478 - Got Milk - Breastfeeding Initiation and Duration During the 2022 Infant Formula Shortage

Poster Number: 478
Publication Number: 478.2186

Background: The infant formula shortage in 2022 impacted the majority of infants across the nation, as many infants rely upon formula as their primary source of nutrition. According to Datasembly, in the first half of 2021, the out of stock rate for baby formula fluctuated between 2-8%. In April of 2022, shortages hit upwards of 30%, and by the first week of May it rose to 48%. This shortage is the result of compounded supply chain issues from the 2020 pandemic, product recalls, and the closing of the Abbott manufacturing plant in February 2022.

Objective: This study’s purpose was to look for a correlation between the nationwide formula shortage of 2022 and breastfeeding initiation and duration both during the shortage and in the months after the resolution of the shortage in an urban, outpatient population. Information such as racial identity, insurance type, and people living in the household were also analyzed in these cohorts.

Design/Methods: This retrospective cohort study utilizes Chi-Square analysis to compare rates of breastfeeding (none, any, or exclusively breastfeeding) in infants 0-12 months of age at Well Child Checks at Danis Pediatrics during the formula shortage 2/1/22 to 9/1/22 (Shortage Group), to the same patient population from one year prior (Pre-Shortage Group), and after the resolution of the shortage from 11/1/23 to 4/30/23 (Post-Shortage Group). A multinomial logistic regression model then compares breastfeeding rates between the sub-group demographics.

Results: During the formula shortage there was a 4.6% increase in exclusive breastfeeding rates and 2.9% increase in any breastfeeding rates (p=0.0003). Variables that favored higher breastfeeding rates before and during the shortage were Caucasian race, private insurance, and two parent households. Infants were 1.53 times more likely to be exclusively breastfeeding during the shortage (p=0.01).

After the resolution of the shortage, the increased breastfeeding rates were not sustained, although subgroup disparities remained.

Conclusion(s): During the formula shortage, there was an increase in breastfeeding initiation and duration which was not sustained in the months after the shortage resolution. Despite the overall increase, within the subgroups of infants with government insurance, single parent households, and of African American race, there was a further decrease in breastfeeding initiation and duration rates during the formula shortage. After the resolution of the shortage, this overall increase was not sustained although disparities remained among sub-groups.