TORONTO — Measures to keep Canada’s stretched baby formula supplies from spiraling into a widespread shortage like that seen in the United States are unlikely to offer immediate relief, and even then may be short-lived, experts say.
On May 9, Health Canada recommended that the Canadian Food Inspection Agency temporarily suspend bilingual labelling and nutrient composition requirements to allow infant formula imports from Europe, and thereby reduce Canada’s reliance on U.S. suppliers.
The move would allow nine previously unavailable products from the United Kingdom, Ireland and Germany to reach the Canadian market, as well as 11 more from the United States.
The products come from “countries that have similar regulatory standards to Canada and are safe to use,” a spokesperson for Health Canada said by email.
Most are for infants who need a specialized diet because of an allergy to cow’s milk or have certain metabolic conditions and don’t necessarily affect the majority of formula-fed babies in Canada. In a release Thursday, the regulator said caregivers of babies with food allergies should speak to a health care professional about alternatives.
The Retail Council of Canada says none of the formulas on the list for temporary import are available on store shelves yet, and the order expires June 30.
In the meantime, the council’s national spokeswoman says she knows of “sporadic shortages for regular formula” in addition to a reduced supply of specialty formulas due to a recall involving some products made by Abbott Nutrition.
“I think Health Canada is working to get them here, in a fast and safe way,” Michelle Wasylyshen says of the additional imports, adding that her members are doing what they can to address consumer demand.
“Many retailers have put in place buying limits … so that there’s enough product for everybody.”
The road to Canadian retail shelves is also a long and complicated one, even after securing Health Canada approval, she adds.
Retailers and vendor partners must hash out pricing, warehouse and delivery plans, the application of federal and provincial tax regimes, and recall protocols.
“You can’t just put a product on the shelf — it needs a SKU, a retailer needs to say, ‘I’ll sell that.’ It’s not as straightforward as you or I might think,” she says.
Then there’s the Abbott factory in Sturgis, Mich., which has been shuttered since February after FDA inspectors began investigating four bacterial infections in infants who had consumed formula from the plant.
Abbott has said there is no direct evidence linking its products to the illnesses.
The head of the U.S. Food and Drug Administration said Thursday that the factory could be up and running as soon as next week, and President Joe Biden has invoked the Defense Production Act to speed up domestic manufacturing.
But again, Wasylyshen said Canadian consumers will likely have to wait at least two months before actual product reaches our shelves: “It still takes a significant amount of time to get that facility up and running to produce product.”
The baby formula crunch has drawn attention to a highly concentrated industry and debate over import restrictions.
Permanently relaxing the requirements to allow non-U.S. baby formulas could help prevent and mitigate future shortages. But that likely won’t happen, says Sylvain Charlebois, professor in food distribution and policy in the Faculties of Management and Agriculture at Dalhousie University.
He says that due to trade agreements and a complicated approval process, the interim measure is unlikely to open the door to more brands flooding the market.
“If the U.S. wasn’t experiencing a shortage, I don’t think Health Canada would have been able to do what they did,” says Charlebois.
“We have a plant in Kingston that cannot ship baby formula to the U.S. That’s how protective they are with this product.”
The Kingston, Ont., factory is the largest baby formula plant in the country and uses cow’s and goat’s milk from Canada to produce infant formula exclusively for China.
Charlebois says the United States wants to remain in control of the Canadian market and suspects that pressures will be purely economic and not necessarily about food security or food safety.
“The players in the United States who control the market are very powerful. Starting with Abbott,” says Charlebois.
Some households already obtain European infant formulas through unofficial channels.
Lesley Frank, Canada research chair in food, health, and social justice at Acadia University and professor of sociology, collected and analyzed 2,000 Kijiji ads over 11 months and found many parents turned to the website to sell, seek, trade, gift, or beg for infant formula, including brands from Europe.
“You don’t see many food items on Kijiji, but you see all kinds of infant formula,” says Frank. “It’s a commodity in the second-hand exchange economy in a way that other food isn’t.”
Dr. Catherine Pound, pediatrician at CHEO in Ottawa and past chair of the nutrition committee at the Canadian Paediatric Society, says there could be risks in ordering formula directly from suppliers abroad.
A European brand brought in through Health Canada regulations and transport channels is a safer alternative, she says, suspecting that improper handling and storage could compromise nutritional integrity.
“I would advise against ordering directly from a European company and have that shipped to us because that’s where the transport issues come up. That’s where we don’t know how things are handled,” says Pound.
Even before the U.S. shortage, the high cost of infant formula has made it inaccessible to many Canadian parents. Costs can range from $2 to $5 per 100 grams which can translate to about $80 to $200 per month, depending on the brand and age of the child.
It is one of the most shoplifted items in the country, says Frank. And unlike other developed countries, there is no government program in Canada that provides infant formula to low-income mothers.
“This has been a longstanding issue that’s only getting worse as our incomes don’t keep pace with inflation,” says Frank.
She surveyed 1,400 families in Nova Scotia to understand how the COVID-19 pandemic supply chain disruptions affected their access to specialty formulas.
A third of respondents said they had trouble finding infant formulas in stores near them and 70 per cent said they had to travel to places where they didn’t normally shop to find it.
A third of respondents were food insecure.
“It’s those folks that this most impacts when there’s a supply issue,” says Frank.
At the pharmacy near her work in the Annapolis Valley, N.S, she found empty shelves with a note reading: “Due to high demand, purchase quantities of infant formula will be limited to two per customer. We are diligently working with our suppliers to restock our shelves for you.”
The infant formulas that were in stock were the most expensive ones, costing roughly $800 per month, she noted.
“People with resources can get what they need,” says Frank. “People without resources will be those that will suffer the most.”
“Even if we fix the supply issue, we’re not going to fix that issue of access to formula and that’s a really unrecognized social problem in this country.”
— With files from Cassandra Szklarski in Toronto and files from The Associated Press.
— Meghan McGee is a nutrition scientist in Toronto and a fellow in the Certificate in Health Information program at the Dalla Lana School of Public Health, University of Toronto.
Meghan McGee, The Canadian Press