Response: Infant and Young Child Feeding in an Emergency

At a glance

During the response phase of an emergency, relief workers can take these actions to help families feed infants and young children safely.

A relief worker assisting a mother and her baby during an emergency.

Identify resource needs

Take the following steps to identify the resource needs in your community.

  • Document the number of pregnant women and families with children younger than 2. Note how the children are fed to determine the resources needed.
  • Conduct a rapid needs assessment that includes:
    • Infant and young child feeding questions to help ensure feeding supplies and support can be appropriately addressed.
    • A disaster assessment of shelter conditions to help identify immediate needs, including safe areas for children and families.

Create safe spaces for all families

Emergency situations can be very stressful and traumatic. Emergency responders should help families safely provide adequate food and water for their children.

To create a safe place for all families:

  • Keep families together.
  • Create safe family-friendly spaces in shelters. Use the Shelter Field Guide as a resource.
  • Reassure breastfeeding women that they can and should continue to breastfeed as often as their infants want.
  • Consider grouping families with infants and young children together to encourage mutual aid and to support resiliency.

Address access

Emergency response providers can:

  • Make pregnant, postpartum (recently given birth), and breastfeeding women one priority group for access to food and water, shelter, healthcare, protection, psychosocial support, or other essential support. Women who are pregnant, postpartum, or breastfeeding need to consume additional calories for their bodies to optimally support pregnancy or breastfeeding.
  • Connect parents and caregivers to breastfeeding (lactation) support providers as needed.
  • Coordinate care for families needing referrals to appropriate psychological first aid and/or mental health and psychosocial support providers and resources.

Maintain cleanliness

Emergency relief workers can help maintain a clean environment for families.

Expressed breast milk

For families who rely on a breast pump, ensure access to safe water and cleaning items. This may include a washbasin, dish soap, cleaning brushes, and a mesh bag to hang dry breast pump kit parts.

Educate families about:

Infant formula

For infants who are not breastfeeding or being fed breast milk, ready-to-feed (RTF) infant formula is safest. Powdered infant formula is not sterile and must be carefully prepared with safe water and stored properly.

Additional considerations

Take the following steps to help ensure cleanliness in disaster and shelter environments:

  • Make disposable cups available. Bottles and nipples are hard to clean effectively when there is limited access to clean water.
  • Make disposable bibs, plates, bowls, and utensils available for feeding children.
  • Provide antibacterial cleansing wipes for families to clean surfaces before and after feeding their children.
  • If there is safe water, ensure access to cleaning items such as washbasin, dish soap, cleaning brushes, and a mesh bag to hang dry infant and toddler feeding items. Educate families about how to clean infant feeding items.

Educate families

Emergency relief workers can be prepared to provide education to families about:

Importance of breastfeeding

Talk to breastfeeding women about the importance of continuing to give breast milk to their children during and after the emergency.

Breastfeeding infants younger than 6 months do not require water supplementation, even in extreme heat environments. With the support of a lactation provider, mothers who are partially breastfeeding their children can breastfeed more frequently. This may increase milk supply and decreases reliance on infant formula.

Infant formula

Some women may be worried about having enough breast milk for their child and request infant formula to supplement. When these families request formula, first conducting a rapid needs assessment can help identify whether breastfeeding assistance, education, and resources might support continued breastfeeding. It can also help ensure the child is receiving adequate nutrition.

Safe storage and preparation of expressed breast milk

Emergency relief workers may need to teach women who hand express breast milk or rely on a breast pump how to safely store their milk and properly clean breast pump kits and infant feeding items, as applicable. Education should consider the immediate available resources, such as refrigeration, safe water, cleaning supplies, and heat sources.

Safe preparation and handling of infant formula

If ready-to-feed (RTF) infant formula is not available, teach formula-feeding families how to safely prepare and feed powdered infant formula in an emergency setting. Even if families had prior experience preparing and feeding powdered infant formula, the risks in emergency situations require additional precautions.

Providing infant formula during an emergency should include support and education to ensure safe preparation and handling. Education and support can include:

Safe feeding of solid foods

When children start eating solid foods, they start with smooth or mashed foods. They begin to eat finely chopped or ground foods as they get older. Emergency relief works can provide families whose children are eating solid foods with information about where to prepare foods. Relief works can also provide materials such as utensils or a blender to mash or chop foods.

Do's and don'ts

DON'T include infant formula in infant/toddler kits, household packages, or other general distributions. Infant formula should not be located in areas where other foods are freely available or being distributed or served.

  • DO: Have a trained health or nutrition worker provide these on a case-by-case basis following a rapid needs assessment.
  • DO: Provide RTF infant formula to infants who are already formula feeding or have had breastfeeding interrupted in certain situations (if donor milk is unavailable).
  • DO: Store infant formula out of public view. This will help ensure that it is appropriately distributed with information about how to safely prepare it.

DON'T call for, accept, or distribute donations of manual or electric breast pumps. Without power, mothers or caregivers cannot use an electric breast pump or safely refrigerate their expressed milk. Keeping pump parts clean is an additional challenge when water is unsafe.

  • DO: For women that rely on a breast pump to feed their infants, encourage them to breastfeed at the breast more and/or hand express their milk for feedings. If this is not possible, make sure they have access to electricity and/or batteries to operate the pump and a refrigerator to store their milk. These families also need access to safe water and cleaning supplies to properly clean the pump part kits after every use. If proper cleaning of breast pumps is not possible, they should not be used, and hand expression should be prioritized.

DON'T call for, accept, or distribute donations of infant formula or toddler milks. Emergency supplies of infant formula are managed and provided by official relief organizations. Relief organizations can manage the process of getting and distributing infant formula. This ensures it is stored at a safe temperature and given only to families that need it. These organizations will also make sure families get the information and supplies they need to feed their babies safely. Learn more about formula donations.

DON'T call for, accept, or distribute donations of reusable feeding equipment, such as feeding bottles, nipples, and pacifiers.

Reminders

The following actions can help ensure that relief workers safely support infants, young children, and families during emergencies.

  1. Have written guidelines for supporting breastfeeding.
  2. Make sure that all volunteers and relief workers are trained to support infant and young child feeding.
  3. Provide appropriate safe feeding information to families who give their infants infant formula.
  4. Educate families about safe complementary feeding.
  5. Prevent donations and uncontrolled distribution of infant formula and other products, such as infant feeding items that need cleaning and that might not be safe during or following an emergency.
  6. Support maternal wellbeing by providing access to mental health resources and providers.
  7. Target support to high-risk infants, children, and their caregivers, including pregnant, post-partum, or lactating women.
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Content Source:
National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP)