Why breastfeeding support must be included in UN appeal for South Sudan, Somalia, Yemen and Nigeria

A  UN appeal to help people in South Sudan, Somalia, Yemen and Nigeria is attracting media attention,  but some reports are conveying unhelpful messages about breastfeeding.  While we applaud the agencies for drawing attention to the food crises in these countries we appeal to them to make sure that the messages about breastfeeding are correct.

For example a BBC Radio 4 report today (11 March 2017) appealed for therapeutic food for babies in the Yemen who, the report said, could not be breastfed because their mothers are too malnourished.  Although the food situation in the Yemen is dire, this is a risky message that is likely to be misinterpreted, opening the door to donations of inappropriate products. In this short report there was no mention of the risks of artificial feeding in emergency situations or that feeding the mother is a much safer option. No one asked why  breastfeeding rates are already so low – for example ‘Only 16 percent of Yemeni women exclusively breastfeed their children in the first six months of life.’ (See  Al Jazeera  report)
Breastfeeding plays a critical role in infant and young child survival, as well as in maternal health and the bonding between mother and baby, so precious in emergency situations.  This is why the UN and aid agencies have all agreed that humanitarian relief programmes must include training on how to protect promote and support breastfeeding, as well as how to support non breastfed children in ways that do not undermine breastfeeding.  So why is  this message  so rarely conveyed?
See: BBC R4 news   UN: World facing greatest humanitarian crisis since 1945 

Here is a section from an Al Jazeera  report I posted on my blog last year about the Yemen

June 2014   Yemen’s breastfeeding challenge  Only 16 percent of Yemeni women exclusively breastfeed their children in the first six months of life.

……While health experts recommend exclusive breastfeeding for a child up to 6 months of age, Yemen’s most recent demographic health survey showed that only 16 percent of women exclusively breastfed for the first 6 months, with a further 33 percent using a mixture of breastfeeding and a homemade solution of sugar and water.

 “Unfortunately, we are one of the less advanced countries in terms of breastfeeding in the region,” Magid al-Gunaid, Yemen’s deputy minister for primary healthcare, told Al Jazeera. “It’s a chronic problem in the country.”

Up to 53 percent of Yemeni women tend to rely on infant formula. However, poor water sanitation, poverty and high illiteracy rates mean that Yemen does not have the social, economic or environmental factors needed for the extensive and safe use of milk substitutes.

“These mothers will make a standard tin of formula, which should last around four days, last for up to two weeks by diluting the product so much that it fails to nourish the child,” said Dr Rajia Sharhan, a nutrition officer for UNICEF in Sanaa. “They just can’t afford to buy it regularly and families are putting themselves in extreme situations to do so.”

IFE Core Group

IBFAN is an active member of the interagency working group on Infant Feeding in Emergencies (the IFE core group).

The IFE Core group is coordinated by the Emergency Nutrition Network (ENN). Members of the IFE Core group include non-governmental and UN agencies (for the list of members of the IFE Core group see www.ennonline.net/ife).

The IFE Core group represented by the ENN is a member of the IASC Inter-agency Standing Committee Nutrition cluster

Aim of the IFE Core group: To develop policy guidance and capacity building in the field of Infant Feeding in Emergencies.

Key documents developed by the IFE Core group over the past 10 years include:

The Operational Guidance on Infant and Young child feeding in emergencies
(version 2.1, February 2007)

http://www.ennonline.net/resources/6

  • For the protection and support of appropriate infant and young child feeding in emergencies, this is a key document. The aim of the Operational Guidance is to ensure optimal infant and young child feeding practices in emergencies. The International Code of Marketing of Breastmilk Substitutes and relevant subsequent World Health Assembly resolutions is embedded throughout the Operational Guidance. There is also a clear statement on the importance of preventing and avoiding donations of breastmilk substitutes, bottles, teats and other milk products in emergencies.There is also a whole section on how to minimize the risks of artificial feeding. It is also reflected in the new Sphere guidelines (see below).
  • Translated into 11 languages
  • Supported by a large number of NGOs, donors, and UN agencies (see www.ennonline.net/ife).
  • Adopted in May 2010 by resolution 63.23 of the World Health Assembly (WHA):
    ” urges Member states to ensure that national and international preparedness plans and emergency responses follow the evidence-based Operational Guidance for Emergency Relief Staff and Programme Managers2 on infant and young child feeding in emergencies, which includes the protection, promotion and support for optimal breastfeeding, and the need to minimize the risks of artificial feeding, by ensuring that any required breast-milk substitutes are purchased, distributed and used according to strict criteria”;
    WHA Resolutions text 2010 http://apps.who.int/gb/ebwha/pdf_files/WHA63-REC1/WHA63_REC1-P2-en.pdf
    This policy development is excellent news and gives all NGOs working on infant feeding and in emergencies an opportunity to advocate with their governments for implementation of the Operational Guidance into relevant national policies. IBFAN will be always happy to hear about such efforts.
  • Reflected in the new Sphere 2011 Humanitarian Charter and Minimal Standards for Disaster Response. The cornerstone of the book is the Humanitarian Charter, which describes the core principles that govern humanitarian action, and asserts the right of populations to protection and assistance. The Sphere project promotes quality and accountability in the humanitarian response. Sphere proposes a common language and criteria to guarantee humanitarian interventions, and promotes a humanitarian ideal with criteria for efficiency and accountability  http://www.sphereproject.org/
  • Regularly updated: This Operational Guidance was first produced by the Interagency Working Group on Infant and Young Child Feeding in Emergencies in 2001. It has since evolved to reflect experiences in the field and the latest version of this document is from February 2007.
  • NEW Operational Guidance Addendum on the type and source of Breastmilk Subsitutes to be considered (Operational Guidance 6.2.3).
    An addendum was made to the Operational Guidance in June 2010, to reflect on the procurement and management of ready to use infant formula (RUIF). This product was widely used in the response to the Haïti earthquake which took place in January 2011. Its use has yet to be evaluated. Seehttp://www.ennonline.net/pool/files/ife/insert-operational-guidance-6-3-2-addendum-2010-final.pdf

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