Before newborns can try solid foods, breastmilk or infant formula are the sole sources of nutrition to keep them fed. This is why the infant formula shortage has added yet another layer of stress on families with infants.  As many families continue to struggle to access formula, a new brief from the Kaiser Family Foundation unpacks which infants rely in whole or part on formula. Unsurprisingly, Medicaid and CHIP cover many of the infants at risk of health complications stemming from the formula shortage, notably low-income infants and babies of color.

Say Ahhh! readers know that Medicaid and CHIP cover a disproportionate number of children of color and low-income children. Kaiser uses CDC data to detail how low-income infants and infants of color—notably Blank and Latino newborns—are less likely to exclusively breastfeed through three months, making formula more critical for these families. The same is true for families under 200% of the federal poverty line.

But what about infant feeding practices among infants covered by Medicaid/CHIP? The brief’s analysis of National Survey of Children’s Health data shows that more than one-third of infants covered solely by Medicaid and CHIP used formula in the first 12 months of life. And as shown below, newborns in Medicaid or CHIP were more likely to be fed formula in their first 6 months of life than their privately insured counterparts in 2020.

State Medicaid agencies and their health plans, health providers, public health agencies, and advocate partners can work to ensure infants get needed formula. Many infants covered by Medicaid may also qualify for the federal Special Supplemental Nutritional Program for Women Infants and Children (WIC) based on their income. As an immediate policy step, states are using new federal WIC flexibilities that waiver certain WIC purchasing restrictions to broaden the brand and type of formulas available for WIC recipients during the emergency. A list of states adopting new WIC flexibilities as of June 15 is here.

National and state efforts to address the formula shortage may offer a new chance for state prenatal-to-three coalitions and partners, including state Medicaid agencies, to examine ways systems could more effectively collaborate in the longer term through a unified state vision and strategy for addressing health and social needs of prenatal-to-3 populations. In the case of access to food, for example, state agencies and coalitions could work together to boost WIC uptake through outreach and eligibility changes or create stronger referral links between traditional health and public health providers to help address families’ health and social needs beyond this acute crisis. But today, the priority is getting formula in the bottles of the infants who need it, and you may not have to look much further than Medicaid enrollment to find them.

The Kaiser brief can be accessed here.

HHS resource for families (including translated content): https://www.hhs.gov/formula/index.html

White House response page: https://www.whitehouse.gov/formula/

FNS Infant Formula Safety webpage

Federal WIC payments: https://www.fns.usda.gov/wic