National Preparedness Month: the U.S.’s deficit in Infant and Young Child Feeding preparedness during emergencies

Photo by Mika Baumeister on Unsplash

 The editors of more than 200 health journals worldwide just released  ​​Call for Emergency Action to Limit Global Temperature Increases, Restore Biodiversity, and Protect Health ahead of The United Nations General Assembly this month. The authors urge critical action to curb global temperature increases in an effort to  “halt the destruction of nature, and protect health.” 

This  piece details how hotter temperatures are taxing public health systems:

“…Hurricane Ida caused dozens of deaths across several states from flash flooding and other impacts. With the power grid down, some died from carbon monoxide poisoning caused by using generators. In the aftermath of the storm in Jefferson Parish in Louisiana, local officials have been working to provide transportation for those who need dialysis and other medical care. Earlier this summer, hundreds died in a record-breaking heat wave in the Pacific Northwest… Wildfire smoke, increasingly clogging skies with dangerous levels of air pollution, causes spikes in emergency room visits.” 

Many of the current humanitarian crises are related to the climate crisis.  It’s driving human displacement which comes with a multitude of consequences. More on that here

Photo by Adrien Taylor on Unsplash
“While filming a climate change documentary called Thirty Million for the United Nations, I was blown away by the beauty of the Bangladeshi people — both in their character and appearance. Bangladesh faces losing 18% of its land, displacing thirty million people, with one metre sea-level rise. At the end of Ramadan every year, the country has one of the world’s largest internal migrations of people going from the cities to their home villages to celebrate the holiday. This type of migration may soon become across borders as climate change makes life difficult in this stunning country.”

Recent hurricane related power outages and water safety issues bring the importance of Infant and Young Child Feeding (IYCF) during emergencies to the forefront.  

“Breastfeeding provides food security for infants and young children specifically in emergency situations,” as noted in IBFAN and BPNI’s Formula for Disaster. “Economic hardship, conflicts and calamities cause disruption, deprivation and severe stress for families, especially for mothers and their children. During such emergency situations, optimal breastfeeding is a lifeline to ensure survival, food and affection for infants and young children, in addition to providing anti-infective agents to protect against disease.”

Threats exasperated by the climate crisis have become the frequent reality for so many families and yet, our nation is abysmally prepared, especially for those with young children.

Participants of the WBTi Assessment Workshop, April 2016

The World Breastfeeding Trends Initiative (WBTi)–an international tracking, assessment and monitoring system for national implementation of the Global Strategy on Infant and Young Child Feeding (IYCF)– scored the United States zero out of 10 for Infant feeding during Emergencies.  

WBTi uses the following criteria for assessment: 

  • The country has a comprehensive policy on infant and young child feeding that includes infant feeding in emergencies and contains all basic elements included in the IFE Operational Guidance
  • Person (s) tasked to coordinate and implement the above policy/strategy/guidance have been appointed at the national and sub national levels
    1. The health and nutrition emergency preparedness and response plan based on the global recommendation includes:  Basic and technical interventions to create an enabling environment for breastfeeding, including counselling by appropriately skill trained counsellors, and support for relactation and wet-nursing
    2. Measures to protect, promote and support appropriate and complementary feeding practices
    3. Measures to protect and support the non-breast-fed infants 
    4. Space for IYCF counselling support services
    5. Measures to minimize the risks of artificial feeding, including an endorsed Joint statement on avoidance of donations of breastmilk substitutes, bottles and teats, and standard procedures for handling unsolicited donations, and minimize the risk of formula feeding, procurement management and use of any infant formula and BMS, in accordance with the global recommendations on emergencies
    6. Indicators, and recording and reporting tools exist to closely monitor and evaluate the emergency response in the context of feeding of infants and young children.
  • Adequate financial and human resources have been allocated for implementation of the emergency preparedness and response plan on IYCF
  • Appropriate orientation and training material on infant and young child feeding in emergencies has been integrated into pre-service and inservice training for emergency management and relevant health care personnel
  • Orientation and training is taking place as per the national plan on emergency preparedness and response is aligned with the global recommendations ( at the national and sub-national levels)
Photo by John Middelkoop on Unsplash

The United States does not meet any of these criteria. 

“Ironically, some [U.S.] states and territories have well-elaborated plans for the care and feeding of household pets in shelters, but none for infants and young children,” Healthy Children Project’s Cindy Turner-Maffei points out. 

Research by Cindy H. Hwang, et al found that in all of the emergency situations they studied in middle and high income countries, The International Code of Marketing of Breastmilk Substitutes was violated.  

The authors report: “Donated and distributed infant formula was often labeled … without adequate preparation guidance. Infant formula was repeatedly distributed as part of the standardized assistance package regardless of mothers’ infant feeding practices. The uncontrolled distribution of donated infant formula not only undermined good breastfeeding practices and efforts of mothers, but also increased the health risk to infants. Mothers often had no access to electricity, gas, safe water, and necessary infant feeding supplies to hygienically prepare infant formula.” 

Breastmilk substitute (BMS) companies are known to exploit emergency situations exacerbating child mortality, morbidity, and malnutrition. Authors of Old Tricks, New Opportunities: How Companies Violate the International Code of Marketing of Breast-Milk Substitutes and Undermine Maternal and Child Health during the COVID-19 Pandemic detail this behavior in the context of the current pandemic.  

Different from the U.S.’s preparedness deficit, WBTi congratulates Bangladesh on achieving “green” status, ranking them number one for supporting healthy infant feeding globally.

Photo by Theodore Goutas on Unsplash

Bangladesh scored 10 out of 10 on Infant Feeding during Emergencies. Find the country’s full report here. Other countries that have achieved high scores in IYCF During Emergencies include the Philippines, Sri Lanka, Afghanistan, Bolivia, and Nepal.  

During National Preparedness Month, individuals, families and communities are urged to take a week-by-week stepwise approach to prepare for disasters: Make A Plan, Build A Kit, Low-Cost, No-Cost Preparedness, Teach Youth About Preparedness.   Authors Karleen D. Gribble and Nina J. Berry offer detailed information on what emergency preparedness entails for breastfed and formula fed infants in Emergency preparedness for those who care for infants in developed country contexts.  Individuals can take action with USBC’s online tool in order to influence policymakers to integrate IYCF into future emergency preparedness and response efforts. 

Find general information about breastfeeding during emergencies and more action tools on USBC’s Infant and Young Child Feeding in Emergencies page

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