When Natural Disasters Strike, Breastfeeding Matters

Earthquakes, floods, tornadoes, fires. Recent years have seen their share of natural disasters and emergencies which will only continue to occur with the passing of time. Even now, a State of Emergency has been declared for Hurricane Matthew, and heightened seismic activity at the Salton Sea has prompted scientists to warn of the elevated risk for “The Big One” at San Andreas fault.

Disasters and emergencies, while incredibly devastating, invoke a sense of camaraderie as people from all walks of life and differing backgrounds join together to help; to donate. While the intention is good, the protocol of infant feeding during natural disasters in particular needs dire improvement. This problem springboards from the lack of education on the importance of breastfeeding as a whole.

Residents wait in line at the Superdome for shelter
during Hurricane Katrina. Image source: chron.com

Major health and aid agencies have come to a general consensus on how infant feeding issues should be addressed during disasters. They agree that the use of formula should only occur when mothers have weaned and relactation is not possible, or when the baby has lost its mother and wet nursing is not an option. They agree that ongoing support and assistance is necessary in such a case to limit the risks associated with artificial feeding, and that the distribution of breastmilk substitutes should be tightly controlled, carefully monitored and only provided to babies with a clear need.  

UNICEF, WHO, and the International Red Cross are active in alerting non-government organizations of the need to support breastfeeding and to be extremely careful in the distribution of breastmilk substitutes. Despite their efforts, and despite these guidelines, infant formula and bottles continue to be distributed unnecessarily during disaster situations.

During emergency situations, the cleanest, safest food is human milk.

Myth: Mothers who are under stress cannot breastfeed. Fact: Mothers will continue to lactate in times of stress but will need adequate support.

Myth: If a mother is malnourished, she either cannot breastfeed or the milk she produces is poor quality. Fact: Malnourished mothers or mothers with illnesses CAN provide healthy and safe milk for their babies.

The Problem with Formula Donations During Emergencies

One of the biggest tragedies during Hurricane Katrina was that almost no breastfeeding mothers were found. One-third of Louisiana’s population was displaced, which was about 1,300,000 people, and more than 100,000 evacuees remained in shelters more than one month later.

The distribution of formula and bottles by aid workers during this time disregarded the importance of clean water and utensils to make feeding infants possible and safe, and the more time that passed, the higher the risks for infant mortality continued to climb.

According to the American Academy of Pediatrics, in any given emergency, clean drinking water and a sterile environment may be inaccessible. Even in a potentially less catastrophic emergency, such as being trapped in gridlock for several hours, access to water to make formula as well as the ability to clean and sterilize bottles or feeding utensils is not possible. Infants need to be fed every 2 to 3 hours. When disaster strikes, reality hits, and panic can ensue.

The WHO states that artificially fed babies have a 1300 percent increased risk of death from diarrhoeal disease as compared to babies that are breastfed. The WHO adds that babies who are artificially fed are inherently more vulnerable to disease because they do not receive the disease-fighting antibodies that are in breastmilk.

“In past emergencies, 12–75% of all babies have died, so any factor that increases disease transmission and reduces the ability of babies to withstand disease may well result in their death.” - World Health Organization

At the time of Hurricane Katrina, information was not readily available to support optimal infant nutrition; rescue workers were not trained in breastfeeding support and management. Overall, the distribution of formula discouraged breastfeeding, decreased mothers’ confidence, and increased the risk of infection, illness, and death.

The Clear Advantages of Breastfeeding During an Emergency Provides comfort and relieves maternal anxiety Protects against infectious diseases Readily available Nutritionally perfect Perfect temperature Fights Illness

The Disadvantages of Formula-Feeding During an Emergency It may not be readily available May become contaminated Water mixed with powdered formula may be contaminated There may be no means of refrigeration to preserve it There may be no method to sterilize feeding utensils

While some strides have been made to educate about the importance of breastfeeding during disasters, the lack of normalcy is still present in our society and more efforts should be made to instill it in mothers, aid workers, and government agencies collectively. Milksharing or local donations of expressed milk should be a mainstream option to feed infants in dire cases.

Future natural disasters are inevitable and will continue to have a devastating effect on the economy and well-being of families. Protecting, promoting, and supporting breastfeeding during these natural disasters will help prevent long-term health and developmental problems that may occur as a result of alternative feeding methods. Encouraging breastfeeding will also lessen the economic blow, as the overall cost of the disaster is significantly reduced for both the families and societies affected. It is an investment that will pay for itself in more ways than one, several times over.

Contributing author: Samantha Johnson is a freelance writer, blogger, wife, and breastfeeding mom. Her Bachelor of Arts degree in journalism from California Baptist University has led to more than six years of full-time writing experience and countless exciting opportunities. Aside from writing, her passions include drawing, painting, iced coffee, reaching her goals, balancing life's priorities, and encouraging others. You can visit her blog at unlazylike.wordpress.com.

The Slippery Slope of Supplementing

There are a few pieces of education that can prevent unnecessary supplementation of formula or unintentional weaning. One problem is that many people misinterpret baby behavior. A baby communicates various ways. He uses body language, head movements, hand gestures and crying as forms of expression. The crying stage is usually what brings on the bottle.  A baby's cry brings full attention to the situation. The cry is annoying, upsetting and a "call to action." It was designed that way. If a baby just whispered, "Hello, up there, I'm over here and I need you." More often than not, the busy, distracted people around would not be aroused to take action. Since the cry demands a response, parents begin the ritual of calming baby. If the baby does not settle right away, parents will often resort to a bottle assuming that their baby is hungry. The bottle will elicit the suck reflex, making it difficult to cry. The baby also soothes by sucking so he continues to suck for comfort which reassures the parents that baby was indeed hungry. This sucking reflex is just that--a reflex. When we go to the doctor and he checks our patellar reflex with a hammer, if our leg spontaneously jerks forward, the doctor does not exclaim, "She wants to play soccer, see, just confirmed it!" That would be ridiculous, yet we use this reasoning when deciding that a baby needed supplements.

Everyone must also learn to appreciate and respect the fact that a woman's body and baby communicate through a series of events. Baby does at times need more milk and he must communicate this. The infant will "place his order" by frequently visiting the breast. He even tells his mother's body that he is not satisfied. He fusses, grunts, pulls his head back and arches his back. This arrangement convinces the mom's body to step up production. Many professionals used to refer to these stages as "growth spurts," until it was shown that growth does not necessarily coincide with the frequent breastfeeding. More recently, the feeding frenzies are being called, "frequency days." However they are labeled, they do occur and are necessary for regulating milk supply.

The body is amazing. It does not have to store all the milk the baby needs per day or week. It creates milk made to order. If a baby needs more, he expresses his desire and the breast-feeder complies.  Herein lies the problem. If a baby is given a bottle during these moments of frustration, it communicates with the woman's body, "Never mind, seems like baby is satisfied, it was a false alarm." The mom's body has no reason to produce more. The next time baby models the same behavior, parents may respond with the same solution. The baby will often take more from the bottle and if the supplement is formula, the ingredients are more difficult to digest and this "heavy" meal may encourage baby to sleep longer. A longer nap will also communicate to Mom's body that baby doesn't eat as frequently and she doesn't need to make milk as often. Next. the mom will notice a definite decline in milk, convincing her to supplement even more. Unfortunately, this unintentional weaning happens too often. Disappointed moms feel as though they were broken and could not effectively breastfeed. They think they were starving their newborn because he appeared unsatisfied with her milk, not knowing that this protesting was the exact recipe for increasing milk supply. If moms were encouraged to trust their amazing bodies and constantly put baby to breast so he could effectively communicate his needs and that the body would respond to meet those needs, we would see women empowered rather than defeated.

The good news is that the woman's body still wants to feed and meet the needs of her baby. The situation can be reversed. Mom must put baby to breast every time baby will nuzzle, suck, cuddle or nurse from the breast. It is also a good idea to practice skin-to-skin and get oxytocin freely flowing. Without this contact, the mother's body is persuaded that the baby is getting fed elsewhere and it needs to shut down production.

If breastfeeding has stopped completely, contact an IBCLC to help with re-lactation. Lactation Consultants can also help the mother who needs to supplement by sharing ways to continue the breastfeeding relationship and instruct on how much supplementation is necessary.

Interested in becoming a Certified Lactation Educator (CLE) and sharing evidence-based education with others? Sign up for an upcoming training on the Birthing, Bonding and Breastfeeding website.

Facebook Censored Me

I put a lot of eggs in one basket--the Facebook basket.  I liked the simplistic style of the site and the freedom to create my "own" page and network with like-minded people.  I knew together we could change the world.  The momentum was building.  I had connected with over 3,500 friends and my Birthing, Bonding & Breastfeeding Page was reaching an excess of 700,000 people regularly.  We were pushing the pendulum of infant feeding into the direction of breastmilk and I was riding the wave.  Well, yesterday it was too much for "Big Brother."  My account was disabled, my pages removed, my events canceled, and my friends left wondering how I had vaporized overnight.  I may be hidden for now, but no worries, I am like the tempest under the sea. It may look as though the waters are still, but beneath the surface I am still churning with ideas and possibilities.  I will ride this wave again.  I am working on a blog from my website right now and hope to have it up soon...I was simplistic to think that Facebook was actually allowing me to create my "own" page.  I do appreciate the social networking opportunity and have requested my page be reinstated.

www.birthingandbreastfeeding.com

Here is my plea and reply to Facebook: I am assuming my account was disabled due to breastfeeding photos. I have not received a warning and I did not believe they were in violation, since the "nipple" was not showing. On my stats report 98% of my audience is women, with the exception of a few professionals in the pediatric and OB world, and these photos were not intended to violate a policy, but encourage a community to provide healthy, nutritious food. Please be specific as to what you do not want me to post. I did have someone say FB would probably take the photo down, but I did not think it was policy to remove an account. I need access so I can cancel my Facebook ads for the courses I am advertising and collect my emails. If you decide to close my account, it would be more professional to allow me to explain to my fan base another method to reach me. Please advise and please be specific as to what you do and do not allow. I know this has been a controversial topic for Facebook and I have seen the media coverage. I am not posting pornography-- and to insinuate as much is very offensive to me. I would be happy to share more about my stand on lactation if you would like to explore this topic. Thank you for your understanding. Christy Jo, IBCLC, CD(DONA). Also, as you may notice I am an International Board Certified Lactation Consultant and Certified Birth Doula, so my page will reflect these two professions. I am NOT a person posting images to an audience that does not appreciate the mother/child bond.

The photo that caused the world to stop and for me to be banned is posted here...and this one will not be removed because the author and contributor fully supports this photo.

 My caption read something to the effect that although yesterday was the first day of spring, I captured the best spring photo of the year at the Pass Area Breastfeeding Cafe...

Stay tuned. I will keep you all informed.  Nothing would please the formula companies more than to "divide and conquer"...

In the meantime, I can still be reached at mommymilk@msn.com, and from my website www.birthingandbreastfeeding.com.

I feel like every mother who has been told to cover up, hide or leave while breastfeeding--this has to stop!