Baby formula mystery solved?

Have we solved the mystery of why baby formula has been in such short supply? Actually, we do have the answer, but our government will never admit it. The government, over decades, let two manufacturers jointly corner the market for baby formula. So when one of them failed, the other one, and the “generics,” couldn’t keep up.

Roots of the baby formula crisis

The government laid the foundation for the baby formula crisis in the last century. In 1972, what was then the Department of Health, Education and Welfare first started the Special Supplemental Nutritional Program for Women, Infants and Children. We know it by its acronym, WIC. Your editor first learned about WIC in medical school, during a core clinical clerkship in ambulatory medicine.

WIC works by enrolling young mothers, and families with small children, in various federal assistance programs. If you’re already on one of three federal doles, or make less than 185 percent (not a typo) of the Poverty Line, you are eliglble for WIC. Doctors then screen you for certain kinds of disease risk and diet risk. If you “screen” positive for one of these risks, you’re in.

Among other things, WIC publishes a list of “approved” foods you can buy with their vouchers. The problem is: WIC selected two manufacturers of baby formula to get on the list! They are:

• Abbott Laboratories (makers of the Similac family), and
• Mead Johnson (makers of Enfamil, ProSobee, and so on).

Mead Johnson is no longer a separate company; another firm named Reckitt Benckiser owns it. But the Mead Johnson name, and its brands, are still active.

Between them, Abbott and Mead Johnson have ninety percent of the WIC Market. They are literally the Coke and Pepsi of baby formula!

Abbott comes a cropper

Obviously this baby formula house of cards had two joists: Abbott and Mead Johnson. And in February, the Abbott joist failed, and the house of cards imploded.

The CNAV news bureau broke the story yesterday, from available reports you might have missed. The Abbott plant in Sturgis, Michigan, had to shut down. Its roof leaked, water puddled on the floor, and a germ with the jawbreaking name Cronobacter sakazakii started to grow. As anyone might guess, it contaminated the baby formula the plant made. Several babies fell ill and two of them died. That germ is nasty, and kills 40 percent of babies who catch it. To make matters worse, many workers at the plant didn’t even wash their hands properly.

Why are we hearing about this only now? Because Dr. Robert Califf, a commissioner at the Food and Drug Administration, had to tell it to a Congressional committee. He also revealed that someone had warned the FDA about this plant a year ago. And the FDA didn’t get around to it until after two babies had died!

The head of Abbott has already owned up to this.

To all of the families who depend on us for a reliable supply of formula — we let you down.

And of course he said he was “deeply sorry.”

Sorry doesn’t cut it – but let’s lay the blame where it’s due

Well, “sorry” doesn’t cut it. But let’s not heap all the blame on Abbott. If WIC didn’t exist, or at least if WIC never gave an exclusive contract to Abbott and Mead Johnson, we wouldn’t be at this pass.

But even that’s only part of the problem. Let’s remember how civilization got along – and thrived – before anyone thought of making a formula to replace mother’s milk. To be fair, not every mother can breast-feed. Some have genuine medical issues – and the Standard American Diet could definitely stand some improvement. But companies like Abbott and Mead Johnson made it sound as though their baby formula was better than mother’s milk. They also supported certain lifestyle choices we all have to rethink.

Dr. Robert Mendelssohn, in his 1980 book Confessions of a Medical Heretic, probably sounded the first public alarm. He tried to encourage young mothers everywhere to ditch the baby formula, eat right, and breast-feed. But, of course, the worthies who run WIC never thought of that. They didn’t think of that, maybe because Abbott and Mead Johnson had good teams of lobbyists.

The baby formula airlift

What now? Well, Perrigo, a maker of “store brands” of baby formula, is trying to ramp up. No telling how well that will work, or how fast. And we now hear of airlifts of baby formula from Germany to the United States.

But that airlift has only enough to supply doctors and hospitals to take care of babies who really need it. Needless to say, many people are not receiving this well.

Separately, the FDA eased some regulations, so now retailers can import baby formula from the United Kingdom.

One thing CNAV must warn young mothers not to do is to try to make their own baby formula. Many recipes have gone viral on social media, and most of these are worse than worthless. They simply do not provide enough nutrition. Children are not little adults. Your editor heard that directly from a pediatric surgeon in medical school, and it still goes.

But none of this permanently solves the big problem. When you have two companies making all the baby formula, and one other (Nestle, which owns the Gerber brand) making all those jars of baby food, you’re asking for trouble. A group calling itself Public Citizen has sounded that warning for years.

Encouraging more companies to make baby formula will help – to a degree. But encouraging more mothers to breast-feed, and not shaming them about it, will really solve the problem.