1. Infant Young Child Feeding in Emergency
Daisy Nyaga
Nutrition consultant-UNICEF

2. What is IYCF E
Promotion, protection and support of breast feeding to both the breast fed and non breast feed infant in emergency.
Children 6-24 months are fed with foods from 4 or more food groups per day.
Proper hygiene and safe food handling practices adhered to.

3. Why breastfeeding matters
The younger a child, the more vulnerable they are.
The younger a child, the more the value of breast milk. Thus the requirement to introduce breast milk within 1st hour of birth.
Breast milk comes ready to use, with up todate nutritive value .

4. Risks of death highest for the youngest
at therapeutic feeding centres in Afghanistan, 1999
IFE 1/2
Deaths as % of admissions
Age (months)
Golden M. Comment on including infants in nutrition surveys: experiences of ACF in Kabul City. Field Exchange 2000;9:16-17

5. Times more likely to die
Protection by breastfeeding is greatest
for the youngest infants
WHO Collaborative Study Team. Effects of breastfeeding on infant and child mortality due to
infectious disease in less developed countries: a pooled analysis. The Lancet 2000;355:451-5
IFE 1/4
Times more likely to die
if not breastfed
Risk of death if breastfed is
equivalent to one.
Age in months

6. Common misconceptions on infant feeding in emergencies
IFE PAK 1/8
Misconception
“Stress makes the milk dry up”
“Malnourished mothers cannot breastfeed”
“Once breastfeeding has stopped, it cannot be resumed”
Fact / Recommendation
Stress might temporarily affect the milk let down reflex, but does not affect milk production. Mothers need reassurance and support
Feed the mother and let her feed her infant. All mothers need extra fluids, food to maintain strength and breastfeeding.
It is usually possible to re-lactate. Mothers need support to do this.

7. Common misconceptions on infant feeding in emergencies
IFE PAK 1/9
Fact / Recommendation
Breastfeeding will relax both mother and baby. Mothers need reassurance and support.
Breast milk provides all the fluids an infant under 6 months needs, also when it has diarrhea
The emergency means that the circumstances that made formula-feeding acceptable, feasible, affordable, sustainable & safe have gone. Breastfeeding is best anyway – but especially in an emergency
Misconception
“If the mother is stressed, she will pass the tension on to the baby”.
“Babies with in warm climate, get thirst and need water.”
Women formula-fed here before the crisis & ‘know how to do it’
(We are ‘developed’ and only formula feed)

8. to make breastfeeding easier in emergency
Improving conditions
to make breastfeeding easier in emergency
IFE 1/8
Mothers’ difficulties
time constraints
long time to fetch water,
queue for food
lack of protection, security, and (where valued) privacy
lack of social support and the familiar social network
free availability of breastmilk substitutes,undermining mothers’ confidence in breastfeeding
Staff should ensure
priority access
Shelters, breastfeeding havens
groups of women who support each other
effective controls on availability

9. Problems of artificial feeding in emergencies
lack of water
poor sanitation
inadequate cooking utensils
shortage of fuel
daily survival activities take more time and energy
uncertain, unsustainable supplies of breastmilk substitutes
lack of knowledge on preparation and use of artificial feeding
IFE 1/11

10. Inappropriate donations of milk products
IFE PAK 1/15
Pakistan 2005
Lebanon, 2006
Ali Maclaine, Nutrition Consultant, Lebanon
Maaike Arts, UNICEF Pakistan
Maaike Arts, UNICEF Pakistan

11. Some important points from the
International Code of Marketing of Breast milk Substitutes
no advertising or promotion to the public
no free samples to mothers or families
no donation of free supplies to the health care system
health care system obtains breast milk substitutes through normal procurement channels, not through free or subsidised supplies
labels in appropriate language, with specified information and warnings
IFE 1/13

12. Points of agreement
on how to protect, promote and support breastfeeding
1. Emphasise that breastmilk is best.
2. Actively support women to breastfeed.
3. Avoid inappropriate distribution of breastmilk substitutes.
4. When necessary (following assessment) use infant formula if available. It must be targeted only to those who need it.
IFE 1/16
HONDURAS. UNICEF/HQ /BULAGUER
RWANDA. UNICEF/DOI /PRESS
NGARA, TZ/LUNG’AHO

13. More points of agreement
on how to protect, promote and support breastfeeding
IFE 1/17
5. Do not distribute feeding bottles/teats; promote cup feeding.
6. Do not distribute dried skim milk unless mixed with cereal.
7. Add complementary foods to breastfeeding after 6 full months.
8. Avoid commercial complementary foods.
9. Include pregnant and lactating women in supplementary feeding when general ration is insufficient.
EX-Yugoslavia UNICEF/HQ /LEMOYNE

14. Thus, what do we need to do

15. Scale up IYCF E interventions

16. Adaptation /development of tools and materials for use in IYCF E programming
Form IYCF TWG at national and state levels
Orientation of partners /MoH staff in IYCF E programming.
Develop IYCF E monitoring tool
Advocacy on IYCF E
Monitor the use and distribution of BMS