Infant feeding in emergencies

By Dr Karleen Gribble, adviser to the Australian Breastfeeding Association (ABA) and member of the Infant and Young Child Feeding in Emergencies Core Group, ABA community educator and Adjunct Fellow, School of Nursing and Midwifery UWS.

With natural emergencies occurring throughout Australia from time to time, it is important for families to prepare themselves in case they are affected. Older children or adults can survive with only water (or other drink) for several days. However, babies can quickly become very ill if they don’t have the right food. This is why having an emergency plan to care for your baby is very important.

Exclusively breastfed babies are least affected by an emergency as breastmilk provides babies with safe food and water and also acts to protect against infections that are common in emergency situations. Mothers who are exclusively breastfeeding do not need to store any supplies for feeding their babies in an emergency. Continuing to exclusively breastfeed through the emergency season is an emergency preparedness activity.

Even during extreme hot weather, breastmilk provides all of the fluid a baby needs. Giving water to a young baby can cause severe health problems, like water intoxication, because their kidneys are not fully developed.

Emergencies can be very stressful. Stress will not stop mums from making milk but it can inhibit the let-down reflex and this can result in babies being fussy at the breast. This problem will resolve on its own with time if the mother encourages the baby to keep suckling until the milk is released. Our trained breastfeeding counsellors on the Breastfeeding Helpline are able to reassure mothers about their milk supply and offer information and support to help them to manage feeding through the emergency.

Many mothers across Australia exclusively pump their breastmilk and rely on electric breast pumps to do so. During emergencies access to electricity may not be possible and, without hot water, hand pumps cannot be properly cleaned. Breastfeeding counsellors are able to assist mothers to learn how to hand express.

Mothers who are expressing may wish to pack antibacterial wipes for cleaning their hands. Since bottles are impossible to clean properly where water is limited, they may also wish to store disposable plastic or paper cups that can be used once-only to feed their baby.

Many babies in Australia are not exclusively breastfed and parents need assistance to care for their babies in an emergency. Mothers who are combining breast and formula-feeding might wish to consider whether they can return to exclusive breastfeeding. Again, our breastfeeding counsellors are able to offer practical suggestions in this regard. More frequent feeding will increase the amount of breastmilk being made and within a short period of time many mothers can restore their supply.

Those caring for fully formula-fed infants may wish to pack an emergency kit in case they are without power or water. Where access to clean, unlimited hot water is compromised, it is very difficult, if not impossible, to use powdered infant formula safely. For this reason, ready-made liquid (single use) infant formula and disposable (single use) feeding equipment are recommended.

This list may assist parents caring for formula-fed infants to prepare for an emergency:

1.     Ready to use liquid infant formula single serves for three (3) days (one package per feed, once the package is opened it must be used immediately or discarded)

2.     A knife/scissors for opening formula packs

3.     A small bowl for washing the knife or scissors

4.     Detergent for washing

5.     Antiseptic wipes

6.     Paper towels for drying

7.     500 mL of water per feed (for cleaning hands, the knife/scissors and the formula preparation area)

8.     Disposable feeding implements — bottles and teats or plastic/paper cups (enough for one for each feed because, with limited hot water, feeding containers are impossible to clean adequately).

All of these supplies can be stored in a lidded plastic box. The inside of the lid can act as a clean preparation area. Queensland Health suggests that 3 days of feeding supplies be stored in an emergency kit for infants.

It may also be a good idea to store solid food suitable for feeding to babies over 6 months but babies can also return to only milk feeds if solid food is not available in an emergency. In addition to feeding supplies, storing enough nappies and wipes can make coping with an emergency easier.

The Breastfeeding Helpline 1800 686 268 is available to anyone concerned about how to safely feed their baby during an emergency. Our trained breastfeeding counsellors are able to offer assistance with breastfeeding information and as well as with cup-feeding breastmilk or infant formula.

Those who are around mothers or caregivers of babies in an emergency can help to protect these little ones by assisting with other essential tasks so that the carers can focus on the needs of those babies.

References

Gribble K, Berry N 2011, Emergency preparedness for those who care for infants in developed country contexts. International Breastfeeding Journal 16(6):1–12.

Williams HG 2006, ‘And not a drop to drink': Why water is harmful for newborns. Breastfeeding Review 14(2):5–9.

© Australian Breastfeeding Association April 2014