Dr. Rebecca Hill says societal and governmental changes to support to new parents and caregivers are needed, along with a change in how breastfeeding is viewed.

With federal and industry efforts ramping up, the country’s infant formula shortage is showing signs of improving; domestic production is increasing as the Biden Administration is flying in imported formulas to supplement the country’s supply.

While this is welcome news to millions of parents, an infant feeding specialist at the MGH Institute says there are lessons to be learned and action to be taken to prevent a future shortage.

MGH Institute Associate Professor of Nursing Dr. Rebecca Hill hopes the current crisis not only sheds some light on the many reasons why new parents rely on formula, but also leads to important policy changes at every level.

“We really need to better support those caring for infants,” she says. This includes increasing the postpartum care that families receive not only while at the hospital and at their pediatrician’s office, but also from society at-large. 

The shortage began in early April, when a manufacturing plant owned by Abbott Nutrition, one of four companies in the country that make more than 90% of infant formula, was shut down by the U.S. Food & Drug Administration in March for having for unsanitary conditions after some children became sick. When grocery stores began running out of formula, there was an assumption that parents could turn to breastfeeding their children – an incorrect assumption she says needs to be changed.

“Breastfeeding,” says Hill, a family nurse practitioner and certified lactation counselor, “was simply not a quick fix for a crisis like this.” Hill has spent her career studying infant feeding and the various reasons that breastfeeding can not only be challenging, but truly impossible.

According to Hill, the Centers for Disease Control and Prevention reports that while more than 87% of parents report having the desire to breastfeed, and 84% initiated breastfeeding immediately following birth, less than 26% of these parents can sustain exclusive breastfeeding (EBF) for the first 6 months of their infant’s life.

“There are so many reasons that many parents cannot maintain EBF,” says Hill. She cites a 2019 study she conducted which found that low milk supply, sustained pain during feeding, lack of lactation support, medications, health conditions of the mother, and a lack of paid family leave are some of the many reasons parents rely on formula to supplement or replace breast milk. “Even for parents with full-term infants without any medical complexity, it is very common for parents to have feeding concerns.”

Even with more support, many parents will still be unable to breast feed their infants, she says. Because of this, the need to normalize milk sharing and improve affordability and insurance coverage for donor milk is crucial.

“We absolutely need to increase the number of certified lactation consultants throughout the country and invest in the development of pharmacological treatments to increase milk supply,” she says. “We also need to push for federally funded paid parental leave so that parents have the time needed to develop a sustained breast-feeding relationship with their infant.”

And, as parents and caregivers continue through what Hill hopes is the end of this current crisis, she points out that many OB/GYN and pediatrician’s offices have unused samples that patients can inquire about, the U.S. Department of Health and Human Services website provides information on milk formula banks, and there are local milk banks where people can donate extra breast milk.

“I’m really hoping that as formula fills shelves again, we continue talking about how we can best support infant parents and caregivers,” Hill says.