Information for families on the limited supply of infant formula

Canadian families continue to experience a limited supply of infant formula due to considerable market disruptions following the closure of the Abbott Nutrition manufacturing facility in Sturgis (Michigan, USA) for several months in 2022. This closure disrupted the availability of a variety of products in the United States and in Canada over the course of the year. Supply constraints in Canada were at first limited to specialized formula and are now affecting regular infant formula. In particular, regular infant formula powders are often out of stock in various locations across the country.

We share your concerns

We understand that ongoing supply disruptions are distressing. Your usual formula may not be available when you need it, and switching formula is not easy to do. We also know that more affordable products quickly disappear from store shelves, and this is challenging for families who may also be facing other pressures.

Rest assured that improving the supply of infant formula is of the highest importance to the Minister of Health, the Honourable Jean-Yves Duclos. A ministerial roundtable discussion held in March 2023 convened decision makers from the industry sector and key healthcare partners to underscore the importance of this issue and to call upon industry to strengthen the supply.

As a result, and leveraging the tools and strategies already implemented by Health Canada, new regular formulas are now beginning to appear in retail stores and pharmacies across the country and more are expected later in May 2023.

On this page

• What you can do if you cannot find your usual formula
  • Trying a new formula
  • Formula switching tips
  • Feed your baby safely
  • Other resources
  • Cost considerations
• What Health Canada is doing
  • Improving supply
  • Sharing information

What you can do if you cannot find your usual infant formula

Do

• Consider different size packages or formats (powder, liquid concentrate, ready-to feed) of the infant formula brand you are currently using.
• Check the manufacturer's website for resources to locate a specific formula or contact their customer service.
• Try a different brand of formula if your usual product is unavailable. It is normal for infants to take time to adjust to a change in formula.
• Consult your healthcare provider if your infant requires a specialized formula.
• If you are combining bottle-feeding and breastfeeding, maintain your breastmilk supply if you can.
• Start introducing homogenized cow's milk if your baby is between 9 and 12 months old.

Don't

• Make homemade infant formula. It can put your infant's health at serious risk.
• Dilute or water down your infant formula to extend its use. This reduces the nutritional content of the formula, and your infant may not get the nutrition they need.
• Buy more infant formula than you need.
• Use infant formula from unknown sources, such as online third parties.
• Use breast milk obtained online or directly from other individuals.
• Substitute infant formula with other beverages.

Trying a new formula

If you cannot find your usual formula, a different size or format of your usual brand, or a formula from a different brand, may also meet your needs.

Health Canada has facilitated the temporary importation of formula to improve supply. New regular infant formulas are now beginning to appear in retail stores and pharmacies across the country and more are expected later in May.

Although these may be brands that are new to the Canadian market, these products are safe and provide adequate nutrition for infants. All products eligible for temporary importation were reviewed by Health Canada scientists and come from countries that have quality and manufacturing standards which are comparable to those in Canada.

It is not necessary to consult your baby's doctor before switching formula unless your baby has special needs (food allergies for example). Registered dietitians and nurse practitioners can provide advice to support you as you change formulas or transition them into your baby's diet.

If you cannot access your regular health care provider for timely advice, contact the Telehealth service in your province or territory or speak to your local pharmacist.

Formula switching tips

We know that changing formula can be challenging. Some families may find this information useful when their baby is adjusting to a new formula:

• Start by replacing a small amount of your baby's bottle with the new formula, and gradually increase that amount at each feeding. Make sure to follow the instructions on the label for each formula to prepare and store them appropriately.
• It's normal for infants to take time adjusting to a new formula. They may become gassy or fussy, but this should improve in a few days.

Learn more:

• Caring for Kids (Canadian Paediatric Society)

Feed your baby safely

Do not make homemade infant formula. It can put your infant's health at serious risk. Commercial infant formula contains many important nutrients that would not be present in homemade formula.

Do not dilute or water down your infant formula to extend its use. This reduces the nutritional content of the formula and can put your infant's health at risk. Follow label instructions for preparing infant formula.

Other beverages are not substitutes for infant formula. These substitutes do not meet the nutritional needs of infants. Examples include:

• cow's milk
• goat's milk
• evaporated milk
• fortified or unfortified plant- based beverages (like soy, oat, rice, almond, coconut, cashew)

Health Canada does not recommend using human breast milk obtained online or directly from other individuals.

There is generally no need to keep using formula if your child is healthy and over 12 months old.

Learn more:

• Infant nutrition
• Safety of donor human milk in Canada

Other resources:

• Babies and gastroesophageal reflux disease (Caring for Kids)
• Nutrition for healthy term infants: Recommendations from birth to 6 months
• Nutrition for healthy term infants: Recommendations from 6 to 24 months
• Breastfeeding your baby

Cost considerations

Although the cost of infant formulas is not regulated by Health Canada, we understand that it is an important consideration when choosing a new formula. It can sometimes be difficult to know which products are more affordable because of the different sizes and formats of formula, such as powder, liquid concentrate, or ready-to-feed.

On a per feed basis, the cost of liquid concentrates can sometimes be comparable to powders, whereas ready-to feed formula is generally more expensive. The following information can help you calculate the cost per feed for powdered infant formula and liquid concentrate:

• 1 can of 900g powder produces approximately 29 bottles of 237 mL (8 oz)
• 1 can of 500g powder produces approximately 16 bottles of 237 mL (8 oz)
• 12 cans of 385 mL liquid concentrate produce approximately 39 bottles of 237 mL (8 oz)

What Health Canada is doing

Health Canada is taking this situation very seriously and has been working diligently behind the scenes to minimize the impacts of the limited supply of infant formulas on Canadian families.

Improving supply

Health Canada is working closely with manufacturers to increase the availability of formulas normally found in the Canadian market to compensate for the reduced supply of many products since February 2022.

In addition, Health Canada's interim policy has been an essential tool to mitigate the shortages by facilitating the importation of formula from countries which hold comparably high quality and manufacturing standards. Health Canada made it easy for manufacturers to propose new products for temporary importation and the review is accelerated so they can quickly be made accessible to Canadian families.

More than 70 products are currently eligible for temporary importation under this policy, and the list is updated regularly. New products continue to be added to the list to help strengthen the supply where needed. Products imported under the interim policy include formula sold at retail stores and pharmacies as well as products that are reserved for medical use.

• Products reserved for medical use include infant nutrition products used in hospitals for premature babies and those who have cardiac or other serious medical conditions. They also include life sustaining products for patients that have a hereditary metabolic condition requiring a highly specialized diet. Without the interim policy, these patients would not have had access to the products they need.
• The interim policy helped stabilize the supply of hypoallergenic products, a type of specialized product available in retail stores and pharmacies for babies with food allergies. Their supply reached critical levels in summer 2022. Health Canada alleviated the shortage by facilitating the importation of formula from other countries and working with pharmacists to make sure these were reserved for babies who needed them for medical reasons. For many months, only hypoallergenic formula imported under the interim policy was available for Canadian families. The shortage of hypoallergenic formulas has now largely subsided and a limited, but stable supply is available across the country.
• Since fall 2022, the priority has been to bring more regular formulas to the Canadian market. While Health Canada determines what products are eligible for temporary importation, the decision to import it is made by individual companies. For this reason, Health Canada does significant engagement with manufacturers, distributors and retailers to reduce or eliminate barriers to timely and fair access to infant formula. Regular formulas that are new to the Canadian market have started arriving on store shelves, and more are expected in late May 2023.

Learn more:

• Health Canada provides update on supply of infant formula in Canada
• List of products eligible for temporary importation

Information sharing

Health Canada has played an important convener role, engaging with a wide range of different stakeholders and promoting a collaborative approach.

• Multi-stakeholder meetings are held regularly with representatives from the industry (manufacturers, distributers, retailers), provinces and territories and the health care community to keep everyone abreast of new developments as the situation evolves.
• At the height of the hypoallergenic formula supply challenges, Health Canada met with manufacturers several times a week to discuss the available supply and upcoming shipments. Weekly meetings with provinces and territories ensured a fair and equitable distribution of these products across the country and opportunity to discuss emerging local concerns. The focus of these meetings has evolved from specialized formula to also include other types of formula, and they have continued following a regular schedule.
• Working groups with a broad representation were established to identify and address emerging communication gaps. This resulted in the development of information packages for pharmacists and other health care professionals to raise awareness, provide information to concerned parents and support clinical decisions, and to promote consistent messaging.