Infant and Young Child Feeding in Emergencies, including COVID-19*

But breastfeeding isn’t easy for everyone, particularly in emergencies. – Uploaded from Save the Children USA

Key Facts about Breastfeeding and EmergenciesEmergencies often occur when least expected, and sometimes when we are least prepared. They can include a wide range of unsettling events, including personal or family crises, public health emergencies (such as a flu pandemic), acts of terror and violence, and natural disasters or weather-related events (such as floods and blizzards).

COVID-19 Resources

COVID-19 Interim Guidance for Infant and Young Child Feeding in Emergencies:

• Centers for Disease Control and Prevention:
  • “Care for Breastfeeding Women“
  • “Pregnancy & Breastfeeding: Information about Coronavirus Disease 2019“
  • “Interim Considerations for Infection Prevention and Control of Coronavirus Disease 2019 (COVID-19) in Inpatient Obstetric Healthcare Settings“
  • “Coronavirus Disease (COVID-19) and Breastfeeding“
  • “Evaluation and Management Considerations for Neonates At Risk for COVID-19“
• World Health Organization: 
  • “Clinical management of severe acute respiratory infection when novel coronavirus (nCoV) infection is suspected“
  • “Q&A: Breastfeeding and COVID-19“
  • “FREQUENTLY ASKED QUESTIONS: Breastfeeding and COVID-19 For health care workers“
• Department of Defense: “DoD COVID-19 Practice Management Guide Clinical Management of COVID-19“
• Emergency Nutrition Network: “Operational Guidance on Infant Feeding in Emergencies (OG-IFE) version 3.0“

Resources for Families:

• Academy of Breastfeeding Medicine: “ABM Statement on Coronavirus 2019 (COVID-19)“
• Asian & Pacific Islander American Health Forum: “AA and NHPI In-Language Resources for Coronavirus (COVID-19)“
• Carolina Global Breastfeeding Institute: “COVID-19 Resources“
• Centers for Disease Control and Prevention: “How to Keep Your Breast Pump Kit Clean: The Essentials“
• Human Milk Banking Association of North America: “COVID-19 Resources” 
• National Child Traumatic Stress Network: “Parent/Caregiver Guide to Helping Families Cope with the Coronavirus Disease 2019“
• UNICEF: “Coronavirus disease (COVID-19): What parents should know“

Resources for Health Care Providers, Lactation Support Providers, and Administrators:

• American Academy of Family Physicians: “AAFP Statement on Breastfeeding and COVID-19“
• American Academy of Pediatrics: “Critical Updates on COVID-19“
• American College of Obstetricians and Gynecologists/Society for Maternal-Fetal Medicine:
  • “Outpatient Assessment and Management for Pregnant Women With Suspected or Confirmed Novel Coronavirus (COVID-19)“
  • “Coronavirus (COVID-19), Pregnancy, and Breastfeeding: A Message for Patients“
  • “COVID-19 FAQs for Obstetrician-Gynecologists, Obstetrics” 
• International Board of Lactation Consultant Examiners: “IBLCE Advisory Opinion on Telehealth“
• International Lactation Consultant Association: “ILCA Statement on Breastfeeding and Lactation Support During the COVID-19 Pandemic“
• Lactation Education Resources: “Resources for Lactation Supporters During COVID-19“
• Society for Maternal-Fetal Medicine: “Coronavirus (COVID-19)“
• UNICEF/USAID: “Infant and Young Child Feeding Recommendations when COVID-19 is Suspected or Confirmed.” 
• United States Lactation Consultant Association: “Recorded Webinar: COVID-19: Best Practices for Lactation Consultants & Perinatal Educators“

Resources for Public Health Workforce and Advocates:

• Association of State and Territorial Health Officials: “COVID-19” 
• National Association of County and City Health Officials: “COVID-19 Data Lab“
• National Indian Health Board: “Tribal COVID-19 Resource Center“
• National Perinatal Association: “COVID-19” 
• National WIC Association: 
  • “Breastfeeding and COVID-19 Guidance” 
  • “COVID-19 Resources“
• Public Health Institute: “Protecting Public Health During the COVID-19 Pandemic: PHI Response & Resources“
• U.S. Department of Agriculture, Food and Nutrition Service: “FNS Program Guidance on Human Pandemic Response“

General Information

Research shows that 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.
• Breastfeeding releases hormones that lower stress and anxiety in both babies and mothers.
• Mothers who breastfeed are able to keep their babies warm to prevent hypothermia.

Mothers can breastfeed in an emergency!

• The safest food in an emergency is the mother’s own milk. Donor human milk is the next best option. Mothers who cannot directly feed their babies can also be supported to express their milk.
• Women who are stressed can continue to make milk. A quiet area that helps mothers relax can help their milk flow to the baby.
• Malnourished mothers can make plenty of milk.
• Even mothers who have already discontinued breastfeeding may be able to restart breastfeeding (known as
  “relactation”).
• If a baby (or mother) becomes ill, the best thing the mother can do is to continue breastfeeding to provide her baby with human antibodies that fight the illness.
• Support makes the difference!

USBC Resources

• Position Statement: “Statement on Infant/Young Child Feeding in Emergencies“
• Racial Equity Webinar: “Infant and Young Child Feeding During Emergencies (IYCFE)“
• 2018 National Breastfeeding Coalition Convening Presentation: “Adapting the Models of Prevention to Address Lactation and Safe Infant Feeding in Emergencies in Puerto Rico”
  • Presented by Lourdes Santaballa and Lourdes Amadeo Ocasio, Alimentación Segura Infantil (ASI)
  • Download slides (must be logged in to the website).

Additional Resources

• 1,000 Days: “5 Things You Need to Know About Breastfeeding in Emergencies“
• American Academy of Pediatrics Flyer: “Infant Nutrition in Disasters and Other Emergencies: Breastfeeding and Other Options”
• Centers for Disease Control and Prevention: 
  • “Disaster Planning: Infant and Child Feeding“
  • “Participation in Community Preparedness Programs in Human Services Organizations and Faith-Based Organizations — New York City, 2018“
• Interagency Working Group on Infant and Young Child Feeding in Emergencies: “Infant and Young Child Feeding in Emergencies Operational Guidance for Emergency Relief Staff and Programme Managers” 

International Lactation Consultant Association:

• “Emergency Preparedness Checklist for Breastfeeding“
• “Facts about Breastfeeding in an Emergency – Especially for Health Workers“

Kansas Breastfeeding Coalition

• Guidelines to Support the Breastfeeding Infant During Emergencies While in Child Care

Kellymom:

• “Infant Feeding in Emergencies“
• “My power went out and I have breastmilk in the freezer – Help!“

La Leche League International Website: “Infant Feeding In Emergencies (Multilingual)“

National Association of Professional and Peer Lactation Supporters of Color: “Statement on Infant Feeding During Disasters“

Office of Human Services Emergency Preparedness and Response: “Infant Feeding During Disasters“

Save the Children: “IYCF-E Toolkit“

U.S. Department of Agriculture, Food and Nutrition Service: “Special Supplemental Nutrition Program For Women, Infants, And Children (WIC): Guide To Coordinating WIC Services During Disaster“

World Breastfeeding Week 2009 Website: “Breastfeeding: A Vital Emergency Response. Are you ready?“

World Health Organization Website: “Child and adolescent health and development, documents on emergencies“

WHO / UNICEF / WFP Joint Statement: “Call for support for appropriate infant and young child feeding in Haiti“

Resources on Talking with Children / Helping Children Cope

American Academy of Pediatrics: “Promoting Adjustment and Helping Children Cope” 

National Association of School Psychologists: “School Climate, Safety, and Crisis“

National Child Traumatic Stress Network: “Parent/Caregiver Guide to Helping Families Cope with the Coronavirus Disease 2019“

Save the Children: “10 Tips for Helping Children Cope with Disaster” 

Resources on Different Types of Emergencies

The chart below provides a compilation of resources from several key national agencies and organizations (columns), organized by type of emergency (rows). See below the chart for descriptions of the sources.

	Ready.gov	National Child Traumatic Stress Network	American Academy of Pediatrics
Biological	Pandemics	Epidemics	Anthrax  Influenza/Pandemics
Earthquakes	Earthquakes	Earthquakes	Earthquakes
Floods	Floods	Floods	Flash Floods/Flood Recovery
Fires	Wildfires	Wildfires	Wildfires
Hurricanes	Hurricanes	Hurricanes	Hurricanes
Tornadoes	Tornadoes	Tornadoes
Other Weather  Events	Drought  Extreme Heat  Severe Weather  Thunderstorms & Lightning   Winter Storms & Extreme Cold		Extreme Temperatures: Heat and Cold
Violence		School Personnel
Terrorism	Bioterrorism   Chemical Emergencies   Cybersecurity   Explosions	Terrorism and Violence	Terrorism & Agents  Biological  Blast Terrorism and Explosions  Chemical  Radiologic/Nuclear
Other	Power Outages  Hazardous Materials  Household Chemical Emergencies  Landslides & Debris Flow  Nuclear Power Plants  Space Weather  Tsunamis  Volcanoes	Tsunamis	Financial Crisis

Shelter During and After an Emergency

Ready.gov offers information and resources on taking shelter in an emergency. The safest locations to seek shelter vary by hazard. Be informed about the sheltering suggestions for each hazard. There may be situations, depending on your circumstances and the nature of the disaster, when it’s best to shelter in place. Search for open mass care shelters by texting SHELTER and a zip code to 43362 (4FEMA). Ex: Shelter 01234 (standard rates apply).

The American Red Cross responds to approximately 70,000 disasters in the United States every year, providing shelter, food, health, and mental health services to help families and communities get back on their feet. Use their tools to search for the closest open shelter during an emergency, and to register or search the Safe and Well listings.

Recovery Resources

Ready.gov provides advice on steps to take to recover from a disaster and begin getting your home, your community, and your life back to normal, including: health and safety guidelines, returning home, seeking disaster assistance, coping with disaster, and helping others.

The American Red Cross has Recovery Guides on more than 20 types of emergencies.

The Substance Abuse and Mental Health Services Administration Disaster Distress Helpline provides 24/7, year-round crisis counseling and support. Call 1-800-985-5990 or text “TalkWithUs” to 66746.

The majority of this information was compiled by the United States Breastfeeding Coalition