Policy changes to US federal infant feeding laws and regulations from 2014-2023: evidence that the 2022 infant formula shortage had a narrow policy impact

Abstract

In the spring and summer of 2022, an infant formula shortage in the United States received extensive media coverage, widespread social media engagement, and visible political attention. The purpose of this study was to explore changes to federal infant feeding policies in relation to the 2022 infant formula shortage to determine whether the shortage provoked policy change, and if so, the nature of those policy changes. A mapping of federal laws, regulations, and presidential documents passed or substantively amended between 2014 and 2023 was conducted to explore changes in US infant feeding policies prior to and following the shortage. Fisher's exact tests with post hoc comparisons were used to determine associations between policy topic areas and when policy changes occurred. Fifty-seven infant feeding policy changes met the inclusion criteria. There was a statistically significant relationship between the formula shortage and policies addressing infant formula supply, suggesting policy mobilization and attention from policymakers. There was no statistically significant change in policies on breastfeeding or other infant feeding dimensions associated with the timing of the shortage, suggesting that policymakers' attention was narrow in scope. It is unclear to what degree the policy changes will endure or prevent another infant formula shortage.

Keywords: agenda setting; breastfeeding; focusing event; infant feeding; infant formula; infant formula shortage; policy change.