First Responders Support Infant and Young Child Feeding in Emergencies

Supporting Families in an Emergency

Any time a parent needs a First Responder, it is an emergency for that family. Emergencies come in many forms, including personal or family crises, public health emergencies (e.g., COVID pandemic), fires, acts of violence, power outages or water main breaks (e.g., water no longer safe to drink), and weather-related or natural disasters (e.g., extreme heat waves and floods), and sometimes they take place in combination.

While disasters impact us all, they heavily impact young families, especially vulnerable families already marginalized or without adequate resources, and can make it hard for parents and caregivers to safely feed their infants and young children. How can First Responders help? This article offers guidance and resources to help First Responders provide support for safe infant and young child feeding in emergencies.

Breastfeeding is the safest way to feed children during emergencies, and helping families to continue breastfeeding is critical for the health and safety of young children. We start with the North Carolina law regarding breastfeeding. Being aware that breastfeeding is protected in North Carolina will inform and support your response in an emergency. The law states that:

a woman may breastfeed in any public or private location where she is otherwise authorized to be, irrespective of whether the nipple of the mother’s breast is uncovered during or incidental to the breastfeeding.

N.C. Gen. Stat. § 14-190.9 (1993)

Infants and children are the most vulnerable during emergencies.

  • Nearly 95% of infant and child deaths in emergencies result from diarrhea due to contaminated water and an unsanitary environment.
  • Infant formula has been linked to an increase in infant disease and death: it can also be contaminated and requires clean water and fuel to sterilize formula, bottles, and nipples. Lack of electricity also can make it difficult to preserve formula.
  • Breastfeeding saves lives! Human milk is always clean, requires no fuel, water, or electricity, and is available, even in the direst circumstances.
  • Human milk contains antibodies that fight infection, including diarrhea and respiratory infections common among infants in emergency situations.
  • Human milk provides infants with perfect nutrition, including the proper amount of vitamins and minerals required for normal growth.
  • Mothers who breastfeed are able to keep their babies warm to prevent hypothermia.
US Breastfeeding Committee (https://www.usbreastfeeding.org/breastfeeding-in-emergencies)

Breastfeeding in emergencies is not easy. However, when our community ensures that equitable protection, promotion, and support for chestfeeding/breastfeeding is a part of First Responder training and emergency preparedness planning, families are more likely to receive the help they need to continue nursing their children despite the challenges.

Create a safe place for breastfeeding.

  • Keep families together. Although it may feel good as an emergency worker to feed and comfort a child, emergency workers and volunteers should ensure that families are not separated and provide support to parents so that parents can feed and comfort their children.
  • Create safe, private areas for breastfeeding parents to nurse their infants.

Target support for the nursing family’s needs.

  • Provide nourishment and clean water to the parents to help them stay hydrated and strong to care for their children.
  • Reassure nursing parents that continuing to breastfeed is the best choice for feeding their infant and encourage parents to breastfeed as often as the baby wants. It is clean, safe, and readily available.
  • Encourage parents who are combining both breastfeeding and bottle-feeding to increase breastfeeding during the emergency as the clean, safe, and readily-available feeding method.

Things to Avoid.

  • Avoid providing breast pumps. Without power, parents cannot use an electric breast pump or safely refrigerate their expressed milk. Furthermore, keeping pump parts clean is an additional challenge when the water is unsafe.
  • Avoid giving powdered infant formula or other breast milk substitutes without first assessing need. Formula should not be provided to breastfeeding infants or their families.
  • Avoid accepting donations of infant formula. Agencies should purchase ready-to-feed infant formula, as needed, for families that are already using infant formula.

Resources for First Responders and Emergency Response Teams

Resources for Families

Donations and Distribution of Infant Formula

Often the first thing that our communities want to provide…and individual citizens want to donate…is infant formula for families with young children. Communities and individuals may have the best intentions; it feels good to “do something” so tangible as to support the feeding of babies in times of crises. While some families might be using infant formula for infant feeding before an emergency, many families will be breastfeeding or expressing milk for their infants. Donations of infant formula are not the best way to support safe infant and young child feeding in emergencies. What are some things to consider when distributing or receiving donations of infant formula?

  • Always complete a feeding needs assessment before distributing infant formula to determine the family’s infant and young child feeding needs. Why?
    • A breastfeeding family does not need infant formula. They need reassurance, support and encouragement to continue chestfeeding/breastfeeding.
      • Families can and should continue to breastfeed in an emergency.
      • By giving a container of formula to all families with infants and young children, the emergency worker or volunteer is incorrectly suggesting that the parent should not breastfeed or cannot successfully breastfeed during the emergency.
      • Breastfeeding is the safest way to feed a child.
    • The family may need feeding supplies or education about safe preparation and storage, especially if they do not have access to clean, safe water.
  • Do not request or accept donations of formula.
    • The CDC Infant Feeding Donations in Emergencies states that “only official relief organizations should provide and manage emergency supplies of infant formula”.
    • Relief organizations should purchase ready-to-feed infant formula, as needed. Some families will be using infant formula for infant feeding before the emergency, as determined by the feeding needs assessment, and will need ready-to-feed formula and information about keeping the formula safe for their infants.
Safe Infant Feeding in Emergencies from Breastfeeding Family Friendly Communities

Summary

North Carolina law protects breastfeeding in public.

Policies and practices that support Infant and Young Child Feeding in Emergencies are vital for the health and safety of our youngest community members and their families.

Breastfeeding saves lives! It continues to be the optimal way to feed infants, even in emergencies.