Three weeks after her daughter was born, Lena Nguyen could no longer find the formula that worked best for the baby in any local stores. Her family was on their last can and starting to panic.

“My daily activity was to get up, have my husband watch the baby, and just drive around. I would stop by every CVS, every Target, every Safeway, you name it, every store possible to try to find something. And I was not having any luck,” says Nguyen. “Instead of being with her, I had to waste hours and hours driving around.”

They tried a couple of different other brands, but the baby didn’t take to them. “Some of them she wouldn’t even swallow,” says Nguyen. “And some of them she would eat, but she would get super gassy, super uncomfortable … As a parent, you feel like a failure just because you cannot provide food for your baby.”

Nguyen posted in a moms group on Facebook about her need for Similac Sensitive formula, saying she would even take a few scoops, when another mom offered her a can of the preferred formula. Nguyen drove all the way from her home in Arlington to Rockville to collect it. That night, her daughter drank her entire bottle, and slept well.

That was four weeks ago. Since then, the nationwide formula shortage has only grown more dire, and Nguyen is among the many parents and caregivers finding empty shelves when they search for formula.

During the first week in May, the out-of-stock rate for baby formula at retailers in D.C. was 50%, close to 47% in Maryland and nearly 49% in Virginia, according to data from the firm Datasembly. In May of 2021, by way of comparison, the out-of-stock rate was about 6%,  3%, and 4%, respectively.

While supply chain woes associated with the pandemic are partially to blame, according to the Food and Drug Administration, the problem worsened after the recall of baby formula produced at a Michigan plant run by the company Abbott Nutrition in February. The plant, which produces many specialty formulas, has been shut down since then.

There’s simply no substitute for formula — physicians advise against watering it down or trying to use any kind of homemade version, which could cause malnourishment in the baby. The formula shortage leaves people with few options.

The vast majority of parents and caregivers rely, at least partially, on formula to feed babies, according to the Centers for Disease Control and Prevention. Breastfeeding requires constant maintenance every two to four hours, which isn’t possible at many jobs; you often need expensive equipment like pumps; and, crucially, lots of people who try cannot produce enough milk to nourish their children.

Even so, many parents — especially mothers — feel a stigma around using formula. The formula shortage hasn’t changed that. Indeed, some public figures and countless online know-it-alls continue to erroneously tout breastfeeding as a solution.

D.C. parent Nicole Hochsprung tried hard to make breastfeeding work for her now-seven-month-old son, and felt guilty when she supplemented his meals with formula. Even now, she’s reticent to post on her social media for friends to keep an eye out for her son’s formula. “I just don’t want to hear it from people about, ‘Oh, are you not breastfeeding?’ ‘Why are you formula feeding?’ ‘Why are you feeding this formula?’ ”

But more and more, local parenting forums, buy-nothing groups, and other online meeting places are rife with posts from desperate parents crowdsourcing for formula.

Alexa Beichler, a mom of two in Leesburg, VA, has little hope of securing the formula her kids need through the help of social media. Her five-month-old infant and one-and-a-half year old toddler both have the rare metabolic disease phenylketonuria, also known as PKU, which means their bodies can’t properly digest protein. A doctor prescribes them a very particular formula comprised of all the aspects of protein, minus what they can’t eat, which gets shipped directly to them from the company that produces it.

In the last delivery, all of her infant’s formula was in the box, but her toddler’s wasn’t. When she called the company to figure out why, she learned that it was on backorder.

“Their formula literally keeps them alive,” says Beichler. “If they don’t have this, they are going to have severe brain damage and/or die. So, that’s super scary and a super real possibility right now … I would have never, ever thought that a formula, let alone a rare disease formula, would not not be available.”

This week, the FDA said it will allow Abbott to release certain products made at the closed plant for individuals who require specialty and metabolic formulas on a case-by-case basis, but Beichler’s sons’ formula wasn’t made by Abbott. She suspects that others who require PKU-specific formulas may have ordered the one she uses after the Abbott facility shut down, creating a chain reaction of scarcity.

So now Beichler and her family have to play a guessing game. Will her supply of her toddler’s formula last until the backorder ends? Or should they order an alternative, which her son has never tried, and make the switch teaspoon-by-teaspoon? An additional wrinkle is that she’s not sure insurance will cover the $7,000 monthly cost of the prescription formula.

She’s not the only one worrying about cost. As inflation rises, food costs have increased — groceries are 10% more expensive than they were a year ago, putting the squeeze on budgets. And some families are seeing their preferred formulas being sold on second-hand sites like eBay, where their cost is doubled.

The Greater DC Diaper Bank includes formula among the products it provides to social service organizations throughout the D.C. area, who then pass it along to families in need. Nearly 100% of the formula distributed by the diaper bank comes through public donations.

“Our distribution in the month of April especially was a lot lower than it was during the same time period last year,” says Rebecca Kolowé, the organization’s interim executive director. “We’ve had to cut in half the amount that we’re able to provide for partners so that there’s a little bit available for everybody.”

Before February, the Greater DC Diaper Bank allowed partners to take an average of 500 ounces of formula per month, which comes out to about 387 prepared 8-ounce servings. Now, due to the formula shortage, that amount has been halved.

“It’s not a whole lot,” says Kolowé. “That much formula is not going to go very far.”

While the diaper bank is encouraging the public to continue donating formula if they already have it on hand, they’re requesting that people do not buy formula with the intention of donating it, because that means there’ll be less on the shelves.

The Special Supplemental Nutrition Program for Women, Infants and Children, known as WIC, operates by identifying specific products that families can buy with the grants, including formula. About half of the state agencies have rebate contracts with Abbott, including Maryland, Virginia, and D.C., according to Geri Henchy, the director of nutrition policy and early childhood programs at the Food Research and Action Center. WIC offices have issued waivers and substitutions to accommodate the shortages.

WIC products tend to fly off the shelves first, meaning that whatever remains (if there is anything at all) can’t be paid for with WIC vouchers. “And in the worst case scenario, you have people paying full price in order to find something, or they just don’t have the money to do that,” says Henchy.

D.C. is one of the few jurisdictions that still uses paper checks for WIC, rather than the electronic benefit transfers that most states have. That creates additional issues during the formula shortage, because there is a set amount allotted for formula on the check. If the store doesn’t have the full amount in stock, families have to decide whether to pay for what the store has with their WIC check, forgoing additional formula, or risk it by hoping they can find the full amount of formula at a different store. (With electronic benefit transfers, the WIC checks can be separated out.)

The formula shortage marks the latest challenge in having a baby right now, on top of a pandemic and a lack of vaccinations for kids under five.

“It’s really hard to be a mom and try to figure all of it out, even just the normal stuff,” says Jessy Cuddy, a mom in Alexandria. “And then add on top of that the fact that one of the main resources to keep your human alive is starting to become pretty scarce at the grocery store — it’s beyond stressful.”