With the nation’s baby formula crisis worsening, the American Academy of Pediatrics this week changed its longstanding recommendation that cow’s milk not be given to babies under one year of age, leaving some parents questioning whether this is sound medical advice.

“I call it a temporary leniency while we’re in a crisis,” the author of the guidance change on the AAP’s Healthy Children website, pediatrician Steven Abrams, told the Sun. “We have to come up with something because what we’re hearing is that there is just no formula out there.”

Nationwide, 43 percent of baby formula was out of stock in the first week of May, up from 31 percent in early April, according to retail analytics firm Datasembly. The out-of-stock rate topped 50 percent in at least six states.

In response, the AAP now says children between six months and one year of age can be fed cow’s milk “for a brief period of time until the shortage is better.” 

Dr. Abrams says they should not consume more than 24 ounces of cow’s milk per day, but that cow’s milk is better than homemade formula or watering down formula, which the FDA warns poses serious health risks to infants. On feeding cow’s milk to babies, the AAP emphasizes, “This is not ideal and should not become routine.”

Giving cow’s milk to babies can cause intestinal bleeding and stress a newborn’s kidneys due to the high concentrations of proteins, according to the CDC, which recommends waiting until a baby is one year old before introducing it. A NYU Langone Health senior media specialist, Kathryn Ullman, told the Sun that doctors at the hospital are advising that “people shouldn’t primarily switch to cow’s milk because it’s very low in iron.” It also lacks Vitamin C and other essential nutrients.  

The Biden administration publicly addressed the formula shortages for the first time late last week. Much of the focus centered on the Abbott recall of powdered formula from its Sturgis, Michigan, plant in February, after two infants died and others were sickened by Cronobacter sakazakii, a bacterial infection. “The reason we’re here is because the FDA took a step to ensure that babies were taking safe formula. There were babies who died from taking this formula,” the White House press secretary, Jennifer Psaki, told reporters.

Abbott denies any liability, stating in a press release that “there is no conclusive evidence to link Abbott’s formulas to these infant illnesses.”

While the formula shortage predates the recall, the Abbott plant shutdown exacerbated it. Abbott and three other companies control more than 90 percent of the U.S. formula market, and Abbott holds a majority of state WIC contracts. 

On Tuesday, the Biden administration released a video of the president announcing an agreement with the FDA to allow more imports of foreign-made baby formula, as well as a consent decree — subject to court approval — that would allow Abbott to reopen its Sturgis plant within the next two weeks, with a specific focus on producing specialty formulas required for babies with allergies and certain health conditions. “This is a top priority for us,” President Biden said.

Abbott says it would take between six and eight weeks for the formula to reach store shelves.

House Democrats on Tuesday proposed an emergency supplemental funding bill that would give the FDA $28 million to address the shortages, including vague directives on how the money should be spent. Dr. Abrams says structural changes in the U.S. formula market are needed to prevent future shortages, including regarding how WIC contracts are handled and making sure “critical formulas are not produced only by one factory in the United States.”

He warns that babies under six months of age should still only be fed formula or breastmilk. The aim of the new AAP recommendation is that it will ease demand for formula by giving an alternative for older infants, for whom drinking small amounts of cow’s milk is deemed safe. “We really need that infant formula for babies less than six months,” he said.

Whether this new guidance will have any impact on formula demand is unclear. Public discussion of the formula shortages has become politicized, as Americans’ trust in public health institutions in general has declined since the start of Covid. Trust in medical scientists dropped the most among Republicans, with 34 percent having little to no trust in them, according to Pew.

“All of a sudden the medical advice you are getting is switched overnight,” a California state assembly candidate, June Cutter, a Republican, told the Sun. “Cow’s milk has either been okay this whole entire time and they’ve told us it’s not, or they’ve been telling us the truth the entire time and now cow’s milk is not okay. Either way, I would feel skeptical as a mother.”

Other parents said they would call their pediatricians before turning to cow’s milk. 

Dr. Abrams says the AAP’s guidance change is “not political.” The AAP made the same change temporarily in 2020, at the start of Covid, when panic buying of baby formula produced limited shortages. “We pulled it later on that year when the shortages got better,” he told the Sun. He expects to do the same this time around.

“We are trying to help families get through and America get through a very difficult, hopefully short-term situation,” Dr. Abrams says, adding: “Formula is always best.”