CalMatters: Restrictions make it harder for low-income families to get formula

Low-income families scramble to find a formula

– A nationwide shortage of infant formula has been hard on all families who need it, but state and federal limitations have made matters worse for low-income families in California who rely on government assistance.

These families receive vouchers to pay for formula through the federal Women, Infants and Children Program, which provides additional nutritional assistance to low-income pregnant, breastfeeding and postpartum individuals, infants and children under 5. year. But the program limits the brands families can buy, making an already scarce supply even scarcer for program participants.

California received a federal waiver in February, when the shortage began, to make changes to the program to ensure the formula still gets to families who need it. Still, it took the state three more months to expand the list of approved formula brands due to federal restrictions.

Even with the latest relaxation of program rules, families are still struggling to find a formula. Families and advocates say the state should lift all restrictions and allow families enrolled in the program to purchase any type of formula they can find.

“At this point, at this level of scarcity and with zero alternatives and selection, they should relax restrictions as much as possible,” said Jennifer Kelleher Cloyd, CEO of First 5 San Jose. “The way our benefits systems work, they’re not quickly nimble or flexible for situations like this.”

The California Department of Public Health said that when the shortage began, it tried to expand the list of approved formulas, but had to wait due to federal rules limiting the states allowed to do so.

Earlier this year, inflation and supply chain delays had already reduced formula distribution. Then, in February, a recall of certain formulas and the closure of the nation’s largest formula manufacturing plant, Abbott Nutrition in Michigan, crippled the industry. Abbott manufactures the popular brand of Similac formula.

At first, the federal government only allowed states that contracted with Abbott for their program formula to expand their list of approved brands.

California does not have a contract with Abbott, so it did not add any brands and maintained its exclusive contract with Enfamil maker Mead Johnson, according to the Department of Public Health. The limited federal waiver the state received in February allowed recipients to exchange formula, waive medical documentation for formula, and allow the purchase of formula containers of varying sizes. Beneficiaries could request authorization to purchase other brands if they obtained a medical prescription from their doctor.

At the time the state got the waiver, Mead Johnson was making enough formula for families enrolled in the Women, Infants and Children program, according to an email from Ronald Owens, a public information officer at the Department of Health. public.

“Mead Johnson was fully operational at the time of Abbott’s recall and able to provide sufficient contractual form to California,” according to Owens’ email. The agency declined a request for an interview and provided written responses to questions only by email.

But it wasn’t just low-income families who bought the Mead Johnson formula, it was all families who sought out any brand available. As the shortage worsened, Mead Johnson’s supply was not sufficient.

On May 25, federal officials authorized states to work with their contracted companies to expand their lists of approved formula brands. In California, Mead Johnson agreed the state could add more brands to the list on May 26. The next day, the state released the list of alternative options for families participating in the program.

Owens wrote that the state grew rapidly because the voucher redemption rate dropped significantly in May to 970,430 used benefits from a high of 985,011 in March.

Despite the expanded list, with so little formula on the shelves, families are still struggling. The Women, Infants and Children program allows substitutions, but they are limited for many families.

“The shortage has been difficult for all parents, but absolutely devastating for families living in poverty,” said Kelly Sawyer-Patricof, co-CEO of Baby2Baby, a Los Angeles-based nonprofit that provides products basic necessities, such as formula and diapers, for low-income children and families. “The families we serve don’t have the luxury of upgrading to a more expensive brand, buying in bulk, or going to multiple stores to research a formula.”

Infants under 6 months cannot eat anything other than formula and breast milk. Infants over 6 months can eat pureed and solid foods, but they also need breast milk or formula. Babies cannot digest cow’s milk until they are at least 12 months old.

In California, 50% of infants, those younger than 12 months, are in families enrolled in the program and 80% of them are fed formula only or use it to supplement breastfeeding, according to the state. Families purchase nearly one million boxes of formula per month through the program in California.

When families are enrolled in the program, they are placed into categories for certain formulas. In response to the shortage, the agency created a new category called “powder formula”, which features up to 16 brands. It covers 12% of families in the program.

As of last week, 44% of families are approved for Enfamil infant, 35% for Gentlease and 9% for other brands. Those approved for Enfamil Infant and Gentlease now have over 10 other brands to choose from, but others with more specific needs may only have one or a few options.

Owens wrote that families in limited categories can request to be moved to a larger category if it suits their infants.

For families, it’s not just the formula voucher program that’s been impacted, but the food stamps they rely on to feed their families. The Supplemental Nutrition Assistance Program, known as Food Stamps, gives families a certain dollar amount for food, including formula. Some parents used their food stamps to buy infant formula at inflated prices if they couldn’t find the brand authorized by their vouchers.

But buying formula with food stamps reduces a family’s food budget.

Starlyn Darby uses food stamps to buy the kind of concoction her son Zelimir eats when she can find it. But that leaves her less to feed her other children.

“It cost more and I would be lucky to find it,” said Darby, who searched all over Oakland for the formula she needed. “Since there is a shortage of infant formula, I feel like they need to increase the food stamps to be able to buy the more expensive ones.”

Eight-month-old Zelimir is also breastfeeding, but Darby said she was not producing enough milk for her son, who was underweight. She’s reduced his formula to stretch it and tries to breastfeed him more often, but she’s worried he’s not getting enough.

In Southern California, Stephanie Del Toro, a young social worker advocating for First Place for Youth, manages former adoptive youth as they transition into adulthood. Many of them have babies and rely on her to help them find formula.

“Having no transportation, not having big circles of support, they have to fend for themselves and that’s where my role plays a big part,” Del Toro said.

Former foster carer Jewell Stewart, 19, is counting the months until her 9-month-old Ma’laya Sanders outgrows formula. His most recent container of Enfamil Gentlease formula came from his partner’s family more than 60 miles away in the Moreno Valley.

“I still think she won’t need formula any longer,” Stewart said. Her baby will be one year old in October.

Until then, the Department of Public Health is adding options, such as imported brands, to the expanded list as they become available, Owens wrote.

The state estimates it could be a few more months before the shortage eases.

“Despite efforts to increase the supply of infant formula, it is unclear when parents and caregivers may see formula supply levels return to pre-recall levels,” the state wrote in a statement. anonymous reply by e-mail. “It could take another six to eight weeks before the formula from the Sturgis, Michigan plant hits grocery shelves.”

-By Elizabeth Aguilera for CalMatters