9.5 Infant feeding in emergencies
The problem
Some emergency nutrition situations can be anticipated, eg famine and war; however, the majority can not. Earthquakes, floods, tsunami, fire, cyclones, hurricanes and tornadoes happen quickly and with little warning or time to prepare. During or following such an event there may be:
- no clean drinking water
- no clean area for food preparation
- no supplies to clean or sterilize feeding utensils
- no refrigeration
Donations of baby foods and breastmilk substitutes in situations such as this is dangerous and can do more harm to the infants than good.
The solution for the breastfed infant
Some frequently asked questions
Question: | Does a mother lose her milk supply when she is in a stressful situation? |
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Answer: | Stress will not stop the mother producing milk; however it may delay her milk ejection. If a quiet area can be set aside for mothers to breastfeed, with reassurance and support offered, the suckling of the infant will elicit the milk ejection. |
Question: | Won't stress or trauma cause the mother's milk to be unsuitable? |
Answer: | The composition of a mother's milk will always be perfect - it is not possible to make 'weak' or 'spoiled' breastmilk. |
Question: | Could a mother's milk become contaminated? |
Answer: | If the infant is suckling directly from the breast there will be no contamination from infectious organisms in the environment. Even if the mother has diarrhea or other infections acquired as a result of the emergency situation these will not be passed via breastfeeding to her infant. |

Learning from experience
Following the 2010 Haiti earthquake it was expected that disruption of breastfeeding would lead to increased infant morbidity, malnutrition and mortality.
Baby Tents were set up in affected areas where pregnant women and all mothers, whether breastfeeding or artificially feeding, were provided with support and a safe place for mothers to breastfeed or receive ready-to-feed infant formula. Over 180,000 mother-infant pairs were cared for.
Support for breastfeeding was strong and many women who were 'mixed' feeding converted to full breastfeeding. With this support only 13.5% of infants were not breastfed, breastfeeding practices were not disrupted and the fears for infant health were nearly abolished. 1

Helping a mother to breastfeed in a Baby Tent
The solution for the artificially fed infant
- an ongoing source of a safe infant formula, and safe storage for it
- utensils for the preparation of the infant formula, and bottles and teats for feeding
- an ongoing source of clean drinking water
- fuel to heat the water to a safe temperature for formula preparation
- the ability to thoroughly clean all the preparation and feeding utensils
In crisis affected areas where an imminent end is not in sight, assisting mothers to relactate could be the only solution.
What can you do to help?
- Protect, promote and support breastfeeding for all infants for at least the first two years of life, with the addition of suitable complementary foods from six months of age. Breastfed infants are in a much more secure situation should an emergency strike.
- Discourage the public from donating infant formula at these times as it is likely to cause more morbidity than it prevents.
- If you are in a position to, volunteer your services to provide support, encouragement and information to the breastfeeding mothers caught in the emergency; and education to the other relief workers.
- Know how to assist a mother to relactate should it become necessary.
- Discuss with ALL parents emergency preparedness for themselves and their children. Encourage them to have an emergency plan and kit always ready.

Emergency preparations parents can make
Read the paper, provide copies of it for your colleagues at your place of work, and discuss how you can ensure that this very important message is given to all parents who access your care.

What should I remember?
- emergency situations are usually unexpected, with little or no time for preparation
- breastfeeding provides the best food security for infants
- artificially fed infants require a lot of care and resources to ensure their safety
- parents are unlikely to be prepared for an emergency if there is not a procedure in place to educate them
Assessment Quiz
When you are happy that you've understood all the information in this module you will be ready to complete the Module 9 Assessment. To do this, go to the course opening page, scroll down to the Assessment section and choose Module 9.
Notes
- # Ayoya MA et al. (2013) Protecting and improving breastfeeding practices during a major emergency: lessons learnt from the baby tents in Haiti.