Hypoallergenic infant formula shortage – Information for pharmacy professionals
Canada is currently experiencing a shortage of hypoallergenic infant formula. This problem is the result of the unexpected closure of a major North American manufacturing facility operated by Abbott Laboratories in Michigan. This has particularly affected specialized infant formulas, which are often used as the primary source of nutrition for infants with metabolic disorders, severe gastrointestinal diseases and allergic intolerance.
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 in managing and communicating with patients about this shortage.
Inventory of highly hydrolyzed and amino acid-based formulas remain very low across the country. This situation is likely to continue for several weeks despite the recent resumption of production at the Abbott plant in Michigan.
CPhA is encouraging pharmacists to consider measures to manage supply. In some jurisdictions, provincial guidance has already been communicated, including limitations on purchases and locating product behind the pharmacy counter.
- Keeping specialty formula behind the counter: To help manage supply, it’s recommended that pharmacies hold amino acid-based formulas and extensively hydrolyzed infant formulas behind the counter to ensure supply for those infants who need it most.
- Limiting purchases of regular formula: Given the potential domino effect and pressure this shortage could have on regular formula supply; it is also recommended that pharmacies consider placing purchase limits on all formula products.
- Reserving specialty formula: Pharmacists should limit the use of specialty infant formulas where possible and avoid, unless necessary, transferring children to more specialized products.
Note: Pharmacists should consult provincial guidance and recommendations that have been communicated about managing supply in your local jurisdictions.
Clinical decision tree – Use of Specialized Infant Formula During a Shortage
Health Canada has developed a national clinical decision tree tool 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. In addition to CPhA, a broad community of health-care stakeholders participated in its development and review, including: Canadian Pediatric Society, 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
Health Canada has published a complete factsheet that health-care professionals can use to facilitate their discussions with concerned parents and caregivers. The fact sheet includes a description of infant formulas affected by the shortage, tips about what to do and what not to do during the shortage and useful information on possible alternative approaches and products. A link to a downloadable colour PDF can also be found on the webpage.
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.
Health Canada is monitoring the supply situation and is working with manufacturers to import product from counties with similar manufacturing practices and standards and recently updated its interim policy on importation, which includes a recent update to its current list of products highlighting imported formulas that will soon be available to Canadians.
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 imported products as part of its Interim Policy, including both hypoallergenic and regular infant formulas imported to help alleviate the shortage. The list also includes printable labels and other important information. The list continues to be updated as the situation evolves, as we encourage you 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:
- 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)
This page will be updated as new information becomes available.
Last updated: June 19, 2022