Facts About Infant Feeding During Emergencies

1. Even under stress, mothers can still breastfeed during and after a natural disaster.

Mothers can continue to produce breast milk during times of physical and emotional stress. However, the release (or letdown) of breast milk can be affected by stress. Lactating women who are under stress may need support to encourage the letdown of milk. Keep breastfeeding women in close contact with their babies so they can nurse frequently. Timely practical and emotional support can reduce stress related to infant feeding concerns. Because of the release of certain hormones, breastfeeding may even reduce stress for the parent and baby during challenging situations.

2. Extra precautions are needed for families who are feeding infant formula to their child.

Ready-to-feed infant formula (RTF) is the safest option for formula feeding families during an emergency because it does not need to be mixed with water and it is available in sterile individual single-use containers. When powdered infant formula is the only option, extra care must be taken to ensure that it does not get contaminated. Extra precautions include preparing infant formula with safe water and a clean measuring scoop, storing the infant formula can in a cool, dry place with the lid tightly closed, and carefully cleaning all infant feeding supplies such as bottles and nipples.

Powdered infant formula should be prepared using the exact amount of water and formula listed on the container. Use the exact measurement of the scoop provided. NEVER dilute infant formula – too much water may not meet the nutritional needs of the infant. Too little water may cause an infant’s kidneys and digestive system to work too hard and may cause dehydration. It is important to use prepared infant formula within 2 hours of preparation and within one hour from when feeding begins. Any infant formula that is left in the bottle after feeding the baby must be discarded. Learn more about how to safely prepare and store powdered infant formula during emergencies.

3. Infant formula feeding requires more equipment, resources, and effort than breastfeeding during a natural disaster.

Infant formula feeding requires safe water to prepare the formula and cleaning supplies to clean bottles, nipples, and other parts. These resources may not be readily available in an emergency. Powdered infant formula cannot be made in advance without adequate refrigeration, which can create additional barriers to families using infant formula. Breastfeeding is the safest way to feed a baby during an emergency and provides the nutrients and infection protection that babies need. Infants who are unable to breastfeed or be fed expressed breast milk can be fed with ready-to-feed infant formula, which does not require adding water for preparation.

4. With support, parents can feed their baby expressed milk during a natural disaster.

In cases where parents were feeding their baby expressed breast milk prior to a disaster or are currently unable to feed their baby at the breast, learning how to express milk by hand will help them to continue to provide breast milk to their child. Relief staff can make sure there is designated space that is safe and private for lactating women to express milk by hand. Lactation support should be provided to families to learn how to hand express if needed. Expressed breast milk can be fed to a baby in a disposable cup. Expressing milk by hand is preferred to using a breast pump when proper cleaning of pump equipment is not possible or when a power supply is not available for an electric pump.

5. Most parents can continue to breastfeed even when they or their infant is sick.

Breast milk contains antibodies and other immunological factors that can help protect infants from illness, even if the lactating woman is ill with conditions such as the flu or diarrhea. When an infant is sick, the parent can usually continue to nurse, or feed expressed milk to keep their baby hydrated as well. There are rare exceptions when breast milk or breastfeeding is not recommended, such as when the lactating woman is ill with specific transmissible conditions or taking certain medications.

6. Parents can continue to breastfeed even if they are not able to eat a well-balanced diet or if they are hungry during a natural disaster.

Parents who breastfeed can support both their own health and their baby’s health by eating healthy and nutritious meals and snacks when possible and drinking plenty of water to stay hydrated during an emergency. However, parents who are hungry or have limited access to healthy foods are still able to breastfeed. Breast milk provides the appropriate number of calories and optimal nutrition to support the growth and health of the infant. Feeding infant formula instead of offering the breast will decrease a parent’s milk supply and impact their ability to provide a full supply of breast milk to their infant.

7. Breast milk stored in the freezer may or may not be safe to use if the power goes out.

Access to a refrigerator that has running electricity may be limited during a natural disaster. During an emergency situation families can continue to follow CDC’s guidelines for Proper Storage and Preparation of Breast Milk. Once the power goes out, keep the freezer door closed; this will help prevent the milk from completely thawing. If possible, before an anticipated power outage, move all breast milk to the back of the freezer (the coldest part) and ensure that the freezer is full or empty spaces are filled with crumpled newspaper to help reduce air flow. A full freezer stays frozen longer than a partially full freezer. Milk is still considered frozen if ice crystals can be seen in the milk. Once milk has thawed it must be used within 24 hours and cannot be refrozen; if after 24 hours the milk is not used, throw it out. When it comes to safe storage of breast milk, remember: when in doubt, throw it out.

Breast Milk Storage Guidelines:

• Proper Storage and Preparation of Breast Milk
• Frequently Asked Questions about Storage and Preparation of Breast Milk

8. A parent who has stopped breastfeeding may be able to start again with proper support

Relactation is the process by which a parent starts breastfeeding again after having stopped for some time (weeks or months). A parent may wish to relactate as a safe way to feed an infant during a natural disaster or disease outbreak. Breastfeeding is a supply and demand process that requires 1) nipple stimulation and 2) milk extraction. A parent may be able to relactate or re-establish their milk production by frequently stimulating their nipples by pumping, hand expression, and/or nursing directly at the breast. Once milk production has begun again, frequent, and complete removal of the milk helps to develop a milk supply. Relactation depends on many different factors and support and careful monitoring by a lactation consultant or other breastfeeding specialist is important for parents wishing to relactate.