Breastmilk is the best source of food for all babies wherever they live but, in emergency settings where there is a high risk of diarrhoea, pneumonia and malnutrition, breastfeeding can be critical for child survival.
Unfortunately, continuation of breastfeeding can be threatened in times of emergencies.
“When women don’t have enough food to eat, they worry that they won’t produce enough milk. They are sometimes convinced they should switch to formula milk which is often made freely available by infant formula manufacturers who distribute their products as “aid”,” says Dr Hana Bekele, expert in child health and nutrition deployed from WHO’s office in Harare, Zimbabwe, to Mozambique for the response to Cyclone Idai.
“What is most important right now, in this emergency, is to give breastfeeding mothers all possible support so that they can continue to breastfeed,” she says. “These people are traumatized, they have lost everything and are under a lot of stress so we need to support them to do the best thing for their children’s health. Breastfeeding women need everyone’s support.”
In emergencies, the poor physical and mental health of mothers can create special challenges to breastfeeding. Displaced mothers may struggle to find comfortable, private places to breastfeed and their support network of family and friends is often not accessible in emergencies.
With the right support – from a health worker, a counsellor or another mother – a woman who is already doing some breastfeeding can increase her milk production within days just by feeding her baby more frequently. This support could include establishing safe “corners” for mothers and infants, one-to-one counselling and mother-to-mother support in settlement camps or emergency clinics.
In emergencies, all pregnant and lactating women, whether they are malnourished or not, should be given supplementary foods, such as extra energy- and protein-rich foods and supplements. Access to regular medical checks is important to ensure these women are in the best possible health to take care of their baby’s needs.
“Given the situation here in Mozambique, the diarrhoea risk is high, people are displaced and living in crowded conditions in accommodation shelters,” says Dr Nellia Mutisse, specialist in child health from WHO’s office in Mozambique. “Breastfeeding is the best protection against diseases. Breastfed babies face much less risk of illness than babies who are not breastfed and, if they are sick, the duration of their illness is usually less.”
In a statement issued just after Cyclone Idai hit, WHO, together with UNICEF, World Food Programme, Save the Children and World Vision International, called for all responders to the emergency in Mozambique to identify the needs of breastfeeding mothers as soon as possible and provide adequate protection and support.
“We urge all stakeholders not to accept or distribute donations of breastmilk substitutes including infant formula, bottles and teats to the affected population,” said the joint statement. “It is crucial that breastfeeding is not unnecessarily disrupted by disease outbreaks or illness affecting mothers or children.”
At times there might be a need for use of formula milk for infants and children but the products should never be targeted at women themselves and the tin should be a generic brand, without a label that markets the product, says Dr Mutisse.
In Mozambique, WHO and partners are providing guidance on breastfeeding and breastmilk substitutes to nutritionists, administrators of temporary accommodation centres and technicians from the National Institute for Disaster Management who are responsible for the management of food and nutrition in this emergency. WHO also trains health workers how, when and where they can use breastmilk substitutes in cases of emergency.