SOUTH LAKE TAHOE, Calif. — With twin 4-month-old girls and a toddler, getting out to buy formula was already a struggle for South Lake Tahoe resident Sherri, but add in a nationwide formula shortage that has left Lake Tahoe’s grocery store shelves nearly empty, and it has become a huge source of anxiety for the mother of three.

“You already have a huge amount of anxiety just having young children this age, so this being piled on top of it, it’s very stressful,” says Sherri, who asked to not have her last name included. “But being a mom of twins especially, you have to make sure that you have pre-planned for at least a week in advance. It’s twice as hard, especially when purchases are limited. You don’t want to try and convince the cashier to make an exception because you have one more mouth to feed.”

Additionally, as a recipient of the Special Supplemental Nutrition Program for Women, Infants, and Children, Sherri’s benefits only allow her to purchase a certain size container of formula, and those are “non-existent right now,” she explains.

With most stores imposing a four-can limit on formula, or less, Sherri has turned to friends and family around the country to search for the nourishment she needs for her daughters.

“I have enough formula for about a week and a half for my twin girls,” says Sherri, who points to the moral dilemma of wanting to have enough for her children, but also being considerate of the other families who need to stock up, too. “I feel so bad for the moms that have babies that need a certain specific formula. I want to cry right now. They are trying to sift through what doesn’t make their baby fussy and upset and cry or not grow. It’s madness to me.”

Long-term issues stemming from the pandemic have disrupted supply chains and shipment of a multitude of products, including formula ingredients. Supply pressure was ramped up in February due to a voluntary recall by Abbott Laboratories, producer of the popular Similac line of formula, after receiving reports of bacteria infections in four babies resulting in two deaths. The Michigan-based plant, where the powdered products originated from, is only just now set to reopen in two weeks, pending FDA approval, reports a May 16 press release from the company. With only a few manufacturers controlling the formula market — and Abbott dominating 43% of that share, according to the most recent USDA report — the recall had severe repercussions on shelf stock.

For the week ending May 8, 43% of formula was out of stock at retailers across the nation, according to retail-tracker, Datasembly. That’s up from 31% roughly a month ago and 11% in November.

For South Lake Tahoe mother Laurie Jackson, finding special high-calorie formula for her premature son has been a constant source of stress. Born nine weeks early, Wyatt spent six weeks in the newborn intensive care unit.

“Not being able to find it, he hasn’t been able to gain the exact weight he is supposed to gain as preemie. We finally found some but not in Tahoe. We got the last four cans online through a store in Gardnerville, and my mom was able to find some down in Watsonville where she lives,” explains Jackson. She even has a shipment coming in from a family friend stationed with the military in Germany.

After suffering a heart attack during her C-section, Jackson is on heart medication that prevents her from breastfeeding.

“I can’t breastfeed because he has heart meds, and I take heart meds. It would be fatal to him,” says Jackson, who checks local stores every fews days for the formula she needs. “If I didn’t have to take this medication and I could feed him, I would feel so much better. To the people that say, ‘breast is best’ — yeah, we know that. Believe us, we know that. But there needs to be more awareness around the reasons that mothers can’t breastfeed.”

Amid the formula shortage, a conversation has emerged around breastfeeding through online chatter and spurred on by ill-informed comments, like a circulated tweet from Bette Midler declaring, “try breastfeeding! It’s free and available on demand.”

Local lactation consultant and doula Krystal Long knows that the decision to not breastfeed is usually not one taken lightly.

“Most women that I work with have intentions of breastfeeding their babies. We know that it is the perfect food and it provides a bond between mom and baby that’s pretty special. Sometimes there’s just a hiccup whether it’s a physical issue with the baby like an undiagnosed tongue or lip tie. It could be an issue with mom where her nipples are inverted or she simply has insufficient glandular tissue or low milk supply. Sometimes it’s the fallout from a traumatic birth and the body needing time to recover and heal.”

Long notes that given the amount of time and energy that a mother devotes to breastfeeding, it is not something that should be considered “free.” And often continuing with the process without the right support can be to the detriment of the mother and baby’s bond.

“The need to make sure the baby is fed and make sure mom’s mental health is OK outweighs the benefits of breastfeeding,” adds Long. “I will sit with a mother and hold her hand and give her permission to stop breastfeeding — and sometimes that’s exactly what she needs because there is such a stigma around it. I think the level of shame around formula feeding is heartbreaking.”

The FDA recently announced it is making moves to ease restrictions on which manufacturers can sell formula in the U.S., which should allow additional products to hit shelves soon and ease the shortage.