How did we let bureaucracy stop us from feeding babies? : Hope A. Lane-Gavin

Guest columnist Hope A. Lane-Gavin is a health equity fellow at the Center for Community Solutions.

Over the past few weeks, we have been inundated with reports of infant formula shortages after a series of unrelated events and poor public policies have made our current child health crisis worse.

Between continued COVID-related supply and worker disruptions, a recall from Abbott Nutrition (the makers of Similac) and the subsequent temporary shutdown of one of their largest manufacturing facilities, and the impact As Russia’s invasion of Ukraine continues to affect the world’s food supply, anxious caregivers wonder how we got here.

Answering this question requires a basic understanding of the Special Supplemental Nutrition Program for Women, Infants and Children – WIC.

First, some basics: WIC is a federal supplementary nutrition program for low-income families that has largely slipped the radar of policy makers for generations, despite being the number one purchaser of infant formula in the country.

Not only is the WIC program difficult to grasp, but it is also difficult to access.

Each state’s WIC program contracts with a one-size-fits-all company. In Ohio’s case, it’s Mead Johnson, which produces Enfamil. All WIC participants in the state receive this particular formula, regardless of infant or caregiver preference.

While it may sound similar to any other government contract, the infant formula industry is a multi-billion dollar industry dominated by a handful of companies, with just four companies controlling approximately 90% of the US market.

While Ohio WIC participants were less impacted by the Similac recall than state WIC participants under contract with Abbott, Similac was the top-selling formula brand in the United States in 2016. More than two-thirds of State, territory and tribal WIC agencies use Abbott as their sole supplier.

So when Similac unexpectedly rolled off store shelves earlier this year, non-WIC caregivers in Ohio found themselves searching for alternatives, which for many meant Enfamil – the only formula that WIC participants could buy to start with.

Not only are WIC participants tied to a specific brand of formula based on a state contract beyond their control, but they are constrained to a certain box size. Unlike the SNAP (food stamps) program, which offers much more flexibility, the WIC program is a prescriptive program, awarding participants food and formula packages down to the ounce.

Additionally, WIC participants can only redeem their benefits at WIC-authorized retailers. And while these vary from state to state, many popular retailers that have been highlighted as must-stops in the hunt for formulas, such as Sam’s Club, Aldi and Costco, do not participate in the program. WIC.

This has created an uneven playing field for low-income WIC participants who don’t have the resources available to travel in search of formula or scour the Internet for available stock.

Reforms to Ohio’s WIC Program May Help

Despite the fact that approximately half of all babies born in the United States are eligible for WIC, some states, such as Ohio, struggle to enroll all eligible participants due to administrative hurdles. Participants have to jump through many hoops just to get perks loaded onto their cards.

In fact, Ohio’s number of WIC cases has declined by 16% over the past two years, despite rapidly increasing rates of child food insecurity throughout the pandemic.

The Ohio WIC program works hard to effectively serve its customers. However, with declining participation rates – and unpredictable supply chain crises to come – the WIC program must continue to consider administrative barriers that prevent people from entering, such as reloading benefits offline.

Any solution to the infant formula shortage that can stand the test of time must include reform that modernizes the WIC program, removes red tape and includes flexibility. Because our babies depend on it.

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