October 18, 2023
Megha Arora and Sarah Dzubay, third-year MD-MPH students at OHSU, were in the middle of their pediatric clinical rotations when the infant formula shortage hit last year. Witnessing the stressors to Oregon’s families and healthcare systems brought on by this crisis motivated them to conduct a study to examine its impact, with the hope of making much-needed policy and process changes.
The medical students are gathering pediatric perspectives on the 2022 formula shortage and exploring trends of formula redemption through the WIC program (supplemental nutrition for women, infants and children).
With constant national news coverage about the formula shortage, Sarah and Megha observed panicked parents calling pediatric offices with frequent questions and heightened concern. Social media platforms were filled with suggestions of “alternatives” to formula, raising concern for possible electrolyte abnormalities, malnutrition, and other adverse effects. Clinics already feeling the burden of the COVID-19 pandemic now had to address caregiver concerns and prepare to support those in need.
To better understand what effects this national crisis had on patients and medical providers across Oregon, Megha and Sarah reached out to Alex Foster, MD, MPH, pediatric hospitalist at Doernbecher Children’s Hospital and director of the MD-MPH program at OHSU. With a clinical perspective on board, the team decided it was also essential to understand how programs outside of hospitals were impacted and addressing the formula shortage. Knowing that WIC was actively mitigating the formula shortage for thousands of families across Oregon, Dr. Foster connected the students to Julie Reeder, PhD, MPH, MS, CHES, Senior Research Analyst at Oregon WIC.
Dr. Reeder saw the formula crisis first-hand, as WIC worked rapidly to respond. Oregon WIC serves close to 40% of infants born each year and was a vital part of the shortage response. Throughout the emergency, Oregon WIC supported families by temporarily adding more than 100 additional formula brands and sizes to their food list and worked with grocery stores to provide updates on newly approved items.
At the same time, Doernbecher teams at OHSU – including dieticians, social workers, and case managers – actively worked to mitigate the devastating effects of the formula shortage on both families and the health care system. Dr. Foster recognized that communication between physicians, clinics, and the WIC program was not always ideal. Given the large percentage of shared patients between WIC and pediatric providers, there may be opportunities for improvement moving forward.
Sarah and Megha developed a study with two components to address issues brought to light during the formula shortage crisis. Both components are designed to have policy impacts. The first component is looking at the formula redemption data from WIC, and the second component is getting pediatric provider and WIC staff perspectives.