1. INFANT FEEDING IN EMERGENCIES 23-24 September 2002 Facilitator Lida Lhotska Co-facilitators: Helen Armstrong, Felicity Savage

2. The Context Increase in emergencies up from 14 to 35 million in 15years (refugees & displaced) Negative impact on economic and social infrastructure Affects water/sanitation, shelter, food security and health infrastructure Reduction of coping mechanisms, increased vulnerability incl. phychological

3. Household in camp near Goma, Zaire/Congo IFE 1/10 UNICEF-D0194-0285/Betty Press

4. Key issues (W1) Brief history of the infant feeding in emergencies Introduction of Operational Guidance on IFE and Modules 1 and 2. Spillover of therapeutic milk due to perceived endorsement by health workers Silent emergencies

5. Conclusions (W1) Training is key. In established refugee camps awareness of and improvements in appropriate infant feeding practices have been observed.

6. Main recommendations (W1) Collect case studies and experiences in relation to IFE and share them with the Core Group Suggest experts to assist in review of Module 2

7. Main Recommendations (W1) Need to monitor Code compliance in emergencies (part of SIM?) Core Group on IFE to consider adding a section on monitoring of the implementation of interventions

8. Key issues (W2) oExperiences from 3 continents oOperational Guidance on IFE presented oAssessment for 0-6mth and lack of tools HIV/AIDS in emergencies is an issue of concern (gap in information, lack of consensus).

9. Conclusions (W2) oAbsence of understanding of complexities and implications of infant feeding methods in emergencies oWhen mothers and health professionals able to make informed decisions, practices change. oSupport for women in emergencies critical incl. psychological

10. Main recommendations (W2) Need to develop strategies for emergency preparedness in IFE UN should assist with development of IFE guidelines at national level More coordinated approach in emergencies in line with Operational Guidance Include communities in decision-making and implementation of interventions

11. Main recommendations (W2) Closer collaboration and information sharing between relief and development agencies, and emergency and breastfeeding groups. Assessment instruments need to be developed for infants below 6 months HIV/AIDS: urgent need for general consensus. Improved collaboration across sectors (modules do cover it in a manner consistent with the UN policy)