Information for mothers who are formula feeding their babies

Amid the current pandemic, if you are currently having trouble obtaining your baby’s usual formula milk, here is some useful information to support decision making during this emergency.

This information is not advisory but informational during these unprecedented times.

• To reduce the risk to baby, those who are currently being partially breastfed can be put to the breast more often and those who have recently been, but are no longer being breastfed can be put back to the breast in most cases. Please see our Information for Breastfeeding Mothers webpage for details of how to access peer and specialist support to do so.
• If you are struggling to afford formula milk because of an unexpected cash flow problem or higher prices of infant formula, you should firstly contact your Health Visitor. Food banks don't typically stock and supply formula milk due to regulations, but may be able to help via your Health Visitor in exceptional circumstances such as these.
• If local shops and supermarkets do not have stock of formula, ask your pharmacy to order it in for you – be aware that this may take up to 2 days to arrive so plan ahead where possible. Formula may be more expensive when bought this way.
• Try to connect with your local community – use local online parenting support groups or your neighbourhood’s online COVID-19 support group to ask if members of your community could share any spare unopened tins of appropriate formula with you (see point 5) until you can obtain some and replace it for them. If you are finding it problematic to source your baby’s usual milk in your local pharmacies and shops, it may help to know:

1. Formula fed babies up to 12 months can be fed on First Stage infant milk – therefore if your baby is under 12 months of age and is currently on second stage formula, but First Stage formula only is available, you can use this instead. 
2. "All infant formula on the UK market must meet compositional regulations, so all products are perfectly ok to feed a baby. More expensive brands still have to meet the same compositional standards as cheaper brands." (First Steps Nutrition). If your regular brand of formula is sold out but other brands (including supermarket own brands) are available, it's okay to buy another brand. There is no evidence to suggest that switching brands is harmful to babies, however if your baby has reacted negatively to a specific brand previously, try a different one. For any baby under 6 months, First Stage formula of a different brand is safer than stage 2 or 3 of their normal brand. 
3. There is no evidence to support the use of Comfort, Anti-Colic or Hungry Baby versions of formulas, these are classified as, foods for special medical purposes, and are not regulated in the same way as regular infant formula. If you are used to feeding your baby one of these formulas but cannot source it, First Stage formula milk should be suitable to use in an emergency. These milks should never be chosen for a baby that is already having First Stage formula as they could make your baby unwell if not used appropriately. Please speak to your Health Visitor if you have concerns about this.
4. In order to have sufficient nutrition and reduce risk to the baby, formula-fed babies under 12 months of age should continue to have formula milk as their main drink and not be given cows’ milk or plant based milks as their main drink. Cows’ milk and calcium enriched plant based milks can however be used to make foods such as porridge and mashed potato once weaning onto solid foods begins at around 6 months of age.
5. Growing Up milks are unsuitable for babies under 12 months and unnecessary for those over 12 months of age. If your baby is over 12 months of age, they should now be transitioned to cows’ milk or a calcium-fortified alternative where there is cows’ milk protein allergy.
6. Condensed milk and evaporated milk are not suitable alternatives to formula milk.
7. Do not resort to preparing home-made formulations based on recipes on social media – these may be dangerous for your baby and fail to meet their nutritional requirements.
8. For further evidence based information on infant milks, please follow this link to First Steps Nutrition’s page.

• Typical serving sizes suggested on the back of formula tins are often too large. Make up the amount of feed in response to the amount that your baby typically takes, rather than following guidance on the tin – for example, if you find that there is milk left over at the end of each feed, try making smaller amounts and feeding your baby more often. Remember to pace-feed. You can do this by sitting your baby upright during a feed and holding the bottle at a horizontal angle so the milk only comes out when your baby actively sucks. When baby looks sleepy, stops sucking or moves their head away, then they are saying that they have had enough milk. Click here for more information about responsive bottle feeding.
• Even when you are worried about getting a supply of formula milk, to keep your baby safe it is still important to make up feeds following the guidelines.

1. Guidelines for the safe preparation of and storage of infant formula milk can be accessed by clicking here.
2. It is critical that the ratio of formula powder to water is made up according to the guidelines on the tin to ensure the correct and safe amount of nutrients. It is really important to not over dilute formula (e.g. making it with more water per number of scoops of powder) or to concentrate formula (e.g. make it with less water per number of scoops) both of which are harmful to baby.
3. Re-heating or re-using partially consumed formula is dangerous due to the increased risk of bacterial infections. If a bottle of formula has been drunk from, the milk must be discarded within two hours. 
4. Donor breast milk is sometimes be used in a crisis as stated by the World Health Organisation. Peer to peer milk sharing is not without risks. You can find out more information from:​​​​​​Human Milk 4 Human Babies website

Most importantly, if you do manage to find baby milk in the supermarket, please stick to a limit of two tins per baby. Think about how it feels worrying about feeding your own baby, and know that others will also experience this fear if they arrive to empty shelves.

You may also find this information from Unicef useful Guide to Bottle Feeding

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