Ayanna White is used to seeing families in crisis. As the founder of a South Carolina diaper bank, she provides baby supplies to residents experiencing financial hardship. But the nation’s infant formula shortage has put her on the front lines of an “unimaginable” crisis, she says, one that’s hitting rural, low-income parents particularly hard.
White recalls one mother who traveled from a rural part of the state to pick up formula from White’s nonprofit, Power in Changing, after making several unsuccessful stops at local retailers. The mother had found her preferred formula brand in stock at a CVS, but had to leave the drug store empty-handed because it did not accept WIC, the federal food subsidy she uses to feed her baby.
“It’s sitting there right within her reach,” White said. “That was a heartbreaking moment for me. … A lot of parents are finding it not only difficult to find [formula] on the shelves, but they have to go to stores with people who aren’t on WIC, who are on WIC, and they’re fighting amongst each other.”
Months of limited supplies of infant formula have left families nationwide scrambling to find food for their babies. Some infants have even been hospitalized, including at least four in South Carolina. In addition to supply chain disruptions, a formula recall by Abbott Nutrition, the largest infant formula manufacturer in the country, in February exacerbated the shortage.
The crisis has been particularly acute in rural areas, where retailers have suffered from extensive shipping delays and residents have had to travel especially long distances to find stocked shelves. Advocates say WIC — formally known as the Special Supplemental Nutrition Program for Women, Infants, and Children — has created yet another hurdle for rural families, who heavily rely on the government program because the benefits specify what type of infant formula they can buy, how much and from where. States authorize certain retailers to accept WIC benefits, and companies bid to become a designated formula provider for each state’s program.
Combined with the shortage, those regulations severely limit the supply of formula that WIC families can access with their benefits, advocates say.
“If the shelves were empty, or they were limited [in what parents could buy], they couldn’t pick up the amount they wanted,” said Chelesa Presley, director of the Diaper Bank of the Delta in Clarksdale, Mississippi. “A lot of women are wondering how they’re going to feed their babies.”
WIC, which is overseen by the United States Department of Agriculture, provides food and breastfeeding support to low-income families with children up to age 5 who meet federal poverty guidelines and are deemed at nutritional risk. Participants receive monthly benefits to purchase certain foods.
But the formula shortage has brought new scrutiny to the WIC program, revealing how its limitations can hamper food access, particularly for rural families. Earlier this month, the USDA encouraged states to waive certain restrictions on formula purchases, allowing WIC participants to buy alternate brands and container sizes from a wider variety of vendors. On May 21, President Joe Biden signed the Access to Baby Formula Act, which allows the USDA to waive restrictions and provide easy access to baby formula for WIC recipients in emergency situations like the current shortage.
Advocates say that the additional flexibility has been helpful for families. Other initiatives, such as allowing parents to receive their benefits remotely instead of driving to the nearest WIC clinic, also have helped in rural areas, said Geraldine Henchy, director of nutrition policy at the Food Research & Action Center, a nonprofit research organization.
“WIC had to change its rules so that people could buy more different kinds of formula with their WIC benefits,” Henchy said. “The federal rules, the waivers, allow states to be pretty expansive as far as the formula shortage is concerned.”
But the waivers are a temporary fix, and rural health advocates say government officials should do more to prioritize access to formula in rural areas.
Nearly 90% of U.S. counties with the highest rate of children at risk for food insecurity are rural, according to Feeding America, a nonprofit food bank organization. And about 46% of rural, income-eligible families with young kids participated in WIC. Eligible Black families account for 21% of program participants.
“Rural areas are often the last to get the supply chain issues fixed, so it’s really important that the [federal government] moves as quickly as possible and under-resourced communities are not ignored,” Henchy said. “Because the same kind of systemic discrimination that created some of these rural food deserts and supply chain problems to start with are at play here.”
Irene Bean, a family nurse practitioner in Nashville, Tennessee, said she has patients on WIC who have driven three to four hours searching for baby formula. Some parents poured extra water in the formula to preserve food, but this decreases the nutrients that babies need, Bean said.
“We’ve had mothers having to take their babies to the hospital because they’re not receiving the nutrients required for their age,” Bean said. “It’s so heartbreaking to know that, one, I don’t have enough money to purchase the formula that I actually need if I can find it. And number two, the gas prices have skyrocketed, so I’m driving three to four hours to get two or three cans for my baby. … It’s something that really needs to be looked into.”
In recent weeks, the federal government has used its emergency powers to address the formula shortage, even beyond WIC. The Biden administration invoked the Defense Production Act to speed up the manufacture of baby formula and authorized Operation Fly Formula to import infant products that meet U.S. standards.
Despite the progress, the federal Food and Drug Administration Commissioner Robert Califf said his agency’s food safety division responded too slowly to a whistleblower report about safety failures at the Abbott plant, The Wall Street Journal reported.
Before the shortage, people were already struggling to make ends meet, living in food deserts, and paying higher food costs because of inflation, Henchy said. She added that the steps the federal government and states are taking are necessary, and the federal waivers should be extended to help rural families long-term.
“We just need to be really clear that everything possible needs to be done to make sure that people have the choices that they need to make on these government programs like WIC,” she said. “To the extent there’s a recovery in terms of this supply shortage, that it’s equal and there’s equity in how it’s addressed.”