Is the US infant formula shortage an avoidable crisis?

Since February, 2022, there has been an acute shortage of commercial milk formula in the USA. In a media statement on May 12, 2022, US President Joe Biden announced steps to improve formula supply, including simplifying product offerings, calling on state attorneys general to monitor and address price gouging and predatory behaviour in the market, and increasing imports.3 Similarly, when the American Academy of Paediatrics (AAP) provided tips for what parents should do if they could not find formula, its recommendations included checking smaller stores, buying formula online, switching formula brand, and checking social media groups for advice on where to find supplies.12 As one of the most influential sources of paediatric information in the USA, the AAP has a stark conflict of interest, since it receives substantial financial support from commercial formula producers.13,14 Brendan Smialowski/Contributor/Getty Images These responses to the shortage do not recognise the need to reduce demand for infant formula. Human milk banking is gaining increased attention with the growing awareness of potential harm from commercial milk formula, as highlighted by lawsuits against Abbott Laboratories and Mead Johnson that claim the companies did not warn about the increased risk of necrotising enterocolitis in preterm infants fed Enfamil or Similac compared with those fed human milk.15,16 Relactation and increased donation of excess breastmilk to Human Milk Banking Association of North America accredited milk banks would help to minimise the effect of this shortage and are included among the recommendations of the Academy of Breastfeeding Medicine.17 Breastfeeding has substantial benefits for children, women, society, and the environment.