Appropriate Infant and Young Child Feeding Practices in an Emergency for Non-Breastfed Infants Under Six Months: The Rohingya Experience

Abstract

Background: Since 25 August, 2017 over 693,000 Rohingya have been forced from Myanmar due to mass violence, seeking refuge in neighboring Bangladesh. Nutritional surveys during 2017 revealed worrying levels of malnutrition and poor infant feeding practices, including high numbers of infants not exclusively breastfeeding. Infants under 6 months who are not exclusively breastfed are particularly vulnerable to morbidity and mortality and require specialized feeding support, especially in emergency contexts. Research Aim: To describe Save the Children International’s experiences supporting wet nursing, relactation, and artificial feeding for non-breastfed infants under 6 months in the Rohingya Response, Bangladesh. Methods: A retrospective analysis was conducted of routine program data and documentation from Save the Children International’s infant and young child feeding in emergencies interventions for the Rohingya Response, Bangladesh, from November 2017 to April 2018. The study population were infants under 6 months identified as not breastfed during the initial assessment ( N = 15). Results: Although wet nursing was attempted with all infants, it was successful with 6 (40%) of the infants. Additionally, 1 (6.7%) infant’s mother was able to successfully relactate. The remaining infants ended up requiring feeding with human milk substitutes. Conclusion: Gaps exist in operational guidance to support non-breastfed infants with wet nursing and relactation in emergency settings, as well as on how to operationalize safe human milk substitute programming in line with national policies and regulations. There is an urgent need to address this gap to protect the lives of non-breastfed infants in emergencies worldwide.

Breastfeeding, Relactation, and High Impact Factors in Treating Moderately and Severely Malnourished Children Under Two Years of age in Colombia: A Mixed Community Study Protocol

“…In that study, when a non-breastfed infant was identi ed, the rst step taken was to discuss and seek agreement on feeding options with the family. In this way, relactation was presented as the rst-line option (10).…”

Relactação: promover a amamentação em mães separadas dos filhos devido à COVID-19

“…O sucesso da amamentação depende de vários fatores, entre eles a produção e ejeção eficaz de leite. As causas mais comuns para o compromisso da lactação são, de acordo com os vários autores, a crença que o leite é insuficiente para dar resposta às necessidades do lactante [22][23][24][25] , a introdução de leite adaptado 17,23,24 e a alimentação por mamadeira 22 .…”

“…O stress foi também apontado como um fator importante na diminuição da produção láctea 22 . A exposição a expe-riências stressantes e traumáticas, situações de emergência, como pandemias ou guerras 22 , podem afetar a saúde mental da puérpera, o que leva à redução da produção e ao atraso na ejeção de leite contribuindo para a crença que o leite não é suficiente, levando à introdução de leite adaptado e ao abandono da amamentação.…”

“…A falta de apoio foi também uma das causas referidas pelos autores para o compromisso da lactação 15,[22][23][24][25] . Uma mulher que se depare com dificuldades, como a dor mamilar, os problemas da mama e baixa autoeficácia para amamentar, se não tiver apoio acaba por interromper a amamentação precocemente introduzindo leite adaptado, o que leva à supressão da lactação 22,24,25 .…”

Interventions to support the re‐establishment of breastfeeding and their application in humanitarian settings: A systematic review

“…There is a recognised need to increase knowledge about the practical mechanisms contributing to effective relactation support (Burrell et al, 2020;Dall'Oglio et al, 2020;Prudhon et al, 2016).…”