Implications for Public Health
Provide safe infant feeding in shelters and access to maternal, reproductive, and mental health care for families.
Disasters and emergency evacuations can pose feeding difficulties for the mothers of infants and young children, but these challenges can be mitigated—often with nothing more than awareness , some logistical thinking, and a little space.
Although many women choose to breastfeed their children, our research has found that caregivers often report significant challenges when attempting to continue to breastfeed after disaster evacuations. The issue appears to be global. For instance, mothers who fled the Fort McMurray Wildfire in Canada and mothers forced to relocate after the 2015 Gorkha earthquake in Nepal reported that issues such as stress and distribution of formula did not support breastfeeding.
These challenges can be rooted in more than one cause. Some mothers and volunteers mistakenly believe that breastmilk will dry up after a disaster or other high-stress events, or—in some cultural belief systems—that it might be cursed. Others think that if their own nutrition is compromised during the evacuation, it can adversely affect the nutrition of the breastmilk. Some have been separated from their support systems. And some simply need access to space and supplies (such as clean bottles) for safe feeding.
Caregivers who fed children formula also reported challenges in shelters after evacuation. For instance, in the Fort McMurray Wildfire study, respondents cited limited availability of nutritious food for toddlers, private space, and specific types of formula among the problems they faced when feeding.
Previous research suggests that pregnant women and postpartum mothers—and their partners—are at risk of developing depression and anxiety, and that stressful life events can increase that risk. Not surprisingly, research also points to increased prevalence of post-traumatic stress disorders after disasters.
A few simple steps , though, make it possible to avoid adding these symptoms to the public health burden after disasters—and to help the parents of infants and young children in the process. Some helpful measures include:
Provide medical assessments of pregnant women, new mothers, infants, and toddlers as they arrive at shelters.
Provide safe, quiet, and private space specifically for breastfeeding.
Keep families together.
Reassure caregivers that they can and should continue to breastfeed.
For families that use infant formula, provide instructions, clean water, and space for sanitary preparation. Be prepared to supply those families with specific (e.g., milk-free or soy-free) formulas during protracted events.
Ensure that pregnant women and lactating mothers have extra hydration. If possible, provide additional nutritious food as well.
Provide space and supplies to bathe infants and children.
Provide culturally appropriate complementary food for young children who have begun eating solid food.
Plan for differences between cultures. Cultural practices may influence daily routines such as cooking, sleeping, and other activities.
Screen for postpartum depression, anxiety, and PTSD among evacuees and families seeking shelter. Provide on-site services and concrete actions for follow-up care.
When public health practitioners and emergency managers work together to implement straightforward guidelines they can meet infant feeding needs in shelters. Access to maternal and reproductive health care should be a foundation in mass care after hazards and in crises scenarios.
Suggested Tools
Infant and Young Child Feeding in Emergencies
United Nations High Commissioner for Refugees
Comprehensive manual on infant feeding in disasters and emergencies.
Pregnant Women in Disasters and Emergencies: Health Information Guide
Disaster Information Management Resource Center
Collection of articles related to pregnant women’s health in disasters.
Food Safety for Infants After a Disaster
Centers for Disease Control and Prevention
Guidelines for safe infant feeding practices after a disaster.
For a list of all the tools included in this special collection, visit the Children and Disasters Tool Index.
Sarah DeYoung specializes in decision-making in disasters and social aspects of disaster vulnerability. Her research areas include infant feeding in disasters, companion animals in disasters, refugee well-being, weather warnings, and disaster preparedness. DeYoung has a PhD from North Carolina State University in applied social and community psychology. She is a core faculty member at the Disaster Research Center at the University of Delaware.