As alternatives, the American Academy of Pediatrics (AAP) and the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition recommend exclusively breastfeeding for at least 6 months or using a US Food and Drug Administration-approved infant formula or donor breast milk from a reputable milk bank. For a study, researchers sought to determine the prevalence of modern baby feeding techniques such as informal human milk sharing, imported European infant formula, toddler formula, and homemade formula, as well as to obtain insight into parental thinking for their choices. In April and May 2021, an anonymous, cross-sectional, voluntary electronic survey was sent to active prescribers via Yumi (a baby food subscription company) list server. Basic demographic information and the use of infant feeding practices and general feeding practices were gathered. 

At least 18% of the 2,315 respondents followed at least one current feeding practice. About 36% of parents who used donor breast milk acquired it from unregulated sources, 14% used European baby formula, 5% used toddler formula, and 2% manufactured homemade infant formula. When nursing is impossible, the AAP recommends baby formula or donated breast milk from a reputable milk bank. Nonetheless, the survey discovered that at least 18% of families in the United States were engaging in at least one current feeding practice that might pose nutritional and safety risks.