More than six months after one of the largest infant formula manufacturing plants in the United States issued a recall and was then shut down because of contamination concerns, a newborn staple remains in short supply.
In parts of the country, parents and their families are scrambling to locate precious containers of formula for their babies and many large retailers remain out of stock of popular brands. Some companies like Walmart and Target are limiting the number of containers that can be purchased at one time.
While the situation has improved since mid-July, the out-of-stock figures for powder formula on store shelves in late August remained at 23 percent, still above the 10 percent it was before the recall and shutdown, according to the Chicago-based market research firm IRI.
infections in four babies — two of them fatal — who had consumed formula manufactured at the plant. On Feb. 17, two days after the shutdown, Abbott recalled batches of three powdered formulas over complaints of serious bacterial contamination. (Abbott has said that there is no “conclusive evidence” to link the company’s formulas to the illnesses.) That disruption made it clear just how dependent Americans were on a few formula manufacturers, and the Biden administration found itself scrambling to figure out how to make more product available.
ending around Nov. 14, the F.D.A. said it would release guidance this month on how the new companies can continue to sell in the United States past this fall.
“Parents in the U.S. have been looking for a better product than what they were being offered,” said Will McMahon, one of the members of the family who owns the British baby formula Kendamil. The company has spent the last three years working through the formal process, including clinical trials, necessary to get its organic infant formula approved by the F.D.A.
Kendamil was one of the earliest formulas to get its application approved by the F.D.A. in the wake of the Sturgis plant shutdown, and the company has begun sending two million cans of formula to the United States.
dropped in early August after it said the F.D.A. had notified it that it was “deferring further consideration” of its application to import formula into the United States.
resume manufacturing of Similac formulas at its plant in Sturgis.
The company also said that it increased production at other U.S.-based manufacturing plants and one in Ireland, and that it would supply the United States with more than eight million pounds of formula in August, an increase from the year before. But it noted it would take six weeks for the Similac product from the Sturgis plant to start to hit store shelves.
But some industry experts say it will take time for Abbott to gain back the market share it once had. “To be frank, there is a lot of consumer mistrust around Similac right now,” said Mr. Dittmeier of the W.I.C. program.
That could be a boon for Reckitt Benckiser, which has been running its formula manufacturing plants at full tilt all summer, hoping to hold on to the market share it has gained at Abbott’s expense. Its market share has climbed to nearly 60 percent from 35 percent before the recall, said Robert Cleveland, who oversees the Mead Johnson nutrition business at Reckitt.
“We remain committed to making as much formula as we can,” Mr. Cleveland said. “We continue to maximize our domestic manufacturing, running overtime and going 24/7.” He added that the company had received approval to bring in formula from its plants in Singapore and specialty formula from its facilities in Mexico.
Still, in late August, when Lori Sharp, a first-time mother in Port Hueneme, Calif., realized she was down to one container of Reckitt’s Enfamil Sensitive infant formula for her 3-month-old daughter, the formula was out of stock on Walmart.com.
Panicking, she scoured more websites and widened her geographic search. She eventually discovered a container of formula at a Target 40 minutes away in Moorpark, Calif. “I went into the store and they actually had four more, but their shelves were so bare,” Ms. Sharp said. “I bought all of them.”
In Georgia, some of the most acute shortages are in rural areas. Jennifer Kelly, who is the family services manager at the early Head Start program in Swainsboro, which is between Macon and Savannah, said trying to find formula earlier this summer had become a “daily chore.”
The 14 babies she watches drink seven different kinds of formula. She and her staff were often driving to Walmart, Walgreens or a local grocery chain or scouring Amazon for some of the more obscure brands.
“It’s not like it was a few months ago when the shelves were bare,” Ms. Kelly said. “I am hoping we are on the other side of this dilemma.”
When the formula shortage was at a crisis point in May, Ms. Robinson of Bucks County, Pa., created a Facebook group that connected parents around the country. The group, called Formula Hunters, does not exchange money to keep out profiteers who have been hoarding formula and seeking to resell it at a markup.
The group operates on the notion that a parent who buys a hard-to-find formula brand and sends it to another parent in the group will eventually be repaid when others do the same for them.
Formula Hunters now has 1,500 members, who are still actively helping each other locate formula. “This has been going on for so many months,” Ms. Robinson said. “The frustration has been high.”
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But in any individual case, it can be hard to prove what caused an infection. The potentially deadly bacteria resides in dirt and water; studies have found it in kitchens. Because the bacteria can clump together in formula containers, it’s possible for a sample to test negative even if Cronobacter was in the powder that went into a baby’s bottle.
Nick Stein, a lawyer with a small practice in Indiana, recalled the first time he encountered a case involving contaminated formula. A woman walked into his office with her toddler, limp in her arms, and explained that the child had suffered brain damage after being fed formula. Mr. Stein negotiated a settlement. More cases followed, and they, too, resulted in settlements that required Mr. Stein and his clients to keep quiet.
In 2005, Mr. Stein received an email from Kimberly Sisk in rural Pisgah Forest, N.C. Her son, Slade, had suffered debilitating brain damage after consuming Abbott’s Similac powdered infant formula in 2004. Ms. Sisk, who lived in a mobile home and worked as a house cleaner, faced a lifetime of medical costs. In February 2007, Mr. Stein and a colleague, Stephen Meyer, sued Abbott in state court in North Carolina.
The ensuing seven-year battle would become a case study for how firms like Jones Day use their mastery of the legal system to grind down — and in some cases attack — plaintiffs who have limited money and time on their hands.
The first volley came in late 2007. Jones Day filed a motion seeking to remove Mr. Stein and Mr. Meyer from the case. The rationale was that, in an unrelated infant-formula case in Kentucky, Mr. Meyer had been in touch with an expert witness that Abbott had used in a different case. It turned out the expert had an ongoing relationship with Abbott. None of this had anything to do with Ms. Sisk’s case. But the trial judge concluded that the contact with the expert “constitutes the appearance of impropriety” and granted Abbott’s motion. An appeals court reversed the decision. Then, in 2010, the State Supreme Court upheld the initial ruling.
More than three years had passed since Ms. Sisk’s lawsuit was filed, and the case hadn’t progressed. Now she had no lawyers. Mr. Stoffel, the Abbott spokesman, denied that the company was trying to delay the legal proceedings, but Ms. Sisk was skeptical. “Time is on their side,” she said. “It behooves them to stretch it out.”
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SZCZECIN, Poland — The Polish state has banned abortion for 29 years, but that has done little to prevent women from finding access to the procedure, leaving the Rev. Tomasz Kancelarczyk a busy man.
The Roman Catholic priest plays ultrasound audio of what he describes as fetal heartbeats in his sermons to dissuade women considering an abortion. He has threatened teenage girls with telling their parents if they have an abortion. He hectored couples as they waited at the hospital for abortions on account of fetal abnormalities, which were permitted until the law was further tightened last year.
But Father Kancelarczyk’s most effective tool, he acknowledges, may actually be something the state has mostly neglected: helping single mothers by providing them with shelter, supermarket vouchers, baby clothes and, if need be, lawyers to go after violent partners.
abortion bans proliferate in some American states, Poland offers a laboratory, of sorts, for how such bans ripple through societies. And one thing evident in Poland is that the state, if determined to stop abortions, is less focused on what comes afterward — a child who needs help and support.
much the same as in the parts of the United States where abortion bans are being put in place.
“They call themselves pro-life, but they are only interested in women until they give birth,” said Krystyna Kacpura, the president of the Federation for Women and Family Planning, a Warsaw-based advocacy group that opposes the government ban. “There is no systemic support for mothers in Poland, especially mothers of disabled children.”
the measure doesn’t go far enough.
One was that of Beata, a 36-year-old single mother who did not want to disclose her full name for fear of stigma in her deeply Catholic community.
When she became pregnant with her second child, she said the father of the child and her family shunned her. No bank would lend her money because she had no job. No one wanted to hire her because she was pregnant. And she was refused unemployment benefits on the grounds that she was “not employable.”
“The state completely abandons single mothers,” she said.
Then one day, as she was sitting on the floor in her tiny unfurnished apartment, Father Kancelarczyk, who was alerted by a friend, called, encouraged her to keep the baby and offered help.
“One day I had nothing,” Beata said. “The next day he shows up with all these things: furniture, clothes, diapers. I could even choose the color of my stroller.”
Nine years later, Beata works as an accountant and the son she chose to have, Michal, thrives at school.
For many women, Father Kancelarczyk has turned out to be the only safety net — though his charity comes with a brand of Christian fervor that polarizes, a division on stark display in Szczecin.
Father Kancelarczyk’s gothic red brick church towers directly opposite a liberal arts center whose windows are adorned with a row of black lightning bolts — the symbol of Poland’s abortion rights movement — and a poster proclaiming, “My body, my choice.”
Every year, Father Kancelarczyk organizes Poland’s biggest anti-abortion march with thousands departing from his church and facing off with counterprotesters across the street. Before a local gay pride parade, he once called on his congregants to “disinfect the streets.”
He gets hate mail nearly every day, he says, calling it “Satan’s work.”
Ms. Kacpura, the advocate who opposes the government ban, says that the lack of state support especially for single mothers has opened up space for people like Father Kancelarczyk to “indoctrinate” women who find themselves in financial and emotional distress.
Under Communism, child care was free and most Polish workplaces had on-site facilities to encourage mothers to join the work force. But that system collapsed after 1989, while an emboldened Roman Catholic Church put its shoulder behind the 1993 abortion ban as it also rekindled a vision of women as mothers and caregivers at home.
The nationalist and conservative Law and Justice Party, which was elected in 2015 on a pro-family platform, saw opportunity and passed one of Europe’s most generous child benefits programs. It was a revolution in Poland’s family policy.
But it still lacks child care, a precondition for mothers to go to work, as well as special support for the parents of disabled children. Over the past decade, groups of parents of disabled children twice occupied the Polish Parliament to protest the lack of state support, in 2014 and 2018.
When someone contacts Father Kancelarczyk about a woman contemplating abortion — “usually a girlfriend” — sometimes he calls the pregnant woman. When she does not want to talk, he says he will engineer bumping into her and force a conversation.
He also admonishes the fathers, waving ultrasound images in the faces of men looking to leave their pregnant girlfriends. “If men behaved decently, women would not get abortions,” he said.
While abhorred by many, he is admired in the religious communities where he preaches.
Monika Niklas, a 42-year-old mother of two from Szczecin, first attended Mass with Father Kancelarczyk not long after she had learned that her unborn baby had Down syndrome. This was 10 years ago, before the ban included fetal abnormalities, and she had been contemplating an abortion. “I thought my world was crumbling down,” she said.
During his service, Father Kancelarczyk had played a video from his phone with the sound of what he described as a fetal heartbeat.
“It was so moving,” Ms. Niklas recalled. “After the Mass, we went to talk to him, and told him about our situation.” He was one of the first people to tell her and her husband they were going to make it and offered support.
After her son Krzys was born, Ms. Niklas gave up on her career as an architect to take care of him full time. Krzys, now 9, got a place in a school only this fall, one example of how government support falls far short of matching their needs.
She now advises expecting parents of disabled children, trying to counsel them to keep their babies — but without sugarcoating it.
“I never just tell them, ‘It will be all right,’ because it will be hard,” she said. “But if you accept that your life will be different from what you had envisaged, you can be very happy.”
“We have these ideas about what our children will be — a lawyer, a doctor, an astronaut,” she added. “Krzys taught me about love.”
But in all her counsel, she said, one thing barely features: the abortion ban.
“This has not impacted how people make decisions,” she said. “Those who want to get an abortion do it anyway, only abroad.”
Many women here concurred.
Kasia, who also did not want her full name used because the stigma that surrounds the issue, is one of nine women currently living at Father Kancelarczyk’s shelter. She was 23 when she became pregnant. She said her boyfriend had abused her — the police refused to intervene — and then left her. Her mother had kicked her out of the house. A friend contacted an abortion clinic across the border in Germany.
“It is not difficult,” she said of getting an illegal termination. “It is a matter of getting a phone number.”
In the end, it was a near-miscarriage in the eighth week of her pregnancy that changed Kasia’s mind and persuaded her to carry out her pregnancy.
Father Kancelarczyk offered her not just free room and board in his shelter but a lawyer, who took the former boyfriend to court. He is now serving a 10-month sentence and might lose custody.
“I feel safe now,” Kasia said.
Father Kancelarczyk says the number of women referred to him because they were considering abortion did not increase when Poland’s ban was tightened for fetal abnormalities. But he still supports the ban.
“The law always has a normative effect,” he said. “What is permitted is perceived as good, and what is forbidden as bad.”
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RIO DE JANEIRO — Fretting over a fever in her toddler that wouldn’t break, the mother took the young girl, Letícia, to a hospital. Doctors had worrisome news: It was Covid-19.
But they were reassuring, noting that children almost never develop serious symptoms, said the mother, Ariani Roque Marinheiro.
Less than two weeks later, on Feb. 27, Letícia died in the critical care unit of the hospital in Maringá, in southern Brazil, after days of labored breathing.
“It happened so quickly, and she was gone,” said Ms. Marinheiro, 33. “She was everything to me.”
Covid-19 is ravaging Brazil, and, in a disturbing new wrinkle that experts are working to understand, it appears to be killing babies and small children at an unusually high rate.
scientists say are leading to more severe cases of Covid in young, healthy adults and driving up death tolls in Brazil — on babies and children.
But experts say the variant appears to be leading to higher death rates among pregnant women. Some women with Covid are giving birth to stillborn or premature babies already infected with the virus, said Dr. André Ricardo Ribas Freitas, an epidemiologist at São Leopoldo Mandic College in Campinas, who led a recent study on the impact of the variant.
“We can already affirm that the P.1 variant is much more severe in pregnant women,” said Dr. Ribas Freitas. “And, oftentimes, if the pregnant woman has the virus, the baby might not survive or they might both die.”
Lack of timely and adequate access to health care for children once they fall ill is likely a factor in the death toll, experts said. In the United States and Europe, experts said, early treatment has been key to the recovery of children infected with the virus. In Brazil, overstretched doctors have often been late to confirm infections in children, Dr. Marinho said.
“Children are not being tested,” she said. “They get sent away, and it’s only when these children return in a really bad state that Covid-19 is suspected.”
study published in the Pediatric Infectious Disease Journal in January foundthat children in Brazil and four other countries in Latin America developed more severe forms of Covid-19 and more cases of multisystem inflammatory syndrome, a rare and extreme immune response to the virus, compared with data from China, Europe and North America.
Even before the pandemic began, millions of Brazilians living in poor areas had limited access to basic health care. In recent months, the system has been overwhelmed as a crush of patients have flooded into critical care units, resulting in a chronic shortage of beds.
“There’s a barrier to access for many,” said Dr. Ana Luisa Pacheco, a pediatric infectious diseases specialist at the Heitor Vieira Dourado Tropical Medicine Foundation in Manaus. “For some children, it takes three or four hours by boat to get to a hospital.”
The cases in children have shot up amid Brazil’s broader explosion in infections, which experts attribute to President Jair Bolsonaro’s cavalier response to the pandemic and his government’s refusal to take vigorous measures to promote social distancing. A lagging economy has also left millions without income or enough food, forcing many to risk infection as they search for work.
Some of the children who have died of the virus already had health issues that made them more vulnerable. Still, Dr. Marinho estimates that they represent just over a quarter of deaths among children under 10. That suggests that healthy children, too, seem to be at heightened risk from the virus in Brazil.
Letícia Marinheiro was one such child, her mother said. A healthy baby who had just started walking, she had never been sick before, Ms. Marinheiro said.
Ms. Marinheiro, who was infected along with her husband Diego, 39, believes Letícia might have lived if her illness had been treated with more urgency.
“I think they didn’t believe that she could be so sick, they didn’t believe it could happen to a child,” said Ms. Marinheiro.
She recalled pleading to have more tests done. Four days into the child’s hospitalization, she said, doctors had still not fully examined Letícia’s lungs.
Ms. Marinheiro is still unsure how her family got sick.
She had kept Letícia — a first child the couple had badly wanted for years — at home and away from everyone. Mr. Marinheiro, a supplier of hair salon products, had been cautious to avoid contact with clients, even as he kept working to keep the family financially afloat.
For Ms. Marinheiro, the sudden death of her daughter has left a gaping hole in her life. As the pandemic rages on, she says, she wishes other parents would quit underestimating the dangers of the virus that took Letícia away from her. In her city, she watches as families throw birthday parties for children and officials push to reopen schools.
“This virus is so inexplicable,” she said. “It’s like playing the lottery. And we never believe it will happen to us. It’s only when it takes someone from your family.”