DOVER (May 17, 2022) – The Division of Public Health (DPH) is providing guidance to families struggling to find formula due to a shortage caused by a supply chain issues, including avoiding taking certain measures that could be harmful to their infant’s health.

DPH sent out a letter from U.S. Department of Health and Human Services (HHS), Health Resources and Services Administration’s Maternal and Child Health Bureau to families and maternal child health stakeholders, offering individuals information on how to safely navigate the shortages. 

Parents and caregivers are offered the following guidance:   

•  Talk to your doctor: Families should consult their pediatrician to discuss the best options for their child. Doctors can provide guidance on comparable formula and specialized formula to meet their babies’ medical and nutrition needs. 
• Consider a substitute formula: For most babies, it is OK to use a similar version of their formula if their regular brand of formula is not currently available. Talk with your baby’s pediatrician about alternatives.  
• Check the manufacture’s site online for formula availability before going to a store to purchase.    

DPH reminds parents/guardians: 

• Do not make or use homemade formula: Per the American Academy of Pediatrics (AAP) and Food and Drug Administration (FDA), homemade formulas often lack or have inadequate amounts of critical nutrients vital for a babies growth and development and in some cases can cause infants to be hospitalized due to low calcium. 
• Never dilute formula: Watering down infant formula can be dangerous and even life-threatening, leading to a serious nutritional deficit and health issues. 
• Consider a substitute formula: For most babies, if their regular brand of formula is not currently available, using a similar version of their formula is ok. Talk with your baby’s pediatrician about alternatives.  
• If not receiving breast milk, formula should be used until your baby turns 1 year old, but if your child is over six months you can start to supplement nutrition with some solids. Talk to your pediatrician about introducing some solids like fortified cereal, mashed bananas and pureed poultry and beans. 
• Talk to your doctor: Families should consult their pediatrician to discuss the best options for their child. Doctors can provide guidance on comparable formula and specialized formula to meet their babies’ medical and nutrition needs.  
• Breastfeed your child: When possible, breastfeeding is the healthiest option for children under age 1. 
• For parents who are breastfeeding or need additional support, they may want to consider a lactation consultant or support groups, or seek assistance to access a breast pump at a low cost through your insurance provider, Medicaid, or WIC to assist with milk supply. There are also breast milk banks that properly store, test and distribute donated mothers’ milk to meet the specific needs of infants for whom human milk is prescribed by physicians.  The Delaware WIC program offers breastfeeding assistance to new mothers, including peer counselors, lactation consultants and manual pumps. Details on WIC’s breastfeeding programs can be found here. 

DPH has also taken the following steps to help parents and caregivers as the supply chain issues get resolved nationwide: 

• WIC recipients have been asked to return any unused formula to the Food Bank of Delaware or another state agency food pantries.   
• WIC recipients also were granted a waiver to substitute formula this winter when supply chain issues that were made worse by a recall first emerged. A chart of formula alternatives was created to help parents and caregivers select the right formula for their child.   
• Parents who are breastfeeding or need additional support may want to consider a lactation consultant or support groups, or seek assistance to access a breast pump at a low cost through their insurance provider, Medicaid, or WIC to assist with milk supply. The Delaware WIC program offers breastfeeding assistance to new mothers, including peer counselors, lactation consultants and manual pumps. Details on WIC’s breastfeeding programs can be found here.   
• DPH reminds parents that state and community resources that could be helpful during this time are available, such as WIC, SNAP, or TANF to help with the cost of buying formula or to find other infant supplies through local food banks including the Food Bank of Delaware. DPH also offers a breastfeeding guide for mothers who want to find support or learn more about breastfeeding.

Several birth hospitals in Delaware also offer breastfeeding support and parent education. Individuals should check with their local hospital to see what services are offered.   

Delawareans are encouraged to visit dethrives.com for up-to-date information on Delaware’s response to the infant formula supply chain issues, call 211 for community resources and services near you, or follow DEThrives and DPH on Facebook and Instagram.     

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Anyone who is deaf, hard of hearing, Deaf-Blind or speech disabled can contact DPH by dialing 711 first using specialized devices (i.e., TTY, TeleBraille, voice devices). The 711 service is free and to learn more about how it works, please visit delawarerelay.com.   

Delaware Health and Social Services is committed to improving the quality of the lives of Delaware’s citizens by promoting health and well-being, fostering self-sufficiency, and protecting vulnerable populations. 

DOVER – The Delaware Division of Public Health (DPH) is reminding Delawareans to avoid consuming raw dairy products as it announces a confirmed case of brucellosis caused by Brucella melitensis in a 46-year-old Sussex County woman. The illness is a bacterial infection, which primarily affects those consuming, or coming into contact with, contaminated animals or animal products. The most common source of infection is through the consumption of raw, unpasteurized dairy products. Prior to becoming ill, the patient in this case had consumed unpasteurized homemade dairy products from Mexico. No other risk factors have been identified. The individual was hospitalized and is recovering after being treated for the illness. A second, related case of brucellosis is also pending confirmation by the Centers for Disease Control and Prevention (CDC).

Brucellosis infection is most frequently transmitted by eating or drinking raw/unpasteurized dairy products such as milk and cheese, yet can also be contracted through inhalation or physical contact with infected animals or animal products. When sheep, goats, cows or camels are infected, their milk becomes contaminated with the bacteria. If the milk from infected animals is not pasteurized, the infection will be transmitted to people who consume the milk and/or cheese products. Brucellosis is not common in the United States. Nationally, the average is less than 200 human cases each year. Person to person transmission is rare. Prior to this case, DPH has confirmed three cases since 2010; those cases occurred in 2010, 2017 and 2018. The case in 2010 was associated with consumption of unpasteurized milk while the nature of exposure in the 2017 and 2018 cases is unknown.

“Cases such as this one can serve as an unfortunate reminder that we are vulnerable to certain bacteria and should take precautions to protect ourselves,” said DPH Medical Director Dr. Rick Hong. “Delawareans are encouraged to avoid purchasing and consuming unpasteurized dairy products. Consuming questionable food items is not worth the risk to your health.”

Raw milk and milk products are those that have not undergone a process called pasteurization that kills disease-causing germs. These types of products are common outside the United States and are increasingly being sold in mainstream supermarkets in the United States as well, though sales are not permitted in Delaware. A wide variety of germs that are sometimes found in raw milk can make people sick. These germs include Brucella, Campylobacter, Cryptosporidium, E. coli, Listeria, and Salmonella.

The state’s Milk Safety Program, as well as statewide inspections of retail food establishments, are in place to protect consumers from purchasing or consuming raw dairy products, but unlawful distribution may still occur. Some neighboring states allow for the sale of raw dairy products, therefore residents should be aware of the health risks associated with consuming these products before purchasing and consuming them.

Signs and Symptoms of brucellosis are similar to the flu. Initial symptoms include fever, sweats, malaise, anorexia, headache, muscle or joint pain, and fatigue. Antibiotics are typically prescribed to treat brucellosis. In pregnant women, Brucella infections can be associated with miscarriage. Symptom onset can occur anywhere from five days to six months following exposure. Depending on the timing of treatment and the severity of illness, recovery may take several weeks.

No vaccine is available to prevent developing brucellosis, but preventive measures can be taken:

• Do not eat, drink, or purchase unpasteurized milk or dairy products, especially while traveling outside the
U.S. Locations that commonly sell dairy products include supermarkets, farmers’ markets and dairy farms.

• Read the label on milk or milk products before you buy them. Many companies put the word “pasteurized” on the
label. If you are not sure, ask a store employee if specific brands are pasteurized.

• At farm stands or farmers’ markets, ask if the milk and cream being sold have been pasteurized. If the
market sells yogurt, ice cream, or cheese, ask if they were made with pasteurized milk.

• Meat packers, hunters and slaughterhouse employees should wear protective gloves and wash their hands
thoroughly when handling raw meat.

For more information about brucellosis, visit https://www.cdc.gov/brucellosis/index.html. For more information about the risks of consuming raw milk and unpasteurized dairy products, visit https://www.cdc.gov/foodsafety/rawmilk/raw-milk-index.html.

The Delaware Department of Health and Social Services is committed to improving the quality of the lives of Delaware’s citizens by promoting health and well-being, fostering self-sufficiency, and protecting vulnerable populations. DPH, a division of DHSS, urges Delawareans to make healthier choices with the 5-2-1 Almost None campaign: eat 5 or more fruits and vegetables each day, have no more than 2 hours of recreational screen time each day (includes TV, computer, gaming), get 1 or more hours of physical activity each day, and drink almost no sugary beverages.