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Call for support for appropriate infant and young child feeding in emergencies

 Belgrade, 19 May 2014 – The United Nations Children Fund (UNICEF) and the World Health Organization (WHO) Representation in Serbia recommend those involved in the response to the Serbia floods, and for those people who were displaced, to avoid unnecessary illness in children by promoting breastfeeding and appropriate complementary feeding and strongly discourage the uncontrolled distribution and use of breast-milk substitutes (e.g. infant formula), bottles and teats and other powdered or liquid milk and milk products. 

UNICEF and the World Health Organization said that statistics showed that in serious emergency situations, such as the one currently facing those affected by floods, disease and associated death rates among under-5 children are higher than for any other age group. 

The risk of dying is particularly high because of the combined impact of communicable diseases and diarrhoea together with possible increases in rates of under-nutrition as people flee their homes. The people inside Serbia and those displaced may find themselves often in very difficult and unsanitary conditions thus can be at major risk of serious water-borne diseases. Breastfeeding confers critical protection from infection, especially where safe water is unavailable and poor sanitation conditions are present - breastfeeding saves lives. 

Artificial feeding with breast-milk substitutes in an emergency carries high risks of malnutrition, illness and death and is a last resort only when other safer options have first been fully explored and deemed unavailable. 

Where the use of breast-milk substitutes is unavoidable, the partners only recommend ready-to-use formula that should adhere to the International Code for Marketing of Breast-milk Substitutes.

Any distribution and use of breast-milk substitutes should be carefully monitored to ensure that only infants who have no possibility to be breastfed receive it and that they are used safely. 

The nutrition partners and specialists agree that, in line with internationally accepted standards, donations of infant formula, bottles and teats and other powdered or liquid milk and milk products should not be made. 

Misconception: During emergencies, mothers can no longer breastfeed adequately because of stress or inadequate nutrition 
Although stress can temporarily interfere with the flow of breast milk in some women, it is not likely to inhibit breast milk production, provided mothers and infants remain together and are supported to initiate and continue breastfeeding. 

Donations and procurement of breast-milk substitutes and other milk products 
In accordance with internationally accepted standards and guidelines, donations of infant formula, bottles and teats and other powdered or liquid milk and milk products should not be made. Experience with past emergencies has shown an excessive quantity of products, which are poorly targeted, endangering infants’ lives. Any use and procurement of breast-milk substitutes (BMS) should be based on careful needs assessment according to strict protocol set out in the Operational Guidance on Infant and Young Child Feeding in Emergencies - UNICEF and WHO can provide technical assistance. Breast-milk substitutes should adhere to International Standards and the International Code of Marketing of Breast-milk Substitutes. Ready-to-use infant formula consumed using a cup is recommended in this context. Any distribution and use of breast-milk substitutes should be carefully monitored to ensure that only the targeted infants receive the product. 

Feeding of the non-breastfed child less than six months of age 
The priority to feed infants less than six months of age who are not breastfed should be re-lactation (re-starting breastfeeding). Artificial feeding should only be undertaken following needs assessment by a qualified health/nutrition staff. If BMS is necessary, it must be accompanied by training on hygiene, preparation and use to minimize their associated risks and may require the provision of additional resources as well as the essential regular follow-up. BMS provision must continue for as long as the infant concerned requires it. Artificial feeding in an emergency carries high risks of malnutrition, illness and death and is a last resort only when other safer options have first been fully explored. 

Complementary feeding of children above six months of age 
Children from the age of six months require nutrient-rich, age-appropriate and safe complementary foods in addition to breast milk. If culturally-acceptable, nutritionally adequate and age-appropriate foods are available and accessible these should be prioritized for assistance. If such foods are not available, specialized nutrition products should be provided with appropriate training and support for preparation and use. These options represent a much more appropriate form of assistance than sending milk products. In rations for general food distribution pulses, meat, or fish are preferable to powdered milk. 

UNICEF and WHO strongly recommend all who are involved in funding, planning and implementing the emergency response in Serbia to avoid unnecessary illness and to protect their infants and children by promoting, protecting and supporting breastfeeding and appropriate complementary feeding and by preventing uncontrolled distribution and use of breast-milk substitutes and other milks.  Community leaders are called upon to monitor and report any donations that may undermine breastfeeding. 

We urge governments and partners to include capacity building for breastfeeding and infant and young child feeding as part of emergency preparedness and planning, and to commit financial and human resources for proper and timely implementation of breastfeeding and infant and young child feeding in emergencies. 

For additional information, please contact:

The Institute of Public Health of Serbia “Dr. Milan Jovanovic Batut”, the Offices of UNICEF or WHO in Belgrade

 

 
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