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Infant Feeding in Emergencies
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DISPELLING MYTHS ABOUT BREASTFEEDING IN EMERGENCIES
Myths about breastfeeding can undermine both a mothers confidence and the support she receives. The four most common myths are:
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"STRESS MAKES MILK DRY UP"
While extreme stress or fear may cause milk to momentarily stop flowing, this response, like many other physiological responses to anxiety is usually temporary.There is growing evidence that breastfeeding produces hormones that reduce tension, calm the mother and the baby and create a loving bond.
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"MALNOURISHED MOTHERS CANNOT BREASTFEED"
Food should go to the lactating mothers so that they can feed their babies and maintain the strength to care for older children in the family as well. In the case of severe malnutrition, the use of a breastfeeding supplementer can ensure increased breastmilk production.
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"BABIES WITH DIARRHOEA NEED WATER OR TEA"
As breastmilk is 90% water, exclusively breastfeeding babies with diarrhoea do not usually need additional liquids such as glucose water or tea. What is more, water is often contaminated in emergency situations. In the case of severe diarrhoea however, oral rehydration therapy (administered by cup) may be required. |
"ONCE BREASTFEEDING HAS STOPPED, IT CANNOT BE RESUMED"
With an adequate relactation technique and support, it is possible to help mothers and their babies to restart breastfeeding after they have switched to infant formula. This is sometimes vital in an emergency.
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From: BFHI News, UNICEF, September /October 1999, J. Newman, Dispelling myths about breastfeeding
in crisis - http://www.unicef.org/bfhi/sepoct99.pdf
For more info: see references below.
Breastfeeding women need ASSISTANCE
General promotion is not enough
Women in displacement and emergency situations are at increased risk of facing breastfeeding difficulties. They need help, not just motivational messages.
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HIV/AIDS and breastfeeding
The controversy regarding feeding options for infants born to mothers diagnosed as HIV positive highlights numerous limitations and gaps in our current knowledge about HIV transmission through breastfeeding. Women have the right to be clearly informed about all appropriate feeding options, in order to be able to make an informed choice, and be supported in carrying it out.
Recent reports (Coutsoudis et al, 1999; The Lancet 354: 471-474; AIDS 2001, 15:379-87) suggest that, in the first months of life, infants who were exclusively breastfed, showed similar HIV transmission rates to those infants who received only formula feeds, and lower transmission rates than infants who were mixed fed. Currently, most pregnant women do not know their HIV status and of those who do only a minority receive adequate counselling on infant feeding options.
In most emergency situations, voluntary counselling and testing is not available. Exclusive breastfeeding should therefore be protected, promoted and supported as a general rule. It is simply not realistic to consider testing especially in the initial phase of an emergency, when water and sanitation, food, shelter, immunisation and basic health care are top priorities.
For those mothers who have been tested and are found positive, counselling about the advantages and disadvantages of the various feeding options should be provided, carefully taking into account the situation at hand.
"However, even where testing is possible and the mother has the option to artificially feed, exclusive breastfeeding is likely to remain the safest choice, as the risk of mortality from artificial feeding will in most emergency situations, far exceed the risk of mortality from HIV transmission. The risks of spill-over to the general population and problems of ensuring sustainable supplies of breastmilk substitutes (BMS) in the long term must always be borne in mind."
Source: Declaration of the participants of the inter-agency Africa Regional Meeting of Infants and Young Children in Emergency Situations in Dar-es-Salaam 1999, organised by IBFAN Africa.
For more information :
HIV and Infant Feeding Counselling: a training course. WHO/UNICEF/UNAIDS (2000)
HIV and Infant Feeding guidelines, UNICEF/UNAIDS/WHO, 1998
WHO (2000) Effect of breastfeeding on infant and child mortality due to infectious diseases in less developed countries: a pooled analysis. The Lancet, vol 355. February 5th, 2000.
Bear in mind that …
in a population with a relatively high HIV prevalence of 20%, it is estimated that 15% of infants of HIV positive mothers will be at risk of contracting HIV through breastfeeding. Thus, out of a population of a 100 mothers and infants, only 2 or 3 infants will be at risk of contracting HIV through breastfeeding. 97 will not.
On the other hand, the relative risk of death from diarrhoea for non-breastfed infants in resource poor areas, is known to be significantly higher than for exclusively breastfed infants. A recent analysos by WHO (2000) shows that infants who are not breastfed have a 6-fold greater risk of dying from infectious diseases in the first 2 months of life than those who are breastfed. |
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