ASIA: Breastfeeding more crucial in emergencies

Photo: UNICEF

Statistics underscore the importance of teaching continued breastfeeding during and after emergencies

BANGKOK, 13 November 2009 (IRIN) - A recent spate of natural disasters in Asia has further underscored the importance of breastfeeding during emergencies, with a need for additional policies to support this.
 
Hundreds of thousands were displaced and forced into evacuation shelters following a series of deadly typhoons in the Philippines, Cambodia, Vietnam and Laos, and an earthquake in Indonesia in the past two months.
 
But according to experts, during such disasters, support for mothers to breastfeed is often overlooked and not given the priority it needs, despite its life-saving function.
 
Besides raising awareness of the importance of breastfeeding, aid organizations need to have policies on infant feeding, they say.

“You have to have a strong policy in place, and make sure all the actors and all the staff in that organization know about this policy,” Anna Winoto, a nutrition specialist with the UN Children’s Fund (UNICEF) in Indonesia, told IRIN.
 
In emergency situations, poor water and sanitation and security situations contribute to a heightened risk of disease among children, who are vulnerable to diarrhoea, malnutrition and pneumonia.
 
Practices such as using infant formula milk, when water may be contaminated and feeding bottles cannot be sterilized, contributes to the risk and has been shown to lead to an increase in diarrhoeal disease in infants.
 
“Breastfeeding is actually even more crucial under emergency conditions because children under five, and infants in particular, are at an increased risk of infection, disease and malnutrition,” Winoto said.
 
“Breastfeeding should be seen as a life-saving intervention,” she said.
 
In an emergency situation, establishing private spaces for mothers and infants, one-to-one counselling and mother-to-mother support is needed to encourage breastfeeding, say UNICEF and the World Health Organization (WHO).
 
“As part of emergency preparedness, hospitals and other healthcare services should have trained health workers who can help mothers establish breastfeeding and overcome difficulties,” said WHO Director-General Margaret Chan in a statement to mark World Breastfeeding Week in August.
 
Both UNICEF and WHO advocate exclusive breastfeeding for children up to six months of age, and continued breastfeeding and complementary feeding until age two.
 
Dangerous donations
 
But one obstacle to breastfeeding during emergencies is unsolicited or uncontrolled donations of breast-milk substitutes, which undermine breastfeeding, according to UNICEF and WHO.

Following a 7.9 magnitude earthquake in West Sumatra on 30 September, UNICEF Indonesia, worked with the country’s Health Ministry, and contacted local and national radio stations to broadcast requests to stop milk-substitute donations.
 
“It’s a huge problem, and the problem lies in the lack of knowledge among the donors on the potential harm,” said Winoto.
 
Meanwhile, coordination in emergencies also remains a challenge, with little capacity to locate only those children who truly need infant formula and not disrupt breastfeeding practices, she said.
 
“In our experience, it’s gotten better but it’s still a huge challenge because there are so many actors when an emergency comes, and so many donations,” she said.
 
Helping with trauma
 
Besides the health benefits, breastfeeding advocates underline the psycho-social benefit of maintaining the activity during an emergency, which is traumatic for babies and young children, experts say.
 
“In an emergency, keeping the baby on the breast is not only about nutrition, it is giving the child that security and closeness when it is scared,” Elvira Henares-Esguerra, director of the Philippine NGO Children for Breastfeeding, told IRIN.
 
In the aftermath of Typhoon Ketsana, which caused massive flooding in the Philippines in September, Henares-Esguerra and a handful of breastfeeding mothers with their children visited an evacuation centre.
 
They demonstrated breastfeeding practices, and encouraged displaced mothers to do the same.
 
“We discovered that infant formula was being given out by the government at evacuation centres,” said Henares-Esguerra.
 
“We wanted to encourage the mothers to breastfeed,” she said.

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