Sawbones: A Marital Tour of Misguided Medicine - Infant Formula

Episode Date: May 17, 2022

The United States is currently in a dire formula shortage, and people are taking to the internet to propose some less than ideal solutions. Dr. Sydnee talks about the origins of how formula came about, how the shortage came about, and why people on the internet are wrong. And just in case you miss the message: do NOT try to make your own formula.Music: "Medicines" by The Taxpayers https://taxpayers.bandcamp.com/

Saw bones is a show about medical history, and nothing the hosts say should be taken as medical advice or opinion. It's for fun. Can't you just have fun for an hour and not try to diagnose your mystery boil? We think you've earned it. Just sit back, relax, and enjoy a moment of distraction from that weird growth. You're worth it. that weird growth. You're worth it. Alright, talk is about books. One, two, one, two, three, four. Hello everybody and welcome to Salbones, Marital Tour of Misguided Medicine.

I'm your go host Justin McRoy. And I'm Sydney McRoy. Send him getting over this little cold bug and never even got very serious. I didn't take a day off or anything. It wasn't COVID. It wasn't COVID. You have to specify that.

I feel like great kids awkward. We tested it wasn't COVID. It's just a little bunk. Especially when you have kids with allergies who are just like during the spring, just constantly kind of sniffly, I feel like that I'm frequently announcing loudly to other adults, they don't have COVID.

And kids have no mechanism for getting rid of snot in like a discreet manner. So just like, let me just blow this in my hand, rub it on my forehead. There we go, perfect. Just letting you all know, I did check. It's not COVID. I am being responsible. It's given my voice this little bit of, you hear it, right? You're loving it. I can tell over there from when we recorded before the other podcast and you were like like a lot of parents in this way. In fact, I think it's weird that you're so fixated

on how sexy my voice is when we're in the middle of a national crisis. Sorry, when we're in the middle of... I was gonna say. I was gonna say. One of perhaps a dozen national crises. I've been true for a while. So you probably are aware that we're in the middle of baby formula shortage, an infant

formula shortage. Infant formula is more, I don't know, I guess the other way. You know what I mean? When I say baby formula. Baby formula does, I will grant you and perhaps this is what you're getting at. It does sound like a very polite way of referring to a jacketaculate. So I if that's what you meant, I think infant formula is perhaps more proper. I do agree

baby formula could be misconstrued. Yes, this has been going on and it has gotten quite dire recently and it occurred to me that while we have sort of tangentially discussed a little bit of the history of formula on breastfeeding episode actually very long time ago, one of our very early episodes. That would have been when Charlie was in utero. Mm-hmm. I think it was before I'd given birth. So it was about there. I think it was because

I was doing about anything. Well, I was doing a lot of research at the time on breastfeeding because I intended to breastfeed. And so I was in the midst of it. And we talked a little bit about some of the things that people came up with throughout the years, other than breast milk. We didn't get into the nitty-gritty of how formula, as we know it today, was developed. And then I wanted to talk a little bit about why we're in the midst of a shortage and why some of the solutions people are proposing are not good ideas.

Many of us on the podcast aren't even exactly sure what's in formula. Well, I can unlock that mystery for you. For you. Thank you. A lot of people, by the way, have written in and suggested this topic while I was already sort of in the midst of I've been working on it putting it together. So it's not that I'm not giving you credit.

We just, it was one of those, what is it when we saw you simultaneously come up with an idea like two people at the exact same time. The word for it, I'm not talking about it on the show before. Anyway, I'm just gonna say at the top of the show there are people out there suggesting ways to make your own infant formula. Don't do that.

I just want, I'm going to get into it more, but I just want to, in case people like halfway through the internet and the show, don't make your own formula. That's not a good idea. We're going to go through all the reasons, but so again, we covered a little bit about this in the past. People have been feeding babies things other than breast milk for a very long time, for a variety of reasons.

Sometimes because they thought it was better or because they thought it was also needed like supplemental or for the heck of it. I don't know. We didn't know anything. Or maybe just got into something and it seemed okay. Or they didn't have breast milk because they were just making do with what they had.

Yeah, of course. And so like, as we look back through history and again, we've talked about some of these before, but like the Greeks gave babies honey and wine sometimes. Why not? It was early on identified that milk from a human seems fairly similar to milk from other animals, other mammals.

So why not allow a baby to nurse on an animal if you don't have a human to nurse on. So, I, in my favorite film, in my favorite film, one of the actors in the film, the name of the film is scapes ring. But one of the actors in the film is performing a, he said, a father, sorry, he says, um, one of the younger guys says you can milk anything with nipples. Right. And then, um, the younger guys says, you can milk anything with nipples. Right. And then the older gentleman says, Greg, I have nipples. Could you milk me? And so that's a...

It's like a classic comedic. Yeah, I didn't do the justice. But... No, but no, I know what you mean. Sometimes melted butter was thrown in there with a recognition that fat was important. Nice. Bread soaked in water. We talked about that a lot.

Pap is what it was called. And like that wasstay if you didn't have some other milk product. For most people, these were usually either used as supplements, like I'm going to give the baby this to nursing, or for whatever reason if they didn't have a caregiver who could nurse, you would try to find a wet nurse, right? This was sort of the idea. It wasn't like, it was all just trying to make do, right? And so if you could, you would pay somebody to nurse the child for you, for whatever reason you didn't want to or you couldn't or whatever.

And if you did use an animal, by the way, that's called dry nursing. I don't think we ever talked about that. Yeah, if it's just animal milk, that's dry nursing. We don't recommend that anymore. We never recommended that. It was just what people did, but no, you know what? Someone recommended it. Someone recommended it.

Yeah, I can certain someone recommended it. As we talked about, again, previously, it also took a while for bottles to develop. So if you're going to intentionally feed an infant something other than breast milk, you need a way to give it to the baby. And initially it was just like, I don't know, get like a clay pot or get like an animal horn with a hole. You can kind of see where at least you're getting like a shape, like a sort of shape of it.

You could also do a lot of people would go with goat stands, which is basically like a keg stand, but with a goat. So you can only lay the goat down and then just hold the baby upside down. Hold the baby upside down. And be like slam it baby. Yes, you're finally in fire cap, but Delta. We talked about this in that old episode,

but with the pap that they would make, which again was like bread that you would soak to the point in water, where it was just this sort of like gruel machine thing. Yeah. And then you would put it in. We've all accidentally gotten water on bread. We don't even get into this.

You would put it in a spoon that had like a hollow tube attached to it to like blow it into the baby's mouth. Hotchi mochi. I was thinking about what would this look like. It's like a McFlurry spoon. Okay, perfect. So you put the McFlurry spoon. It's amazing.

The invention of the McFlurry was predicated by the McFlurry spoon. We knew this was important. We just didn't know why. It was really not until the mid-1800s that you see the introduction of like a bottle and like rubber nipples, like the kind of things that were the predecessors of what we would use today, right? Like the early forms of those things. They were actually pretty effective.

Mimicked more. What a, you know, a human breast would be like. And so was a better tool for feeding a baby. And this was a lucky time to be a baby compared to previous times in history because not only did we have devices that were easier to use to feed the baby, like bottles and nipples, but they were cleaner

than drinking, like a lot of the things that they would use previously to feed babies, like because we didn't really understand germ theory or anything, you would just have like milk or water and like some food substance and different. Like I said, melt a butter, whatever, like food substance is sitting in something and it wouldn't be cleaned properly in between.

And so you can imagine how contaminated. So it's actually a little more sanitary, weirdly. Mm-hmm. It was more sanitary because we're also moving into the era where we come up with pasteurization. So all of a sudden we can move into the area where we can properly treat milk so that it won't give you bacteria that will kill you.

That's easy put in the fridge. I don't know why they didn't. But, well, no, they didn't, well, they didn't. Just put in the fridge. No, that's not enough. What? You got to pasteurize it first. You got to kill all the bacteria first.

Yeah, yeah, but after that you'll leave in the fridge. Well, yeah, after that you'll leave in the fridge. If you had a fridge, but they didn't have a fridge yet. Yeah, that's kind of what I was. It wasn't a good, I mean. Well, you can't just put it straight in the fridge or drink it straight from the cow. We don't do those things. I'm not so sure. But when did we figure out that animal milk and human milk were not the same? Because that seems like, I mean, that was probably a big hang-up, right? Like, I don't know.

It feeds cows and they're like bigger than us. So it can probably swing a baby. It's like much smaller. It's a different. Yeah, but why would you have any, especially at that point with our very sort of rudimentary? Yes, that's a good word. Understanding of nutrition, how would you ever know why that was better or worse? Right?

Well, they had some suspicions by the 1800s because they had started to note that infants that were fed only animal milk and no breast milk actually had like more GI problems. They were more likely to be dehydrated and in general their mortality was higher than breastfed infants. And so they knew there was something different in the nutrition they were getting. They just didn't really understand what. It stands to reason to us, modern folk, for lots of reasons, but probably is a pretty big revelation back then.

Yeah, and this is outside of the idea of antibodies and stuff that can be given across in breast milk. I just mean, you know... The nutrient- Yes, that was obviously, if you, there's a reason we do not advise giving a new born straight up cow's milk, right? There are reasons for that, and this is what they were seeing. So in 1838, Johann Franz Simon published what was like the first chemical makeup comparison of human milk and cow's milk, right?

Where we first finally look at the two substances and say, oh, okay, these are the differences between them. Because once we found the differences, then you could start trying to fix the cow's milk, so it's more like the human's milk, right? So the biggest difference that they found is that cow's milk generally is higher in protein and lower in carbohydrates. Oh, okay. So it wouldn't be as sweet. Yes, but also like there's stuff you need, like you need the carbohydrates. Yeah. Yeah. And especially a little newborn baby bodies weren't always necessarily as good at breaking down all that protein. And they needed more carbohydrate.

There's also like some differences with fats that we would later discover. We have all specifically for this to be a good food for babies. Yes. Right. Yes. Well, that's, I mean, I think that's the thing to remember. It's the one to one. It's the one to one.

It's the one to one. For every mammal pairing, Like cow's milk is specifically what baby cows need. Human milk has evolved to be what baby humans need. Although you can probably find them great TikToks of baby cows trying to feed off of mom bears, I bet that is not a common occurrence in nature. I don't know. I think that there are animals like cross nursing each other. I feel like I've seen videos of that. I did just say.

Sure, there's TikTok stuff. Oh, yeah. Yeah, I think that does happen. Yeah, like cute animal friends. It shouldn't be friends. Like when you see like a cheetah, he's got a little monkey friend and they're like best friends.

I love that. And that might work like for a little nip, like a little, yeah, just a little nip. We can have a little nip. We can have a little nip of cow's milk. Yeah, just a little, yeah, it's like a snack, but like just not all the time. So this led to the conclusion that, okay,

we can fix cow's milk if we add cream, sugar, and water. I'm getting hungry, we're here now. We're gonna dilute it and then we're gonna throw in some cream and some sugar, some sweet and some fat, and we're going to fix the cow's milk, right? It's going to be more like human's milk. But it was very unscientific. It was just like added in there. To taste probably.

Probably. Yeah. And so- You didn't analyze the chemical composition. They could probably reverse engineer something approximating a recipe, right? Well, somebody did that. Okay, good. So that fell to Yastos von Leibig,

who was a German chemist, who had devoted his whole career to understanding nutrition, and specifically fighting hunger. I think it's kind of interesting, just as a little bit of a backstory why von Leibig was was so like why he was devoted to this. Why was he driven to this specifically? In 1815, okay, so we're going back a little

bit. Mount Tambor on the island called Sunbaewa in what is now Indonesia. It wasn't Indonesia time, it is now Indonesia. It erupted. So it's this big volcano that erupted, okay? It was the most powerful volcanic eruption in human history. Have you heard of this? No, never have. Okay. So because of this gigantic volcanic eruption in 1815,

the like the big column of ash that this produced, like blocked the sun, and lowered the global temperatures to the point that 1816, the following year, became known as the year without a summer. Oh my gosh. Yes. On earth? Yes. Wow. This was mainly a European concept, but yes, it would have affected temperatures all over the earth. But so anyway, because it was a year without a summer, I mean, I'm not literally like it was probably warmer, but not normal temperatures. Because of this, because of this crops failed. So there's no food. So mass starvation, right? So in this summer, when there was no summer, and people were starving, and a 13-year-old useless was seen, this happened around, hit me, lived in Germany, and he's seen all these people have to eat rats because there was no food. They couldn't grow anything. This is what, I mean, we can assume we think.

That'll get to you. Yeah. And it inspired his journey in life to study nutrition, to understand fighting hunger, to understand feeding people, and create what was the first baby formula, which is pretty cool. I think it pretty cool. I guess cool. Because again, there was no perfect alternative to breast milk at the time. And so babies that were being fed anything other than breast milk were being fed something nutritionally inferior, perhaps dangerous for them.

So he invented libig soluble infant food. Not. I probably a super science genius. Again, you got to get marketers in here. Well, baby juice. And see, here's the problem. So he comes up with the first baby formula. It's a powdered formula. Okay. It's got some cat, a mixture of some cow's milk, some wheat flour,

some malt flour, potassium bicarbonate. It would need some shelf stable, I would imagine. It would be important in the time. So he makes these cans of the Slybig's soluble infant food, sold for $1 bottle in 1869. It's one that went on the market for $1 bottle. $1 bottle in 1860. Yep. A lot of the second one.

I'm gonna have to do some urgent, keep talking. Okay, well, Justin, while you do some math, I'm gonna head to the building department. Oh, that's perfect timing. This has never worked out before. Okay, let's go. The medicines, the medicines that I skill in my cards for the mouth.

Hi, my name is Graham Clark and I'm one half of the podcast stop podcasting yourself. I show that we've recorded for many, many years and at the moment, instead of being in person, we're recording remotely and you wouldn't even notice. You don't even notice the lag. That's right, Graham. And the great thing about this, go ahead. No, you go ahead. Okay.

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a cat and knocking the clean laundry over. Alright, Sid. So that bottle of life-sick, super baby instant soluble baby food, what have you? For $1.86, now it would be $21.26 today. So expensive. Expensive. Expensive stuff. Yeah.

I mean, it was hard to formulate and it was expensive. So he starts selling it. He's the first, but what happens? The big companies. Sweet ban. They swoop in. First of all, Nestlees. Nestlees comes in first, and they make something similar,

and a powdered infant formula. And all of these have similar ingredients, slightly different amounts, maybe, of different things. But generally, these are the same ideas. But this one has two key advantages. Nestleys has two key advantages that outcompete libiGs. First, the libiig formula was made to be reconstituted in warm cow's milk.

So you still had to have milk, right? Right, right. Which I mean, I guess if you had a cow, that's all great. But if you don't have a cow, you still got to buy milk. And you're already paying whatever, 21 bucks a bottle. Secondly, and Nestle's you just had to add water. So that's easier.

Okay. And then secondly, Nestle's was half the price, 50 cents a bottle. That is a steal. I mean, compared to. So Nestle's comes on the market. And that was not the only, the only one who would sort of knock off this idea. By 1900, you could get like eight different infant formulas from the Sears catalog.

And all similar kind of approaches and with varying costs all between $50 cents and a dollar for a bottle somewhere in there with different advantages and things touted by each of the different manufacturers. But the problem, as you're probably already guessing, is that this is still expensive. This is still very expensive. And if you are trying to raise a family, and for whatever reason you're in a position

where breast milk is in an option, this is prohibitively expensive for most people. So they're still just gonna turn to cow's milk because it's what they It would be the same thing our parents would say today, right good enough for me Yeah, right good enough for you as a kid and they couldn't afford the alternative. Yeah, so they would have just done that Now at this point doctors also wanted to get it on the act because they're what low-key and all this and they're like well We're experts in what humans need we're doctors like Why aren't we the ones coming up with these ideas? So they kind of came up with through some research,

like a compounded formula, like their own sort of recipe for you to use, like, okay, you can't buy these formulas because they're expensive, right? And you're not breastfeeding. So the big idea for them is you got to dilute the protein. There's too much protein, we needed to dilute it. So, you take the cow's milk, you add some water, and then you put in, and they had exact

amounts of cream and sugar. And then you could either take this order to a pharmacy, and they would compound it for you, just like they would like a medication. They would compound it from you, just like they would like a medication. They would compound infant formula for you. Or you could take the recipe home and try to do it yourself at home either way. And that could also account for with this sort of method of like the doctor giving you

a recipe for your formula. You could also account for changes. Like once pasteurization became widely accepted, they begin to analyze pasteurize milk and they found that it was lower in levels of vitamin D and C after it was pasteurization became widely accepted, they began to analyze pasteurized milk and they found that it was lower in levels of vitamin D and C after it was pasteurized. Now, you still need to pasteurize it. So you don't die of bacteria

that could be in the raw milk, which is why you should not drink raw milk. Again. Again, I think we've already done that episode, but just say again. So many of you are still drinking raw milk, so. Pasteurization is necessary, but you did need to supplement with vitamin D and C. So, you could throw some of that in there by way of orange juice and cod liver oil. So, some of the doctors formula's got even more, you know, fancy.

Yeah. You need some milk, you need some water, you need some cream, you need some sugar, you need some cod liver oil, you need some orange juice. Now with a great orange flavor, kids get crazy for it. This is how sunny D was invented. And this would be altered even further with it within like this same time period, first condensed milk was invented,

which had a ton of sugar in it, right? It's delicious, it's yummy. They figured out pretty quickly like, there is no way this is good for babies. That had to have been a moment of like, oh, it's more concentrated. Is this? No, this can't be right. There's no way this is what we're supposed to feed babies. It's too delicious. The babies are like, oh, yeah, okay. Hey, some Eagle brand. Yeah. I was also stressed out about immortality right now, but I'm feeling pretty good. I'm ready to go. You want carbs, not that many carbs.

So evaporated milk seemed to be a better option because you didn't add in all that sugar, right? But you're still concentrating the milk and it was more easily digestible what you end up with when you go through the process of evaporating milk. So you could use this to make a compounded infant formula that would become like the mainstay of infant nutrition for decades. That there was this formula that your doctor would tell you, like you take 13 ounces of evaporated milk, you put in 19 ounces of water, and then two tablespoons of either corn syrup or table sugar.

Oh, and you would throw in like a vitamin and an iron supplement too. Is this how we got to the nomenclature formula? Like why it's called that? Because there's so much of this ingredient blending that got to something that you would want to give your kid. Yes, because that's exactly what they're trying to say. They are starting with the natural product, human breast milk, and attempting to devise a chemical formula that will recreate it in a lab. I mean, that is basically what they're trying to do. And then they're usually using cow's milk as a base because it's a good jumping off point,

right? Right. Right. Okay, so throughout the early 1900s, while this is happening, while people are making their evaporated milk formulas, which were again like the mainstay for a very long time. The majority of infants were getting this evaporated milk formula, especially as breastfeeding went out of fashion eventually. But scientists and physicians were still working on like something that would be that would come in a can or a bottle or, or whatever, and be perfect. Like not something you have to make at home. You could just sell it.

So, they were still working on something like that. And you see this introduced throughout this whole time period. Like it wasn't like as soon as it came to market, everybody switched to it. So like in 1926, the first Simulac was developed, which is the word Similac, similar to lactation. Yeah. So, similac was first introduced in 1926. And there were other formulas that were introduced throughout, like the 30s and 40s. There was infamil would come up and then new tramogen.

These are things that are still... The brand was new tramogen. Yeah, this is still a brand. Maybe it loves his new tramogen. There's another one called Alimentum. Like these are still formulas today and they sound very scientific because this was the selling point.

Right. They are scientific. Right. But the thing is like, even as these were introduced at the time, nobody was buying them, because it was still super expensive. And why would I bother? I can make that, I got evaporated milk,

I got cream and sugar, like I got this stuff at home. Why would I mess with this? Yeah. And it really wasn't until the 50s, when people started slowly switching from these ratio-based homemade formulas that they were told to use by their doctors to something that was seen as scientifically superior, medically superior, physician recommended.

And it took doctors a while to switch to recommending them to, but eventually they did because the science was on the side of these formulas. These are better. So if they sound really scientific, that was part of the marketing. It is. This is to build a better baby. Well, and it works so well that like there was this, there was this peak in the 60s and 70s when breastfeeding rates were like 25% of the public or something, but it was because this is scientifically proven to feed your baby.

I can't say that about your breast milk. That's just coming out of your boob. It's like, this is science. It's like, Bronno for babies. It's got what babies crave. It was seen as like, this is the better thing because like doctors and scientists spent years, I mean, decades trying to make this.

They went through hundreds of different formulations to come up with exactly the nutrition that your baby needs. And so it really, like I said, reached a peak in the 60s and the 70s, the American Academy of Pediatric set standards for like the vitamins and mineral levels and the formulas so that, you know, things would, you could make sure that things were coming out right. And the formula industry at this point also started distributing those little pre-filled bottles. You know, like you can get in the hospital. And that was a huge selling point because here you've just had a baby, you're, you know, you're stressed out, you're trying to get the baby to eat, and they can just hand you this pre-filled

like here it is, just take it. It's ready. It's ready to go. Here's one thing you don't have to think about. You don't have to stress about, here's the food. And so that really made uptake of those formulas, go through the roof, you know, because that's so much easier than I'm gonna mix something up in your kitchen at home. There were a couple of cases of like, inappropriately mixed formula in terms of like, deluding and the electrolyte levels and stuff in the late 70s which led to some babies having low sodium levels and

being hospitalized and because of that in 1980 they passed the infant formula act which sort of codified the standards for formula and the standards for like testing and like the process of making the formula and making sure that like these companies that are going to do this are going to go through pretty rigorous processes to make sure that what they're sending into your home or your hospital room. Kind of wild, but that we weren't doing that already in a sense, I guess, maybe.

Well, I mean, that's the whole history of medicine though, right? We start doing things and then somebody goes, that seems like something we should regulate, right? Why are we just letting people do that? So now we have formulas with cow's milk, with soy milk, we've got higher calorie ones for neonates, we've got, like I said, like elemental things that are easier to digest, you know, for a variety of reasons.

We have all kinds of different formulas. Decaf, finally. Hopefully they're all thinking different formulas. D-Caf, finally. Hopefully, they're all thinking. I don't know what took so long. And a lot of them, too, like the idea now, is that you shouldn't have to supplement with like a vitamin D or with an iron or anything like that, it's all in there.

It's in there. Right? So why, what is happening now with formula? So that's where we are. We have formula, which is an excellent alternative to breast milk, which gives your baby the nutrition it needs to be great at basketball or whatever, whatever you're baby to do.

You wait, yeah, run for office. Whatever, whatever you want your baby to do. Climb that, Everest. It's all your baby dreams can be realized. Yeah, exactly. We've come a long way with that. And that's great, except from November of last year to February of this year, they found four cases of newborns becoming quite sick with something called chronobacter,

Socazacii. Socazacii. And in most adults and older kids, the specific bacteria is not particularly harmful, but in newborns, the elderly, the immunocompromised, you know, people who are more vulnerable to these types of bacteria, it can lead to life-threatening infections, things like meningitis, brain abscesses, and in fact, two of these children did succumb to this infection.

So the concern became after it was isolated that this was the bacteria responsible, where did this come from, and this can grow in formula. Like this was this is known to be something that can contaminate infant formula. If the appropriate process, these aren't being done and the checks aren't happening and all that kind of thing. And so because there were these four cases, it led to this huge recall out of concern that what if it is in the formula, all of the effective products. And then one of the plants, it was an Abbott Laboratories plant was actually closed down as a result of this.

And I will say, for what it's worth, they never did, they weren't able to isolate it in the factory, improved definitively, where it came from, but there was enough in common. I mean, it's a better safe than sorry, right? Like, if, I mean, it's life threatening. So, you know. Yeah, yeah, too. So they shut down the plant and this dramatically reduced our stores of formula

in the United States. Because there are only four manufacturers in the US. The vast majority, like 95% of formula is domestically produced. We do not import very much formula at all, because we have really high import tariffs. So in order to encourage people to buy American and to allow our American factories to succeed, we don't import formula.

This is sort of a big sticking point politically for a lot of people because in Canada, there is a booming formula industry, maybe related to all the dairy there, I don't know, but there's a lot of formula. And we could, if we were going to take imports, well, we could take imports from Canada, they're just really expensive,

but we do have the ability to have the FDA inspect their factories and like, it's not necessarily unsafe. It's just expensive. So we don't. So it's not really to make, I mean, that would be the line, right? We don't want it for formula to maintain safety standards. Well, that's not entirely true.

It's really about making sure American manufacturers can sell their product. Right. It seems where they can do an emergency action to like lift those tariffs to get some baby form out there. Yeah, it almost seems like you could. Weird. And the other thing is that things get even more complicated with the WIC program, the Women Infants and Children program, which ensures that everybody can feed their children,

which is wonderful. Obviously, we should have the ability that you can't afford formula. It should be provided free to you and to your child because I don't know, human decency. But it gets complicated because each state awards the WIT contract exclusively to one formula manufacturer which gives them a lot more shelf space in all

the grocery stores in that state. I mean, other formulas can be in the state, but WICM, like your WIC certificate only buys that brand, right? And so if that brand then gets a recall, everybody who uses WIC in that state is in shape, right? And so like this can be disastrous. So now we have a formula shortage. And there are things they can do like, this is really important if you do have WIC. A lot of people, if they found that they, and you can still check, I mean, I think,

the investigation is over at this point, but you can still go to the CDC website. And they have an entire section on this outbreak and they tell you like, you still go to the CDC website and they have an entire section on this outbreak and they tell you like you can go to the Abbott Nutrition website to find out if your product was one of the ones that was recalled At this point it is unlikely you have this But you can still go check that if it's something that you're concerned about because they were specific types of Simulac and Elementum and L.A. Care were Care were the recalls. And they have all the numbers and everything

that you can check. But if you did have, if you get your formula through the WIC program, they were really, they wanted you to know, don't throw it away because you can take it back and get something else. Like you can exchange it basically. And if you throw it away,

it would be harder to prove like, I already used my WIC to get, you know, I need something else. And so that was part of it too. And a lot of states have already done that. I know West Virginia did allow you to get whatever with your WIC, you know, funding so that that way you're not like tied into. The only thing I can get is this and they're out of it. You can get anything.

But even with those sorts of things, it's a huge problem. Of course, yeah. The factory, I think, will reopen shortly or already has or production should be restarting because the investigation is ended and they feel like there's no longer a threat of new cases. And they haven't found any since those four. But we're still where we are.

Obviously, don't hoard formula. I can't imagine any of our listeners would be the people doing that. How are we not doing that? There are people doing that reselling formula for money, for an upcharge. Come on. I can't fathom anybody who listens to our show would do that. But, and then the other thing that has come from this are people saying like, here are ways

to make your own formula. And I know you would ask me about one with like, fruit and milk or something. For older, it's for older kids. So the idea of making your own baby for me or baby food and things like that for over six months old. I mean, there are lots of options for that, right? This is what I'm, yeah.

This is what they were talking about in the news, making a blend of like, I don't know, I don't even do, I'm not giving medical advice here, so I don't know how I'm gonna say around to you, but for six months plus. I mean, this is the tough, this is the tough situation. There is, as we've just charted the history of the development of formula, the point of There is, as we've just charted the history of the development of formula, the

point of it is there, there just isn't anything that's like formula, formula's formula. Again, there's a reason we don't just use cow's milk, it's not the same. Couldn't you do the evaporated milk thing? Like, is that a recipe that? Well, I, I wouldn't because again, it was never proven equal to formula. I mean, so I wouldn't recommend any of these. And certainly what, like something that you're getting from like a YouTube video or a TikTok or something like that, I would not recommend trying any of these homemade formulas. Because again, like the, how can you use sterile technique

at home to make these sorts of formulas? How can you not, which I will say formula isn't technically sterile to begin with, but still. There's a lot of room for dangerous things, for wrong proportions, for something to go wrong that you would inadvertently harm an infant. And obviously nobody wants to do that.

If they did have a big section on the CDC website with the advice of how to deal with us that if you have a child who's supposed to be on specific formulas for perhaps like medical conditions, underlying issues, things like that, please talk to your doctor immediately if you think you're not going to be able to get those products because there was this discussion of like risk-benefit ratios and maybe there are certain things you shouldn't throw away. So like, please, if you have questions like that, you should be reaching out to your child's doctor or to your, if you're the guardian, to the child's doctor, to discuss with them what the best

move is. But I do not advise making- There could be any sort of allergic reaction. Yes. Do you like that possibility contaminants. I mean, who knows? And again, there are like a lot of the babies that we talked about that were dehydrated because they were getting the wrong proportions of sugars and fats and proteins and all those different things and liquid content and all of that. Again, it's scientific, it's formula. It's made to be the perfect food for your baby, just like breast milk is.

I've been seeing a recipe card from like the 50s circulating from this like evaporated milk formula recipes to be able to be sharing around. But it's hard because I understand, again, it's sort of like what we were talking about. I understand this sort of argument like what was good enough for me or it was good enough for my kid or whatever, but like, being from the generation where on long car trips, I was just sort of allowed to roll around in the back seat of the car, under strain, because it would be hard for a kid to be in a seatbelt that long. Like yes, I'm fine.

Thank goodness. I'm still here. I would never recommend that to any parent or guardian today. I would always encourage you to use appropriate car seat, safety seat, booster seat seat belts, depending on the age and weight of your child. I would never, ever encourage that. Even though, yes, I did survive that.

Yes. We grow and we learn and we have made mistakes in the past and we learn from those mistakes and we don't repeat them. And we should not, this is not the best thing. And I know that that doesn't give you like a definitive answer as to what to do, but I do think that it's important not to do something harmful. And then of course, just as like a final word, there are donors of breast

milk that you can find sometimes, sometimes it's free. Sometimes you got to pay and it's expensive to pay for breast milk. It really, I mean, it's expensive as it was back in the day to buy formula. So take it from me. I've been trying to kick the habit for years. I'm going broke on that stuff when I didn't know that. But and I mean, if you can find like a safe donor source, that's that's fantastic. Not everybody can and certainly not everybody can or wants to or chooses to for whatever

reason, breastfeed. And so to just simply suggest this, this kind of to parents and guardians that the solution is breastfeeding. Just breastfeeding. And then about that, it makes me so mad to like, who was it? Some celebrity, I think Batman Lear maybe stepped in at this week who was like, try breastfeeding. It's like, it's so infuriating

that we have this society that has worked against breastfeeding like actively in a culture, I would say, and a society that has discouraged breast feeding for so long. And then it's like, wait, why is everybody just breast feeding? Because it's like, it's not just flipping and swit. Like, it would be akin to if there was a food shortage. And everyone was like, just eat the stuff in your garden. It's like, yeah, not everybody has a garden. Like, we've moved away from that. Yeah, just go kill one of your chickens.

Yeah, just go kill a chicken that you have. Like, we haven't encouraged a culture of breastfeeding for decades. Like, why would you, what? People don't understand, it's not like you can just pop out a boob and go to town. Like, so like these stupid people are like, well, I've got to feed my baby somehow.

I've got delicious milk coming out of my chest. Why did that never occur to me? Like, if a baby's upset or seeing, it could be hard to get them. Some babies never get into it. Some babies just don't. Some parents, she's not to breastfeed, some parents try and just are unable to

for a variety of reasons. We also don't have the resources to help people like to support people who are attempting to breastfeed. Well, we don't give paid family leave. We don't make it easy to leave work, to have a flexible schedule to feed your child or to pump or to do any of those things. We have no support for people who choose to breastfeed already.

And so then to just suggest that like if you're not already doing it and you don't and you're not lactating to just induce lactation, it also assumes that there is a person who can lactate taking care of every infant, which is not true. It's ridiculous. So, that is obviously not going to be a solution for the vast, fast, fast majority of people. And I say this is somebody who I loved my breastfeeding experience. I was very grateful for it. And I encourage people who ask me, I would like help with breastfeeding. I encourage them to do so because I got a lot of joy from the experience. That doesn't mean that

everybody needs to has to, should, wants to. It's not, I mean, the thing about formula that has been wonderful is that formula one provides nutrition for babies who need it, period, which is the most important function of formula. But beyond that, it also is key to allowing people who lactate to make that choice, like to make the choice to breastfeed or not, or if you can't, that's either way, whatever your reasons are. And also to leave the house, to go other places, to work, to have a job, there's all kinds of things that formula allow,

to sleep at night so that perhaps your partner can take a feeding. Or again, just a supplement feeding or replace, breast milk, if that's not the best option for family. Well, we're saying you said this is incredibly complex as you, and if you don't understand it, you should probably, like, you should probably not start talking about it. It's the kind of thing that you certainly can't fix

or explain with a tweet. Hopefully we know that. Right. My hope is that production is going to ramp back up. And I mean, maybe we need to reevaluate. Well, first of all, we could, we can turn factories into whatever we want them to, right? Do we have a defense production act? Can't we just say like make for me, or make formula now?

Everybody make formula. This is an emergency. We need to feed infants. I don't know what's a bigger emergency feed infants. So do that and in formula, whatever we need to do to get say formula to infants. Let's do it. Let's do it. Hang in there folks.

That's a stressful, if you're experiencing this and you're hit by this I Hang in there. I know I wish I had a great alternative to tell you but It's I don't know what it is and I think right now Trying to make your own DIY formula at home Could be very dangerous. Yeah Thank you so much for listening to our podcast, Saul Bones, thanks to the taxpayers for using their song, Medicines as the intro and outro of our program.

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