What’s the Right Way to Feed and Protect Babies in a Humanitarian Crisis?

Published April 14, 2009 @ 10:20AM PT

The use of breastmilk substitutes should be closely controlled. They should be provided through medical professionals. Formula or bottles should never be provided as a part of baby or family kits. Breastmilk substitutes should only be provided when the mother is dead, incapacitated, or unavoidably absent and no other lactating woman is available to nurse the child or if the child was solely artificially fed before the start of the emergency.

When used, breastmilk substitutes should be made as safe as possible. They should be provided along with access to safe water for mixing formula and cleaning cups. Bottles and nipples should not be distributed; babies should be fed using a cup. Any infant who is chosen for formula distribution should receive a supply of formula until six months of age. The formula distributed must me nutritionally adequate, and labeled in a local language. Only unbranded baby formula should be distributed. Powdered milk should not be distributed as part of family food supplies unless it is pre-mixed with some other food stuff.

Women should be supported in breastfeeding. In camps for displaced persons, private, comfortable lactation spaces should be provided. If possible, these spaces should be staffed with personnel trained in breastfeeding support, or peer counselors experienced in breastfeeding. Breastfeeding can actually help mothers cope with the stress of displacement and risk because it suppresses the release of stress hormones and encourages physical contact between mother and baby. Lactating mothers should receive adequate food and water rations to support lactation.

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Comments (5)

I came across this series after reading Hanna Rosin's recent article in The Atlantic ("The Case against Breastfeeding" found here:http://www.theatlantic.com/doc/200904/case-against-breastfeeding). While the article deals explicitly with breastfeeding in the developed world, it was interesting when compared to the points raised here. Rosin speaks from a space in which women have the choice whether to exclusively breastfeed, pump, use formula, etc. This is not to say that issues of privacy and support do not arise in the developed world, and maybe the two can't be compared, but the differences are striking. The issue of breastfeeding in crisis is one that is so rarely addressed (aside from issues surrounding formula) but is obviously of great importance. You make amazing points, but I was wondering what was being done about it? Do you know of any camps for displaced persons that provide lactation support? (I'm not meaning this as a challenge at all, I just really have no knowledge of the kind of support offered--if any--to mothers in camps for displaced persons).

Posted by Annie Heffernan on 04/14/2009 @ 12:21PM PT
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I really hate that Hanna Rosin article, even though she's right about some things.

Plenty of NGOs do get it right, at least sometimes, on breastfeeding. World Vision, for example, has a whole policy document on breastfeeding in emergencies: http://www.ennonline.net/pool/files/ife/wv-milk-policy-revised-july-25-final.pdf

Posted by Alanna Shaikh on 04/14/2009 @ 12:54PM PT
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Thanks so much for the document...the links at the end are especially informative as well. I agree with you on the Rosin article, it was the idea that women are "shackled" to their infants that turned me off...something about that choice of words.

Posted by Annie Heffernan on 04/16/2009 @ 12:05AM PT
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"Breastmilk substitutes should only be provided when the mother is dead, incapacitated, or unavoidably absent and no other lactating woman is available to nurse the child or if the child was solely artificially fed before the start of the emergency."

I would have one very minor quibble with this: it would call for cross-nursing even if and when this is not culturally acceptable. Going against local cultural mores rarely works, so this could also be a reason not to cross-nurse.

Posted by Michael Keizer on 04/15/2009 @ 06:24PM PT
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I gree, but it seems to me that culturally unacceptable would be a valid reason that no other woman is vailable.

Posted by Alanna Shaikh on 04/15/2009 @ 09:33PM PT
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Author

Alanna Shaikh has spent the last ten years immersed in global health; she has worked for NGOs, companies, universities, and the US government on projects that ranged from preventing antibacterial resistance to improving maternal and child health.