Baby Formula Shortage

There have been substantial shortages of infant formula in several supermarkets since the onset of COVID-19. Supply chain concerns and a recall of numerous contaminated baby formula items are to blame for the current shortages. Check availability with your local stores or online vendors.  Currently, we recommend purchasing no more than a 10-day to 2-week supply of formula to assist alleviate the impact of shortages.
What if your child’s formula isn't available anywhere?
The US Food and Drug Administration has indicated that it is taking steps to help increase baby and specialized formula supplies. If you're having trouble finding baby formula during the shortage, here are some suggestions.  Keep in mind that this is just for EMERGENCY situations. Please speak with one of our pediatricians if you have any concerns regarding your baby's nutrition.
  • Smaller businesses and medicine stores may not be out of stock at the same time as the larger ones.
  • Buy formula online if you can afford it until store shortages subside. Rather than buying from individual sellers or auction sites, buy from well-known distributors and pharmacies. Imported formula is not FDA-approved, so don't buy it from another country.
  • Unless your baby is on a specific highly hydrolyzed or amino acid-based formula like Elecare, it's fine to transition to any accessible formula, including retail brands. Inquire with your pediatrician about specialty formula alternatives for your infant. 
  • Look through social media groups. There are groups dedicated to infant feeding and formula, and members may know where to get it. Always consult your pediatrician before acting on any advice.
Is cow's milk a safe substitute for infant formula?
If your child is older than 6 months, you can feed them full cow's milk for a limited time until the shortage is alleviated. This isn't ideal and shouldn't be done on a regular basis, but it's a better option than diluting formula or producing your own. The most crucial consideration when providing cow's milk to a child beyond the age of six months is that they get adequate iron. While utilizing whole cow's milk, make sure to incorporate lots of iron-rich solid foods in their diet. You could also discuss giving your kid an iron supplement with one of our pediatricians.
Is it permissible to add more water to infant formula?
No. While it may be tempting to dilute the mix to make it last longer, this is not recommended. Always follow the directions on the label or those provided by your pediatrician. It's risky to dilute a formula. It might lead to dietary imbalances in your child and major health issues. Always follow the manufacturer's instructions when mixing the recipe.
If necessary, can I substitute plant-based milk for baby formula?
Alternatives to milk are not suggested for babies under the age of one year or for infants who require specialized formulae due to medical issues. In an emergency, soy milk may be given to babies under the age of one for a few days, but always buy one that is fortified with protein and calcium. Avoid almond milk and other plant milks if possible, as they are generally deficient in protein and minerals.
Is it possible to make my own infant formula?
Our providers advise against making your own formula. Although internet recipes for homemade formulas may appear nutritious or cost less, they are not safe and do not meet your baby's nutritional needs. The use of some homemade formulae has been linked to infant deaths.
How long does baby formula stay fresh?
Check the "use by" date on infant formula containers, which is mandated by FDA regulations. Until that date, the formula will contain the amount of each nutrient listed on the product label and be of acceptable quality.
Is it possible to switch toddler formula for regular formula?
Infants should not be given toddler formula. However, if you have no other option, toddler formula is safe for newborns under the age of a year for a few days.
If you have any worries about your baby's health or nutrition, don't hesitate to speak with one of our pediatricians. If your child has a medical condition, talk to your provider about medically appropriate and safe feeding options.
Source: American Academy of Pediatricians Healthy Children



Did you know we are a Mother’s Milk Bank drop-off location?

The Mother’s Milk Bank of SC is a non-profit service to SC hospitals. The milk bank is based at MUSC, and its mission is to promote the health of South Carolina babies by providing access to safe, pasteurized donor human milk. Premature and hospitalized infants have the highest priority for receiving donor human milk. There are many reasons why an infant may require donor human milk including preterm birth, feeding intolerance, or failure to thrive.
The Mother’s Milk Bank of SC is a fully accredited member of the Human Milk Banking Association of North America. They can screen and approve donors, collect milk at 26 milk depot sites across the state, process and pasteurize donor milk on-site, and distribute this life-saving donor breastmilk to 15 hospitals in SC.
SC breastfeeding mothers with surplus milk supplies are invited to become donors to provide pasteurized milk to SC infants for whom the mother’s milk supply is limited. A total of 41,012 ounces of breast milk has been donated to the Breastfeeding Center of Charleston! That is equal to roughly 320 gallons of breast milk! If you are interested in contributing to this program, please call our office to help get you started. 




Breastfeeding Myths Busted-Part 2

It is very likely, some of the breastfeeding advice you'll get may not be accurate. Everyone from your neighbor to your co-worker will inundate you with advice and opinions when it comes to breastfeeding. However, it is very likely, some of the breastfeeding advice you'll get may not be accurate. To help you sort through it all, here are the truths behind some of the most common myths we hear at the Breastfeeding Center of Charleston from many of our new moms.
Myth- You need to nurse every two hours around the clock—no exceptions
Babies' eating patterns are as individual as their parents', but many newborns naturally fall into an every-two-hours routine. If you're worried that your baby isn't getting enough to eat, count the number of dirty diapers. You should see at least six wet diapers plus two or three "seedy" stools daily. You can also schedule a weight check at the Breastfeeding Center of Charleston if you're worried that your baby isn't getting enough to eat.
Myth- If you give your baby bottles of pumped milk, she will refuse the breast. 
Most babies can switch between breast and bottle with no problem. We recommend waiting until your baby has mastered breastfeeding before offering a bottle.  
Myth- Exercise will turn your milk sour. 
We used to think that workouts produce high levels of lactic acid in breast milk, giving it an unpleasant taste. But recent studies show that babies don't typically notice the difference. One thing that could make them turn up their little nose is saltiness left on your skin by sweat, so we suggest showering right after your workout. Also, be careful not to pull up your exercise bra to nurse; the tight band can lead to clogged ducts.
Myth- You can't get pregnant while nursing. 
If you are having sex, you can get pregnant, and it is that simple, regardless of whether you are breastfeeding. Unless you're ready for another child, talk to your doctor about your best birth-control options.
If you have any questions about "advice" you have received from all those willing to give it, please call and schedule an appointment with one of our providers. We are happy to discuss your breastfeeding journey with you.



Breastfeeding Myths Busted!

It is very likely, some of the breastfeeding advice you'll get may not be accurate. Everyone from your neighbor to your co-worker will inundate you with advice and opinions when it comes to breastfeeding. However, it is very likely, some of the breastfeeding advice you'll get may not be accurate. To help you sort through it all, here are the truths behind some of the most common myths we hear at the Breastfeeding Center of Charleston from many of our new moms.
Myth- You need to toughen nipples for breastfeeding. 
During pregnancy, your breasts naturally undergo changes that get them ready for breastfeeding. Even before your baby is born, the area around your nipples will thicken, and the glands in your areolas will produce oils for lubrication and protection. Once your baby arrives and you begin breastfeeding, a surge in the hormone oxytocin makes your nipples more pliable and stretcher for your baby's mouth. 
Myth- It's normal for nursing to hurt. 
Although it's common to feel discomfort at first, pain is a sign that your baby isn't latching correctly. When this issue occurs, we recommend seeing a lactation consultant. The team at the Breastfeeding Center of Charleston can assist you with the proper latching technique. With a bit of time and patience, you'll both get it right.
Myth- Breastfeeding will cause your breasts to sag. 
In reality, droopy breasts result from pregnancy because hormonal changes cause the ligaments underneath them to loosen and stretch. When you first begin to nurse, your breasts may become swollen with milk and grow larger; however, they'll diminish in size once you've established a solid breastfeeding routine. 
Myth- If you have small breasts, you won't produce enough milk to feed your baby. 
Size doesn't matter! The breast tissue you will need to nurse a baby grows in response to pregnancy, regardless of your breast size. Your milk ducts are in the functional tissue of the breast, not the fatty tissue that is responsible for breast size. No need to worry; if you are an A or D cup, your breasts can provide your baby with the milk they need.
If you have any questions about "advice" you have received from all those willing to give it, please call and schedule an appointment with one of our providers. We are happy to discuss your breastfeeding journey with you.



A Recent Mother’s Story on How The BFC Changed Their Breastfeeding Journey

I had read all the books, watched all the videos, and talked to as many of my trusted mom friends about breastfeeding. I knew I would hit a few bumps along the way, but I felt as prepared as I could be in the 9 months leading up to my son’s arrival. 
My son arrived and in the hospital and in the early days at home, he had a great latch. The lactation consultant in the hospital was so impressed with how I knew how to get him to latch and how great he was. I knew so many friends that had struggles in the hospital with latch so  I thought “Yes! Breastfeeding is going to be smooth sailing!”.
I will never forget when my son was 3.5 weeks old and it was our 3 am feeding. He was crying and fussy at the breast and I began to sob. I just didn’t know what happened. We were doing so well! That morning I called the Breastfeeding Center of Charleston.
They were able to see me that day and the lactation consultant and provider could tell I was so discouraged. They took their time with me and we explored all options for what could be the cause of this sudden change. They reassured me that this is actually more common than I realized. After reviewing, we discovered my son had a dairy allergy. Both the lactation consultant and provider saw the tears welling up in my eyes and immediately comforted me. I felt so guilty that my diet was causing inflammation in his little belly which caused him to be fussy. They gave me numerous handouts and directed me to websites that would help me adjust my diet. I felt a sense of relief knowing we had a plan and I could do this.
*I wish I could say that the dairy allergy was the last of my “bumps in the road”. But I had several other issues all of which the team at BFC walked through with me. We found a solution to each problem and we kept going. I can honestly say that I would have given up on breastfeeding had it not been for the team at the Breastfeeding Center of Charleston. I’m thankful for each and every team member that I saw in my many visits there. They are one of the greatest resources in Charleston for a new mom! 




Does the Breastfeeding Center of Charleston recommend the Covid-19 Vaccine for women who are currently breastfeeding or pumping? 
Yes!   This is in line with recommendations of the CDC, Academy of Breastfeeding Medicine, American Academy of Pediatrics, The American College of Obstetrics and Gynecology, the Society for Maternal Fetal Medicine, and the Infant Risk Center.     Initially there was no data on lactating women, as they were not included in the original vaccine studies.   Since the vaccine has been available now for many months, we have had several secondary studies that evaluate the safety with breastfeeding women and their infants.  Overwhelmingly we feel that there are benefits to both the mothers and the breastfeeding infants from the vaccine. .  "The vaccines are safe and effective, and it has never been more urgent to increase vaccinations as we face the highly transmissible delta variant and see severe outcomes from COVID-19 among unvaccinated pregnant people," said Rochelle Walensky, M.D., MPH, director of the CDC, said in a recent press release.
Does the mRNA COVID-19 vaccine get transferred into breastmilk?   
With mRNA vaccines, most is broken down by the muscle when it is injected.     The Academy of Breastfeeding Medicine states that “It is unlikely that the vaccine lipid would enter the blood stream and reach breast tissue.  In the unlikely event that the mRNA is present in the breastmilk, it would be expected to be digested by the child.”   There have been multiple studies that have looked at this and none have found mRNA in the breastmilk.  Neither of the mRNA vaccines uses preservatives or adjuvants so that is not a concern for the breastfeeding mother. 
Could the vaccine be helpful to my baby if I am breastfeeding? 
Yes.  The vaccine will trigger the mother to have an immune response and make antibodies and infection fighting white blood cells called T-cells that we know can transfer in breastmilk.   This may help the baby fight infection if your baby is exposed to Coronavirus-19.   We have found that mothers who are vaccinated while lactating transfer IgA, IgG, and IgM specific antibodies into the breastmilk.  This has been seen within one week of the vaccine and studies have shown that this is still present at day 80 post vaccination.  While the antibodies have not been found in the infant’s blood they have been found in their oral mucosa and throat which could be important in fighting off infection as this is where the virus tends to replicate.
Will the vaccine affect my milk supply in any way? 
It is possible.   There have been several studies now looking at milk supply post vaccination.   In one study of over 400 women who received a mRNA COVID 19 vaccine,  around 8% had a temporary decrease in supply after the first dose of vaccine and 8% receiving Pfizer and 23% receiving Moderna had a drop after the second vaccine.   In all these cases supply returned to normal within three days.  In another study of over 4400 women 4% had an increase in supply after vaccination and 6% had a decrease. 
Will my baby have side effects if I am nursing and get the COVID 19 vaccine? 
  It is possible that your baby may have mild side effects post vaccination.    In all the studies there were no serious side effects of any of the infants.   Together these studies represent thousands of infants.    In a study of over 4000 breastfed infants, 93% had no symptoms post vaccination.   For the very small number of infants found to have symptoms they were considered mild and included irritability, stool changes, sleep changes, rash, and vomiting.   All these effects were short lived and resolved without any intervention.          
What are some of the common side effects to watch for when I get vaccinated? 
Systemic signs and symptoms following COVID-19 vaccination can include fever, fatigue, headache, chills, myalgia, and arthralgia. Most are mild to moderate in severity; occur within the first 3 days of vaccination; and resolve within 1-2 days of onset.    Side effects  were more commonly reported after the second dose than after the first dose. There is no evidence that the shots can cause pregnancy or fertility issues.   Pregnancy women are at higher risk for adverse outcomes of COVID 19 disease and there are concerns for COVID 19 infection harming male reproductive ability.  
 Cough, shortness of breath, rhinorrhea, sore throat, or loss of taste or smell are not consistent with post-vaccination symptom, but symptoms of active infection from COVID-19 and you should seek care if you experience these. 
If you experience a symptom after vaccination you can report it directly to the CDC.   Visit to learn more. 
The COVID-19 vaccine is available to all anyone eligible to receive the vaccine, including breastfeeding mothers Coastal Pediatric Associates. Visit to schedule.




Environmentally Friendly Breastfeeding Tips

August 1st marks the start of World Breastfeeding Week (August 1-7), as well as National Breastfeeding Month. All month long, families are celebrating the incredible benefits of breastfeeding.
As consistent scientific evidence presents itself,  breastfeeding saves lives by protecting babies from life-threatening infections and illnesses. Not to mention, that breastfeeding also is cost effecting and is better for the planet.
Dr. Milliron shares with us some interesting tips on the environmentally friendliness and sustainability of breastfeeding
  • Breastmilk is the most locally produced, environmentally friendly, and sustainable food that you can feed your baby and gives babies all the nutrients they need for the first several months of their life!
  • Breast milk requires no packaging, shipping, or advertising, saving natural resources like glass, plastic, metal, and paper. It generates no trash for landfills.
  • By breastfeeding your baby, you are saving on electricity or fuel that is used in the preparation and manufacturing of infant formula. Feeding baby at the breast saves energy wasted on sterilizing bottles and refrigeration of milk.
  • Unlike breastmilk, cow’s milk-based artificial infant and toddler milk have a negative impact on the environment, contributing to greenhouse gas emissions and contributing to global warming through their manufacturing and processing. Methane and CO2 produced from cows contribute to the greenhouse effect and their sewage contributes to the pollution of lakes and rivers. Breastmilk is produced efficiently by the mother and is a carbon-neutral food.
  • Many infant formulas contain soy which uses pesticides to grow and its farming is a contributor to the deforestation of the Amazon rainforest.
  • According to a 2019 study by The Imperial College, London, “Overall, breastfeeding for six months saves an estimated 95-153kg CO2 equivalent per baby compared with formula feeding.”



COVID-19 and Immune Boosting Breastfeeding Tips

The Breastfeeding Center of Charleston is here to help mothers who choose to breastfeed to provide their newborns immune-boosting breast milk. Here are some helpful facts to help you safely and successfully breastfeed during COVID-19.


First and foremost, breast milk provides protection against many illnesses and is the best source of nutrition for most infants. 
  • Breastmilk contains large amounts of the mother’s immune fighting cells called immunoglobulins, especially IgAwhich can help neutralize infection and prevent inflammation. 
  • White blood cells called leukocytes also pass to the baby through the breastmilk and help fight infection 
  • Human Milk Oligosaccharides (sugars) can help by binding to harmul bacteria. 
  • Lactoferrin in breastmilk can help stall bacteria from replicating by binding to iron 
  • Some studies suggest that breastmilk may help an infant’s immune system to develop faster and babies that are breastfed have better antibody response to vaccinations. 


For all mothers of newborns during the Coronavirus Pandemic: 
  • Continue to follow basic newborn safety guidelines such as keeping your baby protected during the first 4-6 weeks of life while their immune system is developing. 
  • Ensure that anyone around your baby is healthy and has not been exposed to coronavirus. All caregivers should wear masks and wash their hands frequently when providing care for your baby. 
  • No one kisses baby except you and dad. 
  • Ideally, family who comes to visit with you and baby should be adhering to strict social distancing for 2 weeks before the visit.  
  • Avoid large numbers of visitors into the home; consider drive-by visits, outside visits, or online platforms to see the baby.
  • Consider the benefits of help and support a visitor may bring vs the risks of a new visitor into the house. 
  • Use your pediatrician as a resource.  We can help guide you through any changes in CDC and AAP guidelines.  If your comfort levels are more conservative than your family’s you can always blame your pediatrician! 


Guidelines for COVID positive Breastfeeding Mothers 

  • At this time, we do not know for sure if mothers with COVID-19 can spread the virus to babies in their breast milk, but the limited data available suggest this is not likely.
  • If you have COVID-19 and choose to breastfeed:
  • Wear a face mask while breastfeeding and wash your hands with soap and water for at least 20 seconds before each feeding.
  • If you inadvertently sneeze or cough onto your breast, wash the area before putting baby to the breast. 

If you have COVID-19 and choose to express breast milk:

  • Use a dedicated breast pump (not shared).
  • Wear a mask during expression and wash your hand and lower arms with soap and water for at least 20 seconds before touching any pump or bottle parts and before expressing breast milk.
  • Ensure that you are cleaning pump parts and any surface they come in contact with after each use.   Parts should be sterilized once daily. 
  • If possible, expressed breast milk should be fed to the infant by a healthy caregiver who does not have COVID-19, is not at high-risk for severe illness from COVID-19, and is living in the same home.

Ideally, regardless of how you choose to feed your baby,  if you are positive for COVID19, your baby should be primarily cared for by a non-infected adult and distanced from any COVID positive family members.




Top 10 Tips for New Moms

Dr. Bess Milliron

Being a new mom is both exciting and stressful. While baby books may help, often times when your sweet bundle of joy arrives, your world changes. Medical Director, Bess Milliron from the Breastfeeding Center of Charleston shares 10 helpful tips for new moms.
  1. Seek breastfeeding support.  Breastfeeding may be natural, but it is not easy.   I wish someone had recommended for me to reach out to a lactation consultant with my first baby.  Things were going relatively well, but I could have avoided suffering through sore nipples and made pumping more efficient had a reached out to professional support. I recommend to new moms to see lactation soon after they are discharged from the hospital because a lot of things change in those first couple days home. When looking for a lactation consultant, look for one that is an IBCLC which is the highest certification in the lactation world and get personal feedback from other mom friends. A good IBCLC should be there to support your feeding goals and optimize your breastfeeding experience. The Breastfeeding Center of Charleston always here to support local moms.
  2. Find your tribe. They say it takes a village to raise a child, but sometimes you have to really seek out that village. Reach out to friends that have children for support. Join mom groups or lactation support groups in your area. Having a shared experience can allow you to learn from your peers and have your struggles validated if you hit road bumps in child-rearing.  Zoom with friends and family if you are not able to get there in person.  
  3. Don’t hesitate to take offers for help. New moms often do not know what to ask others to do or feel that they should be doing everything themselves. Try to open up and have tasks for others to support you. Family and friends can make meals that you can freeze, run errands for you so you can stay and snuggle with baby, wash bottles and pump parts, or hold your baby so you can get a much-needed nap.
  4. Invest in a good Velcro swaddle. Babies like to be secure and snuggled.  At night a swaddle can help recreate this so you can put the baby down.    Babies are little Houdini’s and can get out of the best swaddle blanket.  A Velcro swaddle makes the middle of the night swaddles so much easier, as well as, safer as there are no loose pieces of the blanket that may come out. I am partial to the Halo baby swaddles. Make sure you get a couple to rotate in case you have a middle of the night spit up or diaper disaster. Always make sure you transition baby out of the swaddle when they are learning to roll to adhere to safe sleep guidelines.
  5. Coconut oil really does work for everything.  I prefer to have moms use this rather than lanolin for nipple soothing. It is safe for baby so no need to wipe off before the next feeding. It has natural antimicrobial and antifungal properties so it can help with cracked nipples as well. There have been good studies to show it has benefits with infant eczema and it can also be used with cradle cap to help soften flakes.
  6. Be a smart shopper with infant clothes. Babies can be messy with spit up and blow out diapers.   Some will be born too big for the newborn sizes and they continue to grow quickly in the first couple months of life. Buy clothes in the first couple of months from discount stores or take hand me downs from friends/family. Even if that little jean jacket and bowtie or ballerina skirt is the cutest thing ever, I guarantee they will only get used for pictures. Skip the snaps and ties and go for magnetic closures or zippers for easier transitions. Save the photo-ready outfits for toddlerhood.
  7. Keep spare baby items in the car. You will always run out of clean diapers at the least opportune time.  Keeping spare diapers, wipes, and a change of clothes for baby in the care can be helpful when you are in a pinch. Add some extra baby toys, baggies to put soiled clothes in, diaper cream, and teething rings too. A change of clothes for mom is always a smart idea.  It was always at daycare drop off on the way to work when my son would spit up on me.  Having the change of clothes helped me avoid odd stares about the mystery substance on my shoulder for the rest of the day.
  8. Start good sleep hygiene early.  While I don’t schedule babies in the newborn period I do recommend having a consistent bedtime routine.  This will help your baby learn patterns at night and start to associate the routine with sleep.  Dim lighting, a favorite lullaby, baby massage, whatever is in your routine to help set patterns.  Always adhere to safe sleep guidelines of a firm surface without any loose blankets or pillows.  As your baby ages, try putting them down drowsy, but awake so they are aware of their sleep environment.
  9. Read to your baby. Even in the newborn period reading, singing, and talking to your baby is so important. Your voice is soothing to your baby. Reading and singing to them can promote bonding.  Babies will learn from the tone, rhythm, and inflection of your voice as they grow.  Studies have shown that babies that are exposed to more language and that are read to as newborns have better verbal skills at age three and may learn to read sooner themselves than their peers. You are also setting them up for a great shared experience as they grow and a love of books.
  10. Educate yourself on postpartum depression and anxiety.  A subject that is not often talked about between friends or family, but that so many moms experience.  70-80% of women will experience at minimum the baby blues and a new study has shown that as many as 1 in 7 will go on to experience true postpartum depression or anxiety in the first year postpartum.   It is important to have a support person educated on this as well so they can be a second set up eyes for your wellbeing.  Find resources in your area to learn more and seek help if needed.  MUSC Women's Reproductive Behavioral Health Program and Postpartum Support Charleston are two great sources of support in the Charleston area.