Formula Shortages Continue....... Over 2 years later...
I would love to say that the infant formula shortage is over. Actually, let’s term it, “formula shortage” because tube
feeding formulas and oral nutrition supplements for older patients have also been impacted and continue as well!!
So, I would love to say that the formula shortage is over. But.. it's not.
It is absolutely insane that we are STILL struggling to consistently get NUTRITION products to those who need it!
The frustrations amongst parents, caregivers, and healthcare professionals are continuing to bubble. I knew this crisis would take some time to dig ourselves out of, but I don't think I imagined that I'd still be sharing unavailable lists like these,
It's been over 2 years since Abbott / Similac initiated their infant formula recall that put the formula industry into a tailspin. It's been 27 months & 2 weeks.
839 days to be exact.
So, why does it feel like I'm sharing info from day 83 instead?....
When is enough, enough?
Just a quick reminder! There are many reasons and considerations why someone may use formula for nutrition that have little to do with 'parent choice'. Here are a few things to know!
Anyone across the ages can use a feeding tube if it is warranted. From premature infancy to elderly and all in between.
All formulas are made to meet the nutritional needs of the intended user. An adult formula will meet an average adult's needs. An infant formula will meet an average infant's needs. Sometimes, specialty formulas are used to meet needs if needed. Sometimes, we add modular supplements to the plan to meet nutrient needs (an extra protein, fiber, vitamin packet, etc.).
Formulas can vary based on caloric / nutrient density, medical use and indications, amongst other factors!
Feeding tubes can be used temporarily or on a more permanent basis.
Some with feeding tubes rely on formula for their sole source of nutrition. Some with feeding tubes get nutrition through a combination of formula and eating by mouth.
Here are 10+ medical conditions that might necessitate the use of formula for feeding across different ages:
Gastroesophageal Reflux Disease (GERD): Specialized formulas can help manage symptoms and provide necessary nutrients without exacerbating reflux.
Crohn's Disease: Formulas can be used during flare-ups when solid foods are poorly tolerated, providing essential nutrition in an easily digestible form.
Cystic Fibrosis: High-calorie formulas can help individuals with cystic fibrosis meet their increased nutritional needs due to malabsorption.
Cancer: Patients undergoing chemotherapy or radiation may have difficulty eating solid food, and formula can help maintain nutritional status.
Short Bowel Syndrome: This condition, often resulting from surgical removal of parts of the intestine, may require specialized formulas to ensure proper nutrition and absorption.
Gastroparesis: This condition, characterized by delayed stomach emptying, can make it difficult to digest solid foods. Specialized formulas, often in liquid form, can be easier to digest and help ensure adequate nutrition
Severe Food Allergies: Hypoallergenic formulas can provide nutrition without triggering allergic reactions in individuals with severe food allergies.
Malabsorption Syndromes: Conditions like celiac disease, pancreatic insufficiency, Eosinophilic gastroenteritis, and many many others. may require the use of formulas that are easily absorbed and nutritionally complete.
Eosinophilic Gastroenteritis. This condition involves the infiltration of eosinophils (a type of white blood cell) into the gastrointestinal tract, leading to inflammation and damage. This can impair nutrient absorption and cause symptoms like abdominal pain, diarrhea, and weight loss. Specialized formulas, particularly hypoallergenic or elemental formulas, can help manage nutritional needs and reduce gastrointestinal symptoms in individuals with eosinophilic gastroenteritis.
Another example = Zollinger-Ellison Syndrome. This rare disorder is characterized by the overproduction of gastrin, a hormone that stimulates the stomach to produce acid excessively. The increased stomach acid can lead to damage in the small intestine, resulting in malabsorption of nutrients, particularly fats and proteins. Specialized formulas low in fat and easily digestible proteins may be recommended to support nutritional needs while managing symptoms associated with Zollinger-Ellison Syndrome.
Dysphagia: Individuals with difficulty swallowing (due to neurological conditions, stroke, or other issues) may use formula to ensure they receive adequate nutrition without risk of aspiration.
Congenital Heart Disease: Infants and children with congenital heart defects may have increased caloric needs and may use high-calorie formulas to support growth and development.
A few examples & reasons I KNOW this shortage is still in full force:
The hospital I was working for had an ever-evolving list of products out of stock with estimated return dates. On my last day, it was the worst I had seen in the last months.... Products include:
Fibersource HN tube feeding formula
Isosource 1.5 tube feeding formula
Impact AR
Boost High Protein
Boost Plus
Vital HP tube feeding formula,
Low* Peptamen VHP tube feeding formula.....
Kendamil and Bobbie have each recently issued statements regarding formulas that they are currently experiencing stock concerns with. These include
Kendamil‘s Goat-based Infant Formula
Bobbie’s Organic Standard Infant Formula (see Bobbie‘s statement here: https://www.hibobbie.com/#announcement )
The USDA sent notice to various state agency’s regarding anticipated supply disruptions to continue for Gerber infant formulas. Specifically
Gerber Good Start SoothePro
Gerber Good Start Gentle.
Abbott has also recently released a list of discontinued items, in an effort to better "streamline Abbott's portfolio". Some items have been long out of stock, while others.. well this comes as a surprise. One thing is certain though, each product serves a specific purpose. So it is definitely a bummer to see some of the products they have chosen to discontinue.
One reason this list of discontinued products has been an extra bummer?
Abbott's communications regarding this have been poor at best I personally am on a number of email and communications lists, as an R.D., as an advocate in this space, and as a parent, yet I have not found any record of communications on this topic. No specific alerts to the mass majority. The only way I found out about this list- through other R.D.'s. Through the grapevine. Via BuildUp RDNs. Via good friends.
and the thing is... I wasn't alone in that sense.. Each of my close R.D. friends that I've spoken with on this topic, discovered this info through the grapevine. Two of these R.D.'s are still actively working in the hospital setting, one within a hospital system that primarily uses Abbott products... and they still weren't informed!
It's exhausting to play these kinds of games. After over 2 years of the ebb and flow of out of stocks formulas and supplements, I can tell you.. we are tired. Healthcare is tired of this. Those who need and use these products are tired of this. Part of my job is to help connect those who need nutrition, with nutrition... but if the main players aren't communicating what tools we have as R.D.s, it makes it much tougher to make those connections, accurately. A lot has been done to work towards improvements, but at the end of the day, we also need accountability, transparency, ethical practices, safe products, reliability, truly sustainable practices, and more if we want to come to a genuine end to this ever-going crisis. And man, do I want to come to a genuine end to this crisis....
❤❤
Thank you for your support and love in this space! It means more to me than you will ever know.
I truly enjoy sharing this information and I hope you find the information provided valuable. If you do find this information helpful, I kindly ask that you consider sharing - via social media, word of mouth, email, etc. I would love to help support as many out there as I can! <3
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Jessica Enderle, R.D., L.D.
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