Supporting Young Child Feeding in Emergency Shelters

Preparing for a natural disaster emergency

Learn about:

• Health equity, to ensure it is included in efforts to keep families safe and well-fed in the shelter.
• Community lactation support resources, such as La Leche League, WIC, Lactation Consultants, breastfeeding counselors, breastfeeding peer counselors, and support hotlines. WIC is the Special Supplemental Nutrition Program for Women, Infants, and Children.
  • Maintain up-to-date community contact and resource lists so breastfeeding support can be accessed easily and quickly from the shelter.
• Differences between cultures for the people you serve. Cultural practices may influence daily routines in the shelter such as preparing foods, eating, and sleeping.

Be ready to provide:

• A safe, clean, and private space for mothers to breastfeed or express milk. See Creating Safe Family-Friendly Spaces in Emergency Shelters.
• Essential infant and toddler supplies.
• A space to store ready-to-feed (RTF) infant formula and powdered infant formula. This space will be temperature-controlled, if possible.
• A space to prepare powdered infant formula safely, if needed.
• Safe and clean diapering stations using CDC's planning checklist for diapering stations in shelters. (Also available in Spanish).
• Accommodations for children with special health care needs who require electricity for their feeds.
• Breast milk storage guidelines for families who arrive with expressed breast milk in a packed cooler. Transfer the stored and labeled breast milk from the cooler to a refrigerator immediately upon arrival.
• Signage to direct families to areas to safely feed their children, clean infant feeding supplies, wash their hands, and change diapers.

During a natural disaster emergency

Address the needs of families:

• Make pregnant and breastfeeding women a priority group for access to food and water, safe shelter, healthcare, breastfeeding support, and psychosocial support.
• Keep families together and in an area where they feel safe.
• Conduct a rapid needs assessment with all families with infants and children. Include information about how they are feeding their children and what feeding support or feeding-related items they need.
  • Shelters that cannot provide ready-to-feed (RTF) infant formula, a safe water source, or the capacity to boil water to prepare powdered infant formula, should not house families who are feeding their infants with infant formula.

Encourage and support breastfeeding:

• Encourage and support lactating women to continue to breastfeed throughout the emergency or displacement.
  • Remind families that breastfeeding is the safest method of feeding and will help protect their baby from illness and infection. Breastfeeding can also provide parents and babies comfort and reduce stress.
  • Explain that breastfeeding doesn't require electricity or water, which may be lacking or unsafe during the emergency.
  • Encourage families to breastfeed whenever and wherever they want to in the shelter, other than a bathroom. If others in the shelter are not comfortable with breastfeeding in public spaces, relocate the uncomfortable people to another part of the shelter, away from families.
  • Identify other breastfeeding families within the shelter that may be willing to serve as peer-support to a family in need (if lactation support is not readily available).

Ensure safe feeding, hygiene, and sanitation:

• Provide education to families about infant formula feeding, infant formula preparation (if RTF infant formula is not available), and proper cleaning of infant feeding items.
• Show families areas of the shelter where they can:
  • Breastfeed or express milk in private if desired, but not in the bathroom.
  • Wash their hands, prepare foods, and clean infant feeding items separate from a bathroom.
  • Safely change and dispose of infant diapers separate from the infant feeding area.
  • Access safe drinking water.
• Provide disposable cups for families to use with their infants and children, as well as cup feeding instructions. Bottles, nipples, and sippy cups are difficult to keep clean when safe water is limited or unavailable.
• Follow all state and local guidelines for safety in a public disaster shelter.
• Always follow shelter protocols when an individual has symptoms of illness.

Tips for shelter staff during an emergency

Handling infant formula

Do not distribute infant formula to all families with infants. Distributing infant formula to all breastfeeding families can send an incorrect message to families that their breast milk is not enough or not safe during an emergency.

• Conduct a rapid needs assessment to help identify which families need infant formula.
• Families needing infant formula should use ready-to-feed (RTF) infant formula when possible.
• Keep infant formula and related supplies out of view to avoid promoting these products to families who could be breastfeeding.

Managing supplies

• Families feeding infant formula should receive support for as long as needed. Support includes infant formula and the supplies to safely prepare it and clean infant feeding items.
• Do not call for, accept, or distribute donations of powdered infant formula or toddler milks. Emergency supplies of infant formula should only be acquired by official relief organizations.
• If local- and state-provided infant feeding supplies become depleted, the state can submit a Resource Request Form to request infant and toddler kits. The form is from the Federal Emergency Management Agency (FEMA).

Providing continued support

• Conduct additional feeding assessments as needed. Remind families that they can ask staff for supplies, information, and support.
• Encourage and help eligible families enroll in a long-term program such as WIC.
• Monitor for mental health concerns among families seeking shelter. Emergencies can cause significant stress on families and may impact the caregiver-infant feeding relationship.
• Provide on-site services if possible or connect the family to follow-up care through referrals. Provide information about caring for children in disasters.