A national shortage of baby formula caused by supply chain issues and a recall has parents scrambling.

On Feb. 17, the largest infant formula manufacturer in the country—Abbott Nutrition—initiated a voluntary recall of several lines of powdered formula. This came after concerns about bacterial contamination at Abbott’s Sturgis, Michigan, facility.

The U.S. Food & Drug Administration announced it is taking steps to help improve supply of infant and specialty formula products. Still, some parents are struggling to find baby formula.

The American Academy of Pediatrics recommends that parents buy only a 10-day to two-week supply of formula to avoid hoarding.

Here are some suggested Do’s and Don’ts:

Do’s

• We encourage mothers who are able to breastfeed to do so. If you are unable to breastfeed, please follow your pediatrician’s recommended alternatives.
• If your favorite stores are short on baby formula, try other stores. Check smaller stores and drug stores, which may not be out of supply when the bigger stores are.
• Discuss changing formulas or appropriate alternatives to formulas with your pediatrician or pediatric specialist, especially if your infant is on a specialized formula.
• Store-brand formulas are generally a safe substitute, unless your baby is on a specific extensively hydrolyzed or amino acid-based formula such as Elecare (for which no store brand exists).
• For premature infants, you can give regular formula used by full term infants for a few weeks until you can find premature infant formula. Make sure you inform your pediatrician so she can advise you further.
• If your infant has special formula needs, check with your pediatrician about medically appropriate safe feeding alternatives.
• Ask if your pediatrician can get you a can from local formula representatives or a charity.
• Even if you don’t qualify for WIC, your local WIC office may also be able to suggest places to look.
• If you can afford it, buy formula online from well-recognized distributors and pharmacies rather than individuals or auction sites. The federal government is importing formula from Europe to help with the shortage. This formula is regulated by the European Food Safety Agency similar to how the FDA regulates USA formula, so it will be safe to use. Do not import formula from other areas, since imported formula is not FDA-reviewed.
• Purchase formula directly from manufacturers or check their websites for stores in your area who carry their brand.

Don’ts

• Don’t try to make your own infant formula at home.
• Don’t dilute formula to make it last longer. Watering down formula is dangerous and can lead to slowed growth, nutritional and electrolyte imbalances and other serious health conditions. Always follow label instructions or those given to you by your pediatrician.
• Don’t offer solid foods or swap to cow’s milk or another milk alternative. Cow’s milk may be an option if your child is older than 6 months of age and is usually on regular formula (not a specialty product for allergies or other special health needs). In a pinch, you could feed them whole cow's milk for a brief period of time until the shortage is better.
• Toddler formulas are not recommended for infants. However, if you absolutely have no other choice, toddler formula is safe for a few days for babies who are close to a year of age.
• The AAP does not recommend plant-based milk alternatives for babies under a year of age or infants with certain medical conditions requiring specialized formulas. Soy milk may be an option to give babies who are close to a year of age for a few days in an emergency, but always buy the kind that is fortified with protein and calcium. Make sure to change back to formula as soon as some is available. Be especially careful to avoid almond milk or other plant milks as these are often low in protein and minerals.

If you have any concerns about your baby's nutrition, please talk with your pediatrician.