The shortage of infant formula has been a nightmare for Aleisha Velez, a 25-year-old mother of two who lives in Philadelphia. Velez relies on the federal government’s Women, Infants, and Children’s (WIC) program to get free formula, which means she can’t just have the product shipped to her home. So, for the past two months, she’s called store after store to find a formula in stock before traveling up to an hour one-way by train or bus (or both) to get it. And then she does it again: Because many stores limit the amount of infant formula parents can buy, she now makes the trip about once a week, up from once a month before the shortages. “I’m sitting here, struggling to make sure my son has what he needs,” she told me as she returned from a formula race. “I don’t see how that’s fair.”
With more than 40% of infant formula in the country currently out of stock, millions of parents are scrambling for supplies. But other parents with the means and the know-how rely on a controversial workaround: they operate a black market that allows them to have formula from around the world delivered directly to their homes. On social media, parents exchanged tips and resources on how to obtain different types of European preparations, the import of which into the United States is illegal.
Access to what is the primary form of nutrition for many babies has long been unequal. The parents of an estimated 1.5 million children must wade through the aggravating bureaucracy of the welfare state just to obtain a necessity. In contrast, a significant number of parents evade the law to import European infant formula to access ingredients and nutritional standards that differ from what the FDA allows. The American formula is already quite expensive, but smuggling European products is at another price point, about four times more expensive than the cheapest American formula, and that’s before you factor in shipping costs. . But now, as wealthier parents opt for a made-in-Europe formula in light of the domestic crisis, inequality is deepening. While some parents struggle to get formula, others are bypassing the US market to get what they consider superior formula delivered right to their doorstep.
The formula sold in the United States is highly regulated and provides adequate nutrition for growth, but circumventing the law to purchase products in Europe opens up a whole new world of options. Although no American manufacturer makes formula with goat’s milk, for example, which some parents say their babies tolerate better, several brands in Europe do. Because of all the different choices, the black market started picking up steam around 2015 among parents who are hyper-focused on the ingredients their kids eat, Anthony Porto, a pediatric gastroenterologist at Yale, told me. which studies infant feeding trends.
Indeed, on a prominent Facebook group with more than 30,000 members, parents write that they are looking for “the formula closest to breast milk” and that they want to avoid “GMO ingredients” and “syrup of maize added”. (The GMOs and corn syrup in US formulas have not been proven to harm babies.) They share ingredient notes and spreadsheets for formulas they consider “best.” », in particular the Swiss brand Holle, the German brand HiPP and the British brand Kendamil.
Given that European brands aren’t out of stock, the latest surge in interest from Americans may have less to do with their ingredients than their availability. Although the Facebook group was created in 2016, the current shortages seem to have drawn even more people into this world. In recent days, the group seems to be full of messages from new members seeking advice on switching to the European formula. A representative for Happy Tots Organic, a website that sells European formulas, said in an email that since news of the shortages began, “sales have increased by at least 25-30%,” and Organic’s Best, another website, noted that “we are getting an exponential number of orders.
But even for people of means, buying infant formula on the black market is not necessarily straightforward. Parents cannot order directly from European infant formula companies or an online retailer like Amazon; they have to go through eBay, Facebook buy/sell groups or third party websites which are sometimes closed. (In some cases, depending on where parents buy European formula, they may not even know it’s illegal.) And while American formulas range from $0.50 to over $1.90 l ounce, Holle’s goat’s milk formula costs about $2.20 an ounce on the black market, excluding shipping. The total cost can be nearly $300 per month, if a baby is exclusively formula fed. In Europe, these same formulas cost about a third of what they cost in the United States.
The potential problems go beyond just finding a place to buy the European formula. In the past, the FDA has cracked down on the importation of European formula by targeting third-party websites that import and sell it online, and US Customs seizes formula it finds at the border. (The FDA is now planning a process to temporarily clear certain formulas from overseas to ease the current shortage, provided they meet certain requirements.) Some safety issues also make using the European formula a bad idea, Porto said. Instructions are usually not in English, preparation requires metric units, the ratio of water to powdered formula is different from the US standard, and parents may not be alerted to reminders. There have been reports of parents mismixing European formula and giving their babies too few or too many calories as a result.
While Porto doesn’t recommend European formulas imported from the black market, he appreciates that the European Union periodically updates its nutritional requirements based on current evidence, while the FDA has only made one change since 1985. For example, in 2016 the EU added a requirement for DHA, which studies have indicated “improvement in children’s outcomes for verbal and nonverbal cognition,” he said, noting that many formulas Americans contain less than half the amount of DHA required in Europe. (When I contacted the FDA for comment on its infant formula standards, a spokesperson declined, citing all media inquiries the agency deals with.)
The black market couldn’t be more different from how families on WIC get formula. Each state operates its own WIC system, each with its own formula offerings. Even normally, WIC parents can only access a handful of options within a single brand, and depending on the state, the formula they buy must be from a physical store. Without a medical exemption, parents in South Carolina can choose from three Gerber formulas; in Georgia, three from Enfamil. Even for states that allow WIC participants more choice than they normally do due to shortage, that choice is unfortunately significantly limited by current low availability.
Parents want the best for their babies, and of course it makes sense that in a crisis they would turn to whatever formula they can get, no matter the cost. . Wealthy parents will always have easier access to products for their babies, whether it’s rocking bassinets, chemical-free car seats, expensive baby food, but none are so essential to the first year of a baby’s life than breast milk or infant formula. The fundamental tragedy of this widening inequality is that while wealthy parents can access European baby formula with higher levels of cognitive-enhancing DHA, for example, parents who have the most to gain from baby formula cannot. . Low-income parents are more likely to use formula than wealthier parents because there are many barriers to breastfeeding for these families, such as no paid family leave and less breastfeeding housing , says Ifeyinwa Asiodu, a professor at UC San Francisco whose research focuses on childhood disparities.
Now that this formula is catching the nation’s attention, Porto are hoping for changes that could ensure access to the formula isn’t so skewed. Perhaps some of the changes the FDA is pursuing now will become permanent, opening the door to European formulas that are legally transported and packaged appropriately for US consumers, which would also make them much cheaper and increase competition in our limited market for American formulas. Or maybe states will relax their WIC restrictions, making it easier for parents to buy the formula they need or want. And changes to FDA regulations could ensure that every formula has the same minimum standards for helpful ingredients and harmful ingredients.
For now, the way American parents approach formula will continue to evolve in opposite directions. When I reached Velez on the bus, she lamented that at various times since the shortage began, she had to hold back bottles of formula and try to get her now 9-month-old to eat more food. he’s old enough for solid foods. And she was coming home without formula – the store she visited was full. The same week, a mum posted in the Formula Europe Facebook group with an update: “Just wanted to share that I ordered Kendamil from FormulaLand Inc and it arrived in 4 days!”