Jessi Whitesides, 33, has been staring down a no-win scenario.

A raft of medical conditions, including food allergies and gastrointestinal issues, had left her 4-year-old autistic daughter with a single option for food — Neocate Junior, an unflavored formula. But supply chain snags, record inflation and product recalls had completely upended access to the cases of formula she received through the federally funded Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). The Advance, N.C., family has not received the formula since April.

“It’s been impossible to get our hands on it, and the only ones we can fine online, people price-gouged,” Whitesides said. “There were two cases on eBay, which is eight cans, that was going for $800.”

For weeks, the family has tried other formulas, but their daughter’s inability to adjust to other products led Whitesides to a difficult decision. “The shortage has led us to decide to put a feeding tube in our child,” she said.

As the country struggles with the fallout from a dramatic shortage of baby formula, infants and children with special needs in rural areas and low-income neighborhoods are at a greater risk of not being fed than more affluent ones, experts and nonprofit organizations say.

The combination of product recalls, rising prices and supply chain issues have particularly affected the availability of formula distributed through the WIC program, according to Norah Weinstein, co-CEO of Baby2Baby, a nonprofit providing items to families living in poverty.

“The families we serve don’t have the luxury to hoard formula. They don’t have access to big-box stores. They can’t afford to buy in bulk, and they don’t have access to Internet deals,” said Weinstein. “All of these things expose the fragility of the formula supply chain, which is so damaging for families in poverty.”

In Virginia, the WIC program expanded formula options available to participants after a February recall of Abbott-made formula, but low inventory has forced many parents to search multiple stores, Paula N. Garrett, the state WIC director, said in a statement. Even state efforts to order formula directly from distribution warehouses came up short because supplies are back-ordered and out of stock, she said. Officials with the WIC program in Washington, D.C., and Maryland did not immediately return calls seeking comment.

With empty shelves sparking growing panic among parents, nonprofits and informal groups are working over time to source unused formula and offer alternatives to parents. Still, the latest market analysis shows the severity of the problem.

This week, Datasembly, the Tysons-based firm that releases real-time product data, released a report showing that the nationwide out-of-stock rate for baby formula was 43 percent. Compare that to the first half of 2021, when the shortage rate for formula was between 2 to 8 percent.

“The category started to see stocking challenges beginning in July 2021, and the situation has continued to worsen into 2022,” Datasembly chief executive Ben Reich said in a statement.

In February, Abbott issued a recall of formula produced at a Michigan plant after four infants became sick with bacterial infections. Two of the children died.

This week, the company released a statement acknowledging the shortage and detailing Abbott’s efforts to resume production at the Michigan plant. “Subject to FDA approval, we could restart the site within two weeks,” the company stated.

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Formula was already a pricey item for struggling parents before the crisis. A family can spend about $1,500 on formula a year, the Department of Health and Human Services estimated before the recent jump in inflation. According to Weinstein, in March 2020, when the coronavirus pandemic hit the country, Baby2Baby’s requests for formula went up 860 percent immediately. The organization has since given out 300,000 cans of formula.

The Greater D.C. Diaper Bank, which takes donations and connects them with partner organizations across the region, saw a drop in formula donations in April, according to Rebecca H. Kolowé, interim executive director.

“We’ve always had a limit on formula, we just never have had enough,” Kolowé said. “But we used to distribute to partners each month the equivalent of 387 prepared bottles of eight ounces each. We have had to cut that in half.”

Alsan Bellard, a pediatrician and chief medical officer at Community of Hope, which serves underinsured and uninsured patients in D.C., said his patients have still been able to get formula but have had to work harder to get it.

Bellard, who is based at the Conway Health and Resource Center in Ward 8’s Bellevue community, said on Wednesday that he spoke to a mom so frustrated by the lack of formula options that she was ready to feed her 9-month-old baby cow’s milk. That practice is not recommended, he said, and can slow growth and development and cause other long-term issues that can be hard to grasp in the face of other challenges. She is a single mom and a student with little time to get to the store, let alone multiple stores in search of formula.

“She was struggling with that conversation because for her the challenge of just finding the appropriate formula was more than the potential risks of putting the child on cow’s milk,” he said. He noted that Community of Hope has worked to build lactation services to help moms avoid formula if possible because “there’s never been a recall on breastmilk.”

Lindsay Gill, 37, who started The Napkin Network during the pandemic, collects diapers, baby wipes and other supplies and distributes them to parents in need through nonprofits and other groups.

As the formula shortage has set in, Gill not only shifted her nonprofit operation toward sourcing formula but had to look for it herself.

“I don’t have formula for my own baby,” she said.

Gill recently put out word on social media that she’s collecting formula for families in need.

“Just yesterday, someone from Stafford, Va., sent me six cans,” she said. “Today they have all been claimed.”

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Doctors recommend that babies are fed breastmilk or formula until 1 year of age, putting parents in an incredibly stressful position if that vital food source is unavailable, said Danielle Dooley, a pediatrician and medical director of community affairs and population health in the Child Health Advocacy Institute at Children’s National Hospital.

“It’s really critical for their growth and development that they are able to access the nutrition that they need,” Dooley said.

Some parents are turning to liquid or ready-to-feed formula, which is much more expensive. Pediatricians have warned desperate parents against diluting the formula or switching to whole milk, toddler formulas or homemade formula, all of which could cause serious health problems, she said.

“You can see people are thinking through every possible option and scenario in order to try to feed their infants,” she said.

Dooley, who has never seen a shortage like this in 20 years of practicing, compared the meager government response with the uproar over shortages of toilet paper and paper products at the start of the pandemic.

“I really do think this is an emergency. It’s a national emergency,” she said. “Infants need to eat.”