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Why the recall?
In May 2022 the FDA issued a recall for powdered infant formula made in Sturgis, Michigan. The products recalled included Similac, Alimentum and EleCare.1 For the most current information about the recall, please visit the FDA’s website or click on this link. The outbreak is considered closed, but the FDA and CDC are continuing to update information regarding their investigation after the recall and ways to prevent future outbreaks.
As we learned with this most recent infant powdered formula outbreak, products we think may be the safest still have risk. This reminds us the risk of foodborne illness is never zero. The process of making baby foods are more regulated to lower the risk of a food safety outbreak, but these safer conditions do not equate to sterile food products.
One way we can take control in lowering our own risk is to read instructions on the packaging of any foods carefully. Careful reading, especially for foods for the young, elderly, pregnant, and immunocompromised, can help in saving lives.
What is Cronobacter?
Cronobacter sakazakii is a germ that lives naturally in our environment. It can be found in dry foods like infant formulas, herbal teas, powdered milk and starches. Cronobacter infections are rare, but they can be deadly in newborns. They can also be serious for the elderly, those age 65 or older, and adults with weakened immune systems. In infants, Cronobacter illness will usually start with a fever and poor feeding, excessive crying, or very low energy. Some infants may also have seizures. You should take an infant with these symptoms to a medical provider as soon as possible.2
Feeding Safe Formula
In addition to reading the specific instruction on how to prepare your specific formula, there are some general rules to follow to keep the formula as safe as possible:
Wash hands well before preparing bottles or feeding your baby. Clean and sanitize the space where the infant formula is prepared.
Bottles need to be clean and sanitized.
Liquid infant formula does not need to be warmed before feeding as it is considered sterile, but some people like to warm their baby’s bottle. Avoid using a microwave to heat bottles to prevent uneven heating.
If you use powdered infant formula:
- Use water from a safe source to mix your infant formula. If you are not sure if your tap water is safe to use for preparing infant formula, contact the local health department.
- Use the amount of water listed on the instructions of the infant formula container. Always measure the water first and then add the powder.
- If a baby is very young (younger than 2 months old), was born prematurely, or has a weakened immune system, they may be at higher risk of getting sick from Cronobacter. The CDC recommends considering extra precautions in preparing infant formulas to protect against Cronobacter, specifically for these infants.3
The safest way to prepare powdered formula is to prepare with water at boiling temperature. This step is not to sterilize the water, but to help in killing any bacteria in the powdered formula itself. Unlike the liquid formulas available, powdered formula is not sterile. This step may help any infants stay safe when choosing liquid formula, but is especially important for those at higher risk of getting sick, mentioned above. To learn more about how to prepare powdered baby formula safely through boiling water, check out the directions from the CDC found here.2
Always Play it Safe
When it comes to baby food, if you have any concern based upon sensory perceptions, storage conditions, or even a gut instinct, it is best to throw the formula out. Likewise, any unfinished bottles should be discarded and not stored for later, even in the refrigerator. If power is lost, you should follow the same protocols you would for other foods in the refrigerator.
Where are we now?
After this outbreak, we have seen some weaknesses in the way we supply baby formulas. The combined effects of supply chain trouble due to the pandemic and the formulas recalled by Abbott Nutrition have led to shortages seen across the country:4
One of our own CFI students has directly felt these effects. Nadira Yasmin, an MPH practicum student and mom to a little one dependent on one of these formulas, shared with us some of the lengths she went to get the formula her son relied on:
“As a mother using formula to supplement my baby’s nutrition, it was very difficult to find the exact one that my son takes available at stores throughout the Columbus area and beyond. I traveled to different Walmart and Target locations that were much further from my home just to pick up some formula that I ordered online once the stock became available again. During this time, there were limits on the quantity of formula that could be purchased as well. There was a good 4-5 weeks that the specific formula I buy was not available in any of the stores here. I ended up ordering from Amazon, which took about 3 weeks to come.”
Months after the recall and improvement of COVID supply issues, we are still feeling effects of this shortage that is impacting some of the most vulnerable members of our communities. In response to the situation, President Biden and his administration have worked with government agencies involved in formula regulation and distribution. Their actions include working with the FDA to allow more formula to be brought in from other countries and working with the USDA to simplify production of formula container sizes to allow for more to be made overall.5 With these and other actions, we hope to see families feel more secure in both the availability and safety of infant formulas.