From Policy to Practice: Challenges in Infant Feeding in Emergencies During the Balkan Crisis

Abstract

The preparation and dissemination of policy statements are necessary but insufficient to prevent the inappropriate use of infant-feeding products in emergencies. The widespread failure of humanitarian agencies operating in the Balkan crisis to act in accordance with international policies and recommendations provides a recent example of the failure to translate infant-feeding policies into practice. This article explores the underlying reasons behind the failures which include: (1) the weak institutionalisation of policies; (2) the massive quantities of unsolicited donations of infant-feeding products: (3) the absence of monitoring systems; (4) inadequate co-ordination mechanisms; (5) the high costs of correcting mistakes; and (6) the cumulative effects of poor practice. Efforts to uphold best practice during the crisis are also documented. Finally, the article identifies actions that could be undertaken in advance of and during future emergencies to enhance the application of infant feeding policies in emergencies.

Supporting breastfeeding in emergencies: protecting women's reproductive rights and maternal and infant health

“…It is also recommended that donations of breast-milk substitutes and commercial baby foods not be solicited or accepted by aid agencies in emergencies (Infant and Young Child Feeding in Emergencies Core Group, 2007b). Solicitation or acceptance of donations creates difficulties with controlling appropriate distribution because it results in a supply that is invariably in excess of that required while often also being of an unsuitable nature (Borrel et al, 2001). Rather, breast-milk substitutes should be procured by agencies, preferably locally, unbranded and in the quantity required (Infant and young Child Feeding in Emergencies Core Group, 2007b).…”

Media messages and the needs of infants and young children after Cyclone Nargis and the WenChuan Earthquake

“…What was found in the Balkans, however, was that since donations were not specifically purchased for particular situations, they were often not of the type required, the quantity required, and in the location required (Borrel et al, 2001). The infant formula industry has been very aggressive in its marketing activities in China in recent years and would have seen the earthquake and the provision of donations as an opportunity to receive positive publicity and promote its products (IBFAN-ICDC, 2009).…”

“…The infant formula industry has been very aggressive in its marketing activities in China in recent years and would have seen the earthquake and the provision of donations as an opportunity to receive positive publicity and promote its products (IBFAN-ICDC, 2009). Donated milk was frequently distributed to the caregivers of artificially fed babies, without any other support, and to breastfeeding mothers (Stojanoska et al, 1999;Borrel et al, 2001). It is important, though, not to confuse a genuine need for infant formula in the emergency response with a need for donations of infant formula.…”

“…Over the past decade, however, it has been common for aid, in the form of poorly targeted distribution of infant formula or other milk products, to undermine the health of children (FAO, 2000;World Health Organization et al, 2000;Borrel et al, 2001; Office of the Iraq Programme, 2002;International Study Team, 2003;Carballo and Heal, 2005;Arts, 2006;United Nations Children's Fund, 2008a;IRIN, 2009). Often concomitant with the poorly targeted distribution of infant formula or other milk products is a lack of support for exclusive breastfeeding and measures to reduce the risks of artificial feeding (Borrel et al, 2001;Maclaine and Corbett, 2006;IRIN, 2009). Often concomitant with the poorly targeted distribution of infant formula or other milk products is a lack of support for exclusive breastfeeding and measures to reduce the risks of artificial feeding (Borrel et al, 2001;Maclaine and Corbett, 2006;IRIN, 2009).…”

Hurricanes and Pregnancy

“…Breastfeeding is often deemphasized in the aftermath of a disaster, because donors may provide formula in an effort to help. Mothers and medical personnel may not realize that most traumatized women still produce good‐quality milk (35), although cases of stress‐induced cessation of lactation were reported after the 1985 Mexico City earthquake (36). Other nutritional issues might also occur.…”