Hypoallergenic infant formula shortage – Information for pharmacy professionals
Canada is experiencing a limited supply of specialized infant formulas, including extensively hydrolyzed formulas (for mild or moderate allergies) and amino acid-based formulas (for severe or multiple allergies). This situation is largely due to the temporary closure of Abbott Laboratories’ manufacturing facility in Michigan. For more information: www.canada.ca/infantformulashortage.
The Canadian Pharmacists Association (CPhA) has been involved in discussions with Health Canada and others to stay updated as the situation evolves and ensure that pharmacy is represented in the conversations. Following, you will find important information, links and resources to help pharmacy professionals communicate with patients about the limited supply.
- Managing supply
- Importation and labelling considerations
- Additional resources to support pharmacists
Managing supply
Regular infant formulas have continued to be available on shelves during the shortage. While individual products may sometimes be out of stock, alternate formats or comparable products from other brands are usually available. Purchase limits can help stabilize the supply.
Extensively hydrolyzed formula and amino acid-based formula have been held behind the counter since May. Although the situation is not completely back to normal, the supply has been more stable since the fall. Therefore, some specialized formulas may now be returning to shelves, at the discretion of manufacturers. The products that were imported from other countries and that do not have a bilingual label will continue to be available for order at the pharmacy counter until supplies last.
- Formula available for ordering: Information to help search for these products in distributor databases (October 2022)
Imported products
Health Canada worked with manufacturers to import products from countries with similar manufacturing practices and standards. The department published an interim policy on importation, which includes a list of imported formulas.
Labelling considerations
To ensure imported products meet labelling requirements and important health/product information is available in both official languages, Health Canada has made printable labels/information available for the imported products.
- Imported products - List and label information: Health Canada has published a list of products imported under its Interim Policy to help alleviate the shortage. The list also includes printable labels in both official languages. The list continues to be updated as the situation evolves, and you are encouraged to consult it regularly. Note: Pharmacists should use their discretion on how best to use and distribute these bilingual labels.
Manufacturer communications to health-care providers
- SMA® ALFAMINO® and SMA® ALTHÉRA® - July 13, 2022 (Nestlé Canada Inc.)
- Nutramigen® Liquid Concentrate - June 13, 2022 (Reckitt/Mead Johnson Nutrition, Canada)
- Gerber® Good Start® Extensive HA® - June 15, 2022 (Nestlé Canada Inc).
- Similac® Alimentum® 32 oz. (946 mL) - June 17, 2022 (Abbott Nutrition)
Coverage information for pharmacists
- Ontario (Notice from the Executive Officer – June 24, 2022)
- Alberta (Pharmacy Benefact - Alberta Blue Cross – August 2022)
Additional resources to support pharmacists
Clinical decision tree – Use of Specialized Infant Formula During a Shortage
A national clinical decision was developed to support health care providers across the country guide treatment decisions, and support families and caregivers to make appropriate formula choices while rationing the use of specialized infant formulas. Health Canada facilitated bringing together experts from a broad community of healthcare stakeholders for its development, including: Canadian Pediatric Society, Canadian Pharmacists Association, Food Allergy Canada, Canadian Society of Allergy and Clinical Immunology, Dietitians of Canada, Hospital for Sick Children and McMaster Children’s Hospital.
Communicating with patients – Information for families factsheet
The situation is distressing for some families who will turn to pharmacists for help. Pharmacists should be prepared to answer questions. Health Canada has published information that health-care professionals can use to facilitate their discussions with parents and caregivers. It includes a description of the different infant formulas, tips about what to do and what not to do while supplies are limited and useful information on possible alternative approaches and products.
Typical Formula Consumption Amounts for Healthy Term Infants
A tool for health professionals on estimated typical consumptions of extensively hydrolyzed and amino acid-based formulas by healthy term infants.
This page will be updated as new information becomes available.
Last updated: October 21, 2022