Emergencies responses are often characterized by large influxes of unsolicited donations of breastmilk substitutes, bottles, teats, and other baby food and milk products. Generous donations often do more harm than good in emergencies- read the IBFAN 2000 briefing paper.

The International Code of Marketing of Breastmilk Substitutes and relevant subsequent World Health Assembly Resolutions are all the more important in emergencies. Monitoring IBFAN monitoring form and reporting Code violations IBFAN-ICDC Focus publication in emergency situations are key components of all emergency responses- see.

Breastfeeding plays a vital role in emergencies, protecting infant and young child survival, health and development, as well as maternal health and the bonding between mother and baby, so precious in difficult situations. Yet protection promotion and support of breastfeeding is lacking in emergencies, and humanitarian agencies lack training on how to protect promote and support breastfeeding, as well as how to support non breastfed children while not undermining breastfeeding.  See the calendar and action folder from the World Alliance for  Breastfeeding (WABA) World Breastfeeding week 2009: Breastfeeding- a vital emergency response. Breastfeeding - a vital emergency response written by ENN and IBFAN, as key members of the "IFE core group", with input from other key collaborators.

IBFAN, represented by IBFAN-GIFA, is an active member of the interagency working group on Infant Feeding in Emergencies (the IFE core group).

The IFE Core group is coordinated by the Emergency Nutrition Network (ENN). Members of the IFE Core group include non-governmental and UN agencies (for the list of members of the IFE Core group see www.ennonline.net/ife ). The IFE Core group represented by the ENN is a member of the IASC Inter-agency Standing Committee Nutrition cluster

Aim of the IFE Core group: To develop policy guidance and capacity building in the field of Infant Feeding in Emergencies.

Key documents developed by the IFE Core group include:

• the Operational Guidance on Infant and Young child feeding in emergencies (version 2.1, February 2007). WHA resolution 63.23 (may 2010) urges Member states "to ensure that national and international preparedness plans and emergency responses follow the evidence-based Operational Guidance for Emergency Relief Staff and Programme Managers2 on infant and young child feeding in emergencies, which includes the protection, promotion and support for optimal breastfeeding, and the need to minimize the risks of artificial feeding, by ensuring that any required breast-milk substitutes are purchased, distributed and used according to strict criteria"; see following link to the WHA Resolutions 2010 http://apps.who.int/gb/ebwha/pdf_files/WHA63-REC1/WHA63_REC1-P2-en.pdf
  This policy development is excellent news and gives all NGOs working on infant feeding and in emergencies an opportunity to advocate with their governments implementation of the Operational Guidance into relevant national policies. IBFAN will be always happy to hear about such efforts.
  
  This Operational Guidance was first produced by the Interagency Working Group on Infant and Young Child Feeding in Emergencies in 2001. It has since evolved to reflect experiences in the field and the latest version of this document is from February 2007. The Operational Guidance has been translated into 11 languages. The aim of the Operational Guidance is to ensure optimal infant and young child feeding practices in emergencies. It is supported by a large number of NGOs, donors, and UN agencies (see www.ennonline.net/ife). The International Code of Marketing of Breastmilk Substitutes and relevant subsequent World Health Assembly resolutions is embedded throughout the Operational Guidance. There is also a clear statement on the importance of preventing and avoiding donations of breastmilk substitutes, bottles, teats and other milk products in emergencies.There is also a whole section on how to minimize the risks of artificial feeding. This is a key document for the protection and support of appropriate infant and young child feeding in emergencies. It is also reflected in Sphere guidelines (presently under revision).

PDF English version

PDF Spansih version

PDF French version

(for other languages visit the ENN website http://www.ennonline.net/resources/view.aspx?resid=6)

NEW Operational Guidance Addendum on the type and source of Breastmilk Subsitutes to be considered (Operational Guidance 6.2.3).
An addendum was made to the Operational Guidance in June 2010, to reflect on the procurement and management of ready to use infant formula (RUIF). This product was widely used in the response to the Haïti earthquake which took place in January 2011. Its use has yet to be evaluated. See http://www.ennonline.net/pool/files/ife/insert-operational-guidance-6-3-2-addendum-2010-final.pdf

Training modules on Infant feeding in emergencies.

• IFE Orientation Package: IFE Module 1 for all emergency relief staff, developed by the IFE Core Group, was initially published in 2001. This module has now been updated and renamed the IFE Orientation Package (2010).  
  
  see  http://www.ennonline.net/ife/orientation
  
  This is a package of resources to help in orientation on infant and young child feeding in emergencies (IFE). These resources are targeted at emergency relief staff, program managers, and technical staff involved in planning and responding to emergencies, at national and international level. The updated content has been developed by the Emergency Nutrition Network (ENN), IFE Core Group members, and collaborators. IFE Module 1 uses the Operational Guidance on IFE as a guiding framework to support its implementation.
  This training package includes e-learning lessons, training resources and technical notes. The e-learning lessons can be used in self learning, in preparation for a face-to-face training, or as a group exercise. The lessons do not have to be completed at the one time, but ‘remember’ where you’ve stopped so that you can return and continue. The e-learning lessons are free. A CD version is also available to download, or from the ENN. The lessons are currently being translated into Spanish and French translation is also planned. For the e-learning lessons,
  see http://lessons.ennonline.net/

• Training for health/nutrition staff: IFE Module 2, developed by the IFE Core group  and additional contributors  (PDF English and French versions), This module includes additional chapters on relactation (chapter 6), on breast conditions (chapter 7), on the young severely malnourished infant (chapter 8), and on when infants are not breastfed (chapter 9)
  
  
• Integration of IYCF support into CMAM (Community based management of acute malnutrition)- Facilitator's guide (2009). The purpose of this facilitator's guide is to train health care personnel and community health workers in the integration of recommended infant and young child feeding (IYCF) practices within CMAM. These health workers will support mothers/caregivers in prevention as well as rehabilitation.

                 http://www.ennonline.net/pool/files/ife/iycf-cmam-facilitators-a4large-final(1).pdf

• IASC Cluster module 17 on IFE (Module 17 on IFE in the set of Nutrition Cluster modules) developed by some members of the IFE Core group for the Capacity building working group of the Nutrition Cluster http://www.humanitarianreform.org/Default.aspx?tabid=488
  For information, this cluster module 17 on IFE is based on the content of the above listed IFE Modules 1 and 2 developed by the IFE Core group. It will be revised in 2010 in order to reflect material from the new upcoming updated IFE Module 1 developed by the IFE Core group and recent field experiences

• The Media Guide on IFE For other languages see www.ennonline.net . Monitor the press for donations of bms, bottles, teats, and other milk products and write and complain using this media guide (see also guide for the public for more information on how to take action)
  Send any press articles on IFE to Karleen Gribble karleeng@netspace.net.au
  
  
• View the recent letter sent by UNICEF to the Guardian in response to the stories about Reza, the little boy in flood-affected Pakistan ('It's been a month since he had any milk' – the human face of Pakistan's deadly flood, 6 September; 'He's not crying any more' – milk at last for refugee boy, 8 September), express UNICEF's concern about the potential impact of this story on the emergency response and the health and survival of young children in Pakistan – a concern shared by many other humanitarian agencies.  http://www.guardian.co.uk/world/2010/sep/22/unicef-bottle-feeding-fears-pakistan/print

• Protecting babies in emergencies: A guide for the Public on IFE

Meetings organized by the IFE Core group

A number of international meetings have been organised by the IFE Core group on IFE and include:
- Oxford 2006: Making it matter
- Bali 2008: Making it happen

Other key documents related to IFE

• Guidance on Infant feeding and HIV in the context of refugees and displaced populations, June 2009, version 1.1 Attach link PDF French and English
• UNCHR Policy Related to the Acceptance, Distribution and Use of Milk Products in Refugee Settings, 2006 version 

Visit the ENN website for many more related documents. Search the ENN website for articles on IFE published in Field Exchange. Join discussion groups on IFE via the En-Net www.ennonline.net/ife

Infant Feeding in Emergencies as a key indicator for action, in the WBTi 33 country report

Read the recently released IBFAN BPNI 2010 " State of Breastfeeding in 33 Countries: Tracking Infant and Young Child Feeding Polices and Programmes Worldwide" World Breastfeeding Trend Initiative 33 country report section on Infant feeding in emergencies, to view progress in this field in these countries. It concludes that "countries are generally ill-equipped to deal with infant feeding in emergencies". IFE is included as one of the 10 indicators for action on infant and young child feeding.
http://www.worldbreastfeedingtrends.org/report/The-state-of-breastfeeding-in-33-countries-2010.pdf