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IYCF_Joint-Statement-V2-06052022-EN

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Joint Statement
Protecting Infant and Young Child Feeding Practices
in the Ukraine Conflict and Refugee Crisis
Version 2: May 2022


UNICEF, UNHCR, the Global Nutrition Cluster, the IFE core group, and partners call for ALL involved in the response to the Ukraine Crisis to protect, promote, and support the feeding and care of infants and young children and their mothers as well as pregnant women. This is critical to support maternal and child health and survival, growth, and development and to prevent malnutrition. 
This joint statement has been issued to help secure immediate, coordinated, multi-sectoral action on infant and young child feeding (IYCF).

The expansion of the conflict is projected to deepen and increase humanitarian needs for millions of Ukrainians. Refugees, families displaced within Ukraine, and those affected by conflict in their place of residence are likely to be in an extremely difficult situation facing high levels of stress and uncertainty, food shortages, unsanitary conditions, risk of communicable diseases, and significant protection threats.

In all emergencies, the youngest children are at the highest risk of illness and mortality. Infants who are not breastfed are especially vulnerable, as the normal environment for accessing and hygienically preparing infant formula is disrupted. This is a concern in Ukraine, where rates of exclusive breastfeeding are low, and a high percentage of infants are partially or fully dependent on infant formula.

Globally Recommended Maternal, Infant and Young Child Feeding Practices
1. Early initiation of breastfeeding (uninterrupted skin to skin contact immediately after birth and putting baby to
the breast within 1 hour of birth)
2. Exclusive breastfeeding for the first 6 months (no food or liquid other than breastmilk, not even water unless
medically indicated)
3. Introduction of age-appropriate, safe, and nutritionally adequate complementary feeding from 6 months of
age onwards; and
4. Continued breastfeeding for 2 years or beyond.
5. Ensure pregnant, post-partum and breastfeeding women, have priority access to food and non-food items.

Interventions to support pregnant women, mothers, and their children should consider:

1. Support mothers to initiate and continue breastfeeding as a priority to help protect their health and well-being and that of their infants. Although stress can temporarily interfere with the flow of breast milk in some women, it is not likely to inhibit breast milk production provided mothers and infants remain together and are supported to initiate and continue frequent breastfeeding. This support entails practical support with attachment and positioning for breastfeeding, confidence building, facilitating skin to skin contact and keeping mother and infant together (e.g., provide baby carriers/slings). It is recommended to draw upon existing breastfeeding support organizations and
individual lactation specialists from Ukraine and surrounding countries for additional guidance.


2. Keep mothers and babies together, even if ill with COVID-19 or variant. Mothers can breastfeed even if they are pregnant or if they become ill, including with COVID-19. If ill, antibodies in their milk will help protect their babies. Anyone who is holding or feeding a baby (whether breastfeeding or feeding with a breastmilk substitute) should wear a mask and wash their hands before feeding the child.

3. Support and protect the nutritional needs of infants and young children who are not breastfed and minimise the risks they are exposed to. Infants who are exclusively dependent on infant formula are highly vulnerable in conflict situations and should be urgently identified, assessed, and supplied with a package of essential support. This package should include adequate breastmilk substitute (powdered infant formula or ready to use infant formula) supplies, equipment and supplies for hygienic storage, preparation and cup feeding, practical training on hygienic preparation and storage, and counselling on responsive feeding. The support should also provide for regular follow-up at
designated transit centres, reception centres, UNHCR-UNICEF Blue Dot Hubs and congregation areas within host countries, as well as at Blue Dot Hubs, Red Cross, and other service providers within Ukraine. Mothers who are mixed feeding should be encouraged and supported to increase their breastmilk supply and/or return to exclusive breastfeeding.

4. In accordance with Ukraine1 and EU2 regulations as well as those of other host countries (3), do not call for, support, accept or distribute donations of Breast Milk Substitutes (BMS), including infant formula, other milk products, commercial complementary foods, and feeding equipment (such as bottles, teats, and breast pumps). Required BMS supplies should be purchased (by the caregiver, procured by UNICEF or other partners in line with the WHO International Code of Marketing and Breast Milk Substitutes, ‘the Code’4, and subsequent WHA resolutions) and provided as part of a sustained package of coordinated care based on assessed need and should be Code-compliant. Donor human milk should not be sent unless based on an identified need and in coordination with state/local medical authorities or UN agencies coordinated intervention that must include a functional cold chain. For infants 6–23 months of age, acceptable milk sources include full-cream animal milk (ow, goat, buffalo, sheep, camel), Ultra High Temperature (UHT) milk, reconstituted evaporated (but
not condensed) milk, fermented milk, or yogurt, and expressed breast milk. Any animal milk given to infants <12 months should be boiled and left to cool before giving the milk.

5. Ensure the availability and continuity of nutritious, appropriate, and fresh food for children, pregnant women, and postpartum and breastfeeding women. Where there are identified shortfalls in local access and availability of foods, facilitate access to age-appropriate and safe, complementary foods for children 6–23 months, older children, and for their caregivers, with particular attention to pregnant, post-partum and breastfeeding women. In all contexts, promote access through inclusion of women and children into national social safety nets and, where access is limited, through direct cash support.

6. Ensure pregnant, post-partum and breastfeeding women, and other caretakers of young children have priority access to food and non-food items including appropriate clothing, water, protection, accommodation, psychosocial support, and other interventions to meet their essential needs. Consider how women in transit can be supported to minimize distress during their journey. At all service points, provide safe and comfortable spaces for mothers and caretakers to feed and care for their infants.

7. Identify higher risk infants, children, and women and respond to their needs. These include (but are not limited to) pregnant women; newborns, low birth weight infants; malnourished children, including infants under 6 months of age; children with disabilities; children experiencing issues with feeding; HIV exposed infants; orphaned infants; in addition, promote the identification of institutionalized children; women who are malnourished or severely ill; women who are experiencing stress and anxiety; instances where mothers are separated from their children.

 

We encourage you to orientate your staff to raise awareness of the contents of this position statement
If you would like to translate this document, please contact: ife@ennonline.net
For more information:
In Ukraine: Kateryna Bulavinova — kbulavinova@unicef.org
Refugee hosting countries: UNHCR Public Health & Nutrition: hqphn@unhcr.org

 

“Annex 1: Resources for IYCF
• Mother and Baby Space resources for Ukraine response
• Ukraine Nutrition Cluster website
• BMS Monitoring and Reporting for all of Ukraine response
Operational Guidance on Infant Feeding in Emergencies V3
• IYCF-E infographic series | ENN (ennonline.net)
• BMS-Procurement-Guidance-Final-June-2021.pdf (unicef.org)
• Breastfeeding-counselling-in-Emergencies-2021.pdf (globalbreastfeedingcollective.org)
• Community based infant and young child feeding | Global Breastfeeding Collective
• Breastfeeding in emergency situations | Global Breastfeeding Collective
• Call to Action: Breastfeeding Counselling in Emergencies
• Supportive Spaces for IYCF-E
• Nutrition Cluster Ukraine Programmatic and Technical Guidance
• WHO UNICEF ten-steps-to-successful-breastfeeding
• Guiding principles for feeding non-breastfed children 6-24months of age
• Infant and young child feeding practices. Standard Operating Procedures for the Handling of Breastmilk Substitutes (BMS) in Refugee Situations”

 

 


 

Joint-statement on Ukraine crisis  March (V1)

Joint Statement
Protecting Maternal and Child Nutrition in the

Ukraine Conflict and Refugee Crisis

Version 1: 8 March 2022

UNICEF, the Global Nutrition Cluster, and Partners call for ALL involved in the response to the Ukraine Conflict Crisis to protect, promote, and support the feeding and care of infants and young children and their caregivers.This is critical to support child survival, growth, and development and to prevent malnutrition, illness, and death.   This joint statement has been issued to help secure immediate, coordinated, multi-sectoral action on infant and young child feeding (IYCF).

The expansion of the conflict is projected to deepen and increase humanitarian needs for millions of Ukrainians.
Refugees, families displaced within the Ukraine and those affected by conflict in their place of residence are likely

to be in an extremely difficult situation facing high levels of stress and uncertainty, food shortages, unsanitary

conditions, risk of communicable diseases, and significant protection threats.

Globally Recommended Infant and Young Child Feeding Practices
1.
Early initiation of breastfeeding (putting baby to the breast within 1 hour of birth)
2.
Exclusive breastfeeding for the first 6 months (no food or liquid other than breastmilk, not even water
unless medically indicated)

3.
Introduction of age-appropriate, safe, and nutritionally adequate complementary feeding from 6 months
of age; and

4.
Continued breastfeeding for 2 years and beyond.

In all emergencies, the youngest children are at the highest risk of illness and mortality. Infants who are not breastfed
are especially vulnerable, as the normal environment for accessing and hygienically preparing infant formula is

disrupted. This is a concern in the Ukraine, where rates of exclusive breastfeeding are low, and a high percentage of

infants are partially or fully dependent on infant formula.

Interventions to support mothers, caregivers and their children should consider:

1. Support mothers to initiate and continue breastfeeding, as a priority to help protect their health and well-being and that of their infants.

Although stress can temporarily interfere with the flow of breast milk in some women, it is not likely to inhibit breast milk production, provided mothers and infants remain together and are supported to initiate and continue frequent breastfeeding. This support entails practical support with attachment and positioning for breastfeeding, confidence building, facilitating skin to skin contact and keeping mother and infant together (e.g., provide baby carriers/slings). It is recommended to draw upon existing breastfeeding support organisations and individual lactation professionals from Ukraine and surrounding countries.

2. Support and protect the nutritional needs of infants and young children who are not breastfed and
minimize the risks they are exposed to.

Infants who are exclusively dependent on infant formula are highly vulnerable in conflict situations and should be urgently identified, assessed, and supplied with a package of essential support including adequate Breast Milk Substitute (powdered infant formula or ready to use infant formula) supply, equipment and supplies for hygienic storage, preparation and cup feeding, practical training on hygienic preparation and storage, counselling on responsive feeding and regular follow up at UNICEF Blue Dot Hubs, Red Cross, and other service providers. Mothers who are mixed feeding should be encouraged and
supported to increase their breastmilk supply and/or return to exclusive breastfeeding.

3. In accordance with Ukraine regulation1 do not call for, support, accept or distribute donations of Breast
Milk Substitutes, including infant formula, other milk products, commercial complementary foods,

and feeding equipment (such as bottles, teats, and breast pumps).

Required BMS supplies should be purchased (by the caregiver or procured by UNICEF) and provided as part of a sustained package of coordinated care based on assessed need and should be Code-compliant. Donor human milk should not be sent unless based on an identified need and in coordination with state/local medical authorities or UN agencies coordinated intervention that must include a functional cold chain.

4. Ensure the availability and continuity of nutritious, fresh food and essential staples for children,
women, and families.

Where there are identified shortfalls in local access and availability of foods, facilitate access to age-appropriate and safe, complementary foods for children 6-23 months, older children, and for their caregivers, with particular attention to pregnant and breastfeeding women.

5. Ensure pregnant and breastfeeding women, and other caretakers of young children have priority
access to food and non-food items including appropriate clothing, water, protection, accommodation,

psychosocial support and other interventions to meet their essential needs.

Consider how women in transit can be supported to minimise distress during their journey. At all service points, provide safe and comfortable spaces for mothers to feed and care for their infants.

6. Identify higher risk infants, children, and mothers and respond to their needs.

These include (but are not limited to) low birth weight infants; malnourished children, including infants under 6 months of age; children with disabilities; issues with feeding; HIV exposed infants; orphaned infants; mothers who are malnourished or severely ill; mothers who are traumatised; instances where mothers are separated from their children.

We encourage you to orientate your staff to raise awareness of the contents of this position statement

Please contact Anna Ziolkovska, Nutrition Specialist, Global Nutrition Cluster for more information. aziolkovska@unicef.org

Annex 1: Resources
IYCF-E infographic series | ENN (ennonline.net)
BMS-Procurement-Guidance-Final-June-2021.pdf (unicef.org)
Breastfeeding-counselling-in-Emergencies-2021.pdf (globalbreastfeedingcollective.org)
Community based infant and young child feeding | Global Breastfeeding Collective
Breastfeeding in emergency situations | Global Breastfeeding Collective
Call to Action: Breastfeeding Counselling in Emergencies
Supportive Spaces for IYCF-E
https://www.nutritioncluster.net/Ukraine_Response_Programmatic_and_technical_response

1 “Preventing the spreading of artificial breast-milk substitutes is defined by the Order of the Ministry of Health of Ukraine as of October 28, 2011  No. 715 “On Further Introduction of Hospital Favourable to a Child Expanded Initiative in Ukraine

_____________________________________________________

Strategies for Infant and Young Child Feeding in Climate-Related Emergencies   Register for Live event – Monday 21st March 2022

Watch the recording

https://www.globalbreastfeedingcollective.org/strategies-infant-and-young-child-feeding-climate-related-emergencies

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    2 thoughts on “NEW Joint Statement on Ukraine crisis – protecting mothers and children

    • 12/03/2022 at 7:55 pm
      Permalink

      Es muy importante mitigar el hambre y la necesidad de mayor afecto de los lactantes y niños pequeños, las situaciones de emergencia deben verse como una oportunidad para apoyar a las madres y sus familias para promover, proteger y apoyar la práctica de la lactancia materna. Generalmente la industria de alimentos aprovecha estas situaciones para hacer donaciones y bajar impuestos; nosotros debemos aprovechar para proteger a los niños, niñas y sus madres para que aún en situaciones de alta vulnerabilidad puedan ser protegidos y apoyados regresando al amamantamiento.
      Se necesita personal que conozca los beneficios y técnicas depara amamantar en las zonas de conflicto, en los países receptores de la población refugiada e incluso en los mismos países en conflicto y me refiero a todos no solo a Ucrania).
      Amanda Valdés Soler
      amandiv@gmail.com
      Bogotá, Colombia

      Reply
    • 15/03/2022 at 7:13 am
      Permalink

      Today, a Russian Army spokeman announced the shipment of humanitarian aid to Ukraine-“including baby food”- he added. This mesagge was broadcasted in many international media, including BBC. Calls to stop formula donations should not be limited to donations from Europe or other western countries. An appeal to the Russian authorities should also be sent.

      Also today, news about the death of a pregnant Ukranian woman were widely disseminated. Measures to identify mothers with infants and small children to protect sake infant feeding should be expanded to include pregnant women. Breastfeeding corners/tents as well as feeding centers should also include food and protection for pregnant women. These facilities should be clearly identifiable and protected from any armed agresion by both conflicting parties.

      Reply

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