As we enter another hurricane season, we must pay particular attention to the health and well-being of infants and young children, as they are vulnerable to serious illness in natural or human-induced disasters.
Because of the increased risk of diarrheal diseases and other infections, the continuation of breastfeeding is particularly important.
Providing infants and young children caught in an emergency situation with substitutes for human milk is extremely risky. The risks associated with bottle and formula feeding are dramatically increased due to poor hygiene, crowding and limited water and fuel. In an emergency, there may be no clean drinking water or electricity, no sterile environment, and it may be impossible to ensure cleaning and sterilization of feeding utensils.
The role of breastfeeding is even more important in emergency situations, where it may be the only sustainable element of food security for infants and young children. A breastfeeding mom does not need to be concerned about a source of nutrition for her infant because she has the perfect milk that does not need sterile bottles or refrigeration.
Women under stress during an emergency situation can successfully breastfeed. Milk release (letdown) is affected by stress, but milk production is not. Different hormones control these two processes.
The treatment for poor milk release is increased suckling, which increases the release of oxytocin, the letdown hormone. These hormones released during breastfeeding promote a sense of well-being, relieving maternal stress and anxiety.
In addition, the security and warmth provided by breastfeeding is crucial for both mothers and children in chaotic circumstances of an emergency. Also, women need validation of their own competence, and breastfeeding is one of their important traditional roles that can be sustained during a stressful situation.
A malnourished woman in an emergency situation will produce enough milk to nourish her baby. Milk production is relatively unaffected in quantity and quality, except in extremely malnourished women (only 1 percent of women). When a breastfeeding woman is malnourished, it is the mother who suffers, not the infant.
Therefore, the solution to helping a malnourished breastfeeding woman is to feed the mother, not the infant. The mother will be less harmed by pathogens than a baby in an unsterile environment. By feeding her, you are helping both the mother and child, and harming neither.
Giving supplements to infants can decrease milk production by decreasing suckling. The treatment for true milk insufficiency is increased suckling frequency and duration.
The American Academy of Pediatrics recommends exclusive breastfeeding until 6 months, and continuing until 1 year of age and beyond. Feeding at the breast or pumping at least once a day will keep the milk-making system turned on; if a disaster happens, all a mom needs to do is latch baby at the breast to cause more milk to be made.
For the mom who never started to breastfeed, and with a baby less than 3 months old, putting the baby to feed at the breast will trigger a return in milk supply. For the breastfeeding mom with a baby 6 months and older, exclusive breastfeeding will be an adequate source of nutrition until food supplies are restored.
If you have breastfeeding questions or need assistance during a disaster, find an emergency relief worker or health care employee to assist you. The Hernando County Health Department offers free infant feeding courses that instruct moms on proper breastfeeding techniques, how to store breast milk and how to maintain a milk supply.
Heather K. Brosi is a nutrition educator with the Hernando County Health Department.