Sunday, September 25, 2022

Lessons from World War II can help us navigate the baby formula shortage

492
SHARES
1.4k
VIEWS


Placeholder while article actions load

The United States is suffering from a severe shortage of baby formula, with the nationwide out-of-stock rate climbing to an alarming 43 percent. The shortage has prompted frantic parents to post pleas on online neighborhood networks. The shortage, and desperate parents seeking to overcome it, has echoes of the World War II era when infant feeding became a matter for government intervention.

Wartime conditions — most especially a demand for tin to manufacture military equipment — led to a shortage of infant formula because tin was used for canning condensed milk. This history offers a lesson as the government scrambles to address the infant formula shortage in 2022. Since such shortages hit vulnerable families hardest, efforts to overcome them require full mobilization to ensure that every infant is fed.

By the 1920s, breast feeding had fallen out of favor among all social classes. Infants who were not breast fed or who received a combination of breast and bottle and solid foods typically consumed canned sweetened condensed milk, the most popular being Bordon’s Eagle Brand Baby’s Milk. Other families used a homemade formula usually consisting of condensed milk, water and karo syrup. Cow’s milk, which today is not given to babies until age one, was used in some of these formulas.

For much of the 20th century babies also began eating solid foods in their fifth or sixth month. They consumed an astonishing variety of foodstuffs as evidenced in a warning from the New York State Department of Health that “Ham, bacon or pork, cabbage, pickles, tea, coffee, or beer, bananas, berries, cake, candy or ice cream should not be given to babies or little children.”

During World War II, however, the free market gave way to wartime emergency government controls. Just like their parents and siblings, that meant infants received ration books from the government — after the ration board saw their birth certificate or a statement from a doctor or hospital. Infants’ ration books provided them with 16 ration points per week to spend on canned condensed milk. This ensured that babies had equal, if limited, access to the food they needed. Since canned milk was a primary food source for very young infants, some needed more than the ration points allowed.

While the government did not ration fluid milk, it had to be mixed with syrup and diluted with boiled water to be part of a prescribed formula. More critically, it required refrigeration and not all families had refrigerators or ice boxes in the 1940s. Moreover, to purchase the most desirable Grade A milk, families needed a prescription, and low-income families and those living outside cities often lacked the means of obtaining those prescriptions. That forced them to purchase Grade C milk instead, which, while safe and not adulterated, was of lower quality in terms of production, taste and fat content. Similarly, powdered milk could become part of formula, but although the government did not ration it, a substantial amount was sent overseas to feed the troops.

Faced with rationing of tinned condensed milk, limited access to Grade A fluid milk and general limitations on moving products from farm to factory to table, families attempting to follow medical advice about infant feeding struggled to access a sufficient supply for their babies. Some undoubtedly turned to the black market. In some cases, they turned to local charities. Mrs. Border, for example, a mother of six, received free milk from the New York City Charity Organization Society for her infants born in 1943 and 1945.

Then, as now, disparities in access reflected income, race and geography. The most stunning example of this came in the Japanese American incarceration camps. Supplies of baby food sent to the isolated camps were limited or slow to arrive. Demand was great. Government reports revealed periodic shortages.

Hints about the conditions also emerged in camp newspapers, though these publications typically shied away — or may have been censored — from criticizing camp conditions. The Tule Lake, Calif., camp newspaper, for example, printed a story in 1942 about the 450 bottles of milk being prepared daily for the infants in the camp. It explained how a registered nurse and 11 “formula aides” supervised this work. Presumably this involved mixing fluid milk with syrup and sterile water.

The postwar recollections of those who spent time detained in the camps told a clearer story. One woman reported on her infant daughter’s repeated hospitalizations resulting from the fact that she was allergic to the powdered milk provided to her and the family could not afford to purchase tinned milk from outside the camp. Even when sufficient milk arrived at the camp to be mixed into formula, there sometimes was not enough food for older babies.

During the war, parents who were not detained had access to more state resources to grapple with infant feeding problems. They turned to the social media of their generation: radio. “Aunt Sammy,” the “wife” of “Uncle Sam,” had a radio show created by the U.S. Department of Agriculture that went on air in 1926. Aunt Sammy offered tips on household management and diet. “Aunt Sammy’s Radio Recipes,” which you can now purchase online, offered recipes for nutritious, inexpensive meals that proved especially useful during the Great Depression. The Blue Network (once a part of the NBC radio network until the Blue Network became American Broadcasting Company, or ABC, in 1946) also aired a weekly program, “The Baby Institute,” featuring educators and physicians. Among the topics addressed on the show were “Feeding Babies in Wartime” and “Milk in Wartime.”

Other sources of advice abounded as well: the U.S. Children’s Bureau and other experts provided basic infant feeding instructions and detailed information about mixing formulas. They also explained to families how to substitute goat’s milk for cow’s milk if babies were allergic to the latter. Condensed milk manufacturers and the karo syrup company also communicated with buyers with print advertisements, by distributing free booklets on baby food preparation and as sponsors of commercial radio broadcasts. Parents welcomed this child-care advice.

If World War II condensed milk shortages reflected a supply chain concern — tin needed for troops overseas — our current condition appears to reflect other supply chain problems, as well as contamination problems and product recalls. The Food and Drug Administration reports it is working to fix this problem, members of Congress have called for action and President Biden announced plans to speak directly with formula manufacturers and take other actions.

The rationing efforts during World War II, as well as the government advice on which parents relied, revealed the collective interest in infant welfare, focused on all babies. While this approach had its limits — in particular, it left poor families and those detained in Japanese American incarceration camps vulnerable to infant hunger — solving today’s problem requires replicating a focus on the collective good. Only this way can we make sure that infants, including those with special formula needs and those in low-income families, have access to the nutrition they need. For history tells us that those families, more than others, are struggling to take care of their babies.



Source link