wind up with Black children and other poor children putting their lives at risk, we really have to ask ourselves, is this the legacy that we want for the richest nation in the world?"

Coming from a low-income background does not guarantee that parents can even qualify for WIC. Alexis Perry, a stay-home-mom from Rhode Island, told Know Your Value that she has a son who was born with a rare food allergy that affects his GI tract: food protein-induced enterocolitis syndrome.

Image: Alexis Perry of Rhode Island with four sons.
Alexis Perry of Rhode Island with four sons.Courtesy Alexis Perry

At two years old, her son, Ja'Zekiel, relies on infant formula to maintain a healthy weight. Although the family is considered low-income, Rhode Island's WIC policies don't cover the $300 monthly formula cost because he is over a year old.

Creating an added pressure for her is the recall of the specialized Similac formula she gave Ja'Zekiel. In December, she took him to the hospital after he developed a fever, severe diarrhea and would not stop vomiting. Doctors surmised his food allergies caused his symptoms, but Perry was doubtful. “As a mother, I feel like it was probably something more,” she said.

When Perry received a mail notice that her son’s Similac had been recalled, she switched him to a different, allergy-friendly formula. But Alfamino Junior couldn't be purchased in stores and proved difficult to find online amid the shortage.

Ja'Zekiel wasn’t gaining any weight when she gave him alternatives like soy and almond milk either. In fact, he grew sicker. "I was trying just to supplement what I could, but not having the formula affected him," Perry said.

"You want your child to have the best," she added. "Not being able to give them that is hard."

When breastfeeding isn’t ‘free and available on demand’

Celebrities and commentators like Bette Middler, Eric Sammons, and others have argued mothers can solve the formula crisis by simply breastfeeding their children. But the reality of breastfeeding for many parents is far more complicated and often exacerbates racial and income inequities.

According to the ACLU, women of color are more likely to work in jobs that pose challenges to breastfeeding or pumping, such as inflexible work hours and a lack of paid family leave. Black mothers in particular return to work after having a baby on an average two weeks earlier than any other racial group, according to the National Institutes of Health.

"Providing formula is one issue, but giving paid sick leave, paid family leave, and support for those who need to express or pump breast milk at work, so they do not have to depend on formula should they not want to, is another," Davis said. "A lot of the formula demand comes from the fact that almost immediately after giving birth, low-income people have to go back to work."

Many mothers who can breastfeed still rely on baby formula to supplement their child's needs. Such was the case for Kali McCoy from Atlanta, who found she couldn't produce the same level of milk her son needed while she was pumping at her office.

Image: Kali McCoy of Atlanta with her husband, Elijah, and their son Kai.
Kali McCoy of Atlanta with her husband, Elijah, and their son Kai.Courtesy Kali McCoy

McCoy, 26, relies on Enfamil Enspire for her 11-month-old son, Kai, when she isn't home to breastfeed and when pumping isn't enough. "Breastfeeding is a journey that you have no control over. It can stop as quickly as it started," she told Know Your Value. "I know breastfeeding moms are on edge right now and doing whatever they can to keep their supply up so that they don't become sitting ducks."

McCoy remains worried about the scarcity of baby formula, even with the various forms of federal intervention. But she is predominantly concerned for moms who rely solely on formula. "I would not know how to cope if there were no way for me to feed my child," she said.