While other supply chains appear back on track, certain types of baby formula remain elusive for families trying to feed newborn children.

Sarah Morrow, who had given birth to triplets in July, was searching in November for the ready-to-feed, liquid formula recommended by the doctors providing her care.

“We called as many as 18 stores, from here out to Indiana, Pa., and the whole way up to Oil City and Titusville,” said Morrow, whose husband, Randy, searched for formula with her. “And none of the stores we called in any of those areas had the formula.”

“We had friends looking,” she said. “We had family looking. We called all around, and we had no luck with that.”

Morrow’s three children — Beau, Rhett and Luke — all came into the world premature, and the Centers for Disease Control website recommends that families raising premature babies avoid powdered formula.

The CDC also recommends liquid formula for any child younger than 2 months old, although pediatrician Brian Donnelly recommends the baby reach at least 3 months of age before they switch to powdered formula.

Caregivers can prepare powdered formula in a way that makes it safe for babies, Donnelly said.

He refers caregivers to a page on the CDC site that can walk them through that process at https://www.cdc.gov/nutrition/infantandtoddlernutrition/formula-feeding/infant-formula-preparation-and-storage.html.

Powdered baby formula could become contaminated with germs that cause cronobacter — a rare but serious disease — according to the CDC website.

“They said it’s a sterilization issue,” Morrow said, referring to doctors’ guidance. “So when you get the ready-to-feed, it’s going to be better sterilized — because they use sterilized water — than if you use a powder.”

The Morrows eventually received approval from their children’s doctors to use NeoSure, a powder formula that’s richer in calories.

Abbot Nutrition, which sells NeoSure under its brand name Similac, recalled NeoSure (along with other products) in February and October. The February recall followed investigations by the Food and Drug Administration after four babies were hospitalized — three with cronobacter, one with salmonella.

One of the babies infected with cronobacter died.

“It can be sneaky,” Donnelly said, referring to cronobacter. “It can hide in the powder. That’s the idea of trying to keep the reconstituted formula safe or safer.”

Caregivers’ accidental use of contaminated water to prepare baby formula, which then leads to illness, tends to happen more commonly in the Third World, Donnelly said.

Babies might require more calorie-rich formulas because they’re born premature or because they’re born with congenital heart or lung diseases, he said.

“So the extra energy would be useful because they have a hard time feeding, finding the energy to feed,” he said.

“The premature babies, once they start gaining weight ... that’s often when we would think about going to a regular formula as opposed to the fortified-with-extra-calories formula,” he added.

“That [powdered formula] was our only option, and thankfully that is a little bit easier to find now, depending on what store you go to,” Morrow said. “Walmart never has it. Target sometimes has it ... but it’s a little bit easier to find than the ready-to-feed.”

Morrow said she at first noticed that smaller grocery chains, such as Giant Eagle, proved more likely to sell the approved formula, rather than nationwide megastores.

Other caregivers appeared to frequent these stores and deplete their supplies less, she said.

Morrow remembered a different experience obtaining formula samples, too. When her eldest daughter, who is now 4 years old, was an infant, it was possible to find samples at her doctor’s office. Now it isn’t, she said.

Donnelly said his office has received fewer deliveries of formula samples, and that this inconvenience goes along with the shortages.

Morrow said when all else failed in the search for needed formula, it helped to learn from experts what the next best alternative would be.

“Obviously, you have to feed your kids,” she said.

Donnelly warned caregivers to avoid purchasing any products marketed as breast milk online.

“There had been a study a couple years ago looking at that,” Donnelly said. “The researchers actually purchased it themselves, acted like they were a consumer, and then tested it and found contamination — both extra unhealthy amounts of bacteria in the samples, but also actual cow’s milk that they were adding to whatever breast milk was in there.”

Donnelly cited another study where researchers divided healthy, nine-month-old babies into two groups, one which received baby formula and another which received cow’s milk. By the end of the study, doctors diagnosed a third of those babies who had received cow’s milk with anemia.