Nutrition in emergencies: the importance of exclusive breastfeeding

Photo: WHO/F. Guerrero

Nutrition in emergencies (NiE) has two objectives: preventing deaths and protecting peoples’ right to nutrition. When disaster strikes, people who are already malnourished before the emergency are more vulnerable to illness and death. The communities affected by the emergency are also at risk of malnutrition because of lack of food or only access to inadequate food and water, poor sanitation and lack of access to health services.

Coordinated by the National Nutrition Council, the 40th Nutrition Month campaign focuses on nutrition in emergencies with the theme ‘Kalamidad paghandaan: Gutom at malnutrisyon agapan!” (Prepare for emergencies to prevent hunger and malnutrition!). It aims to inform the public about the importance of preparedness during emergencies, how to respond and what recovery measures can be taken to prevent death and the worsening of malnutrition of affected populations.

The importance of exclusive breastfeeding

Breastmilk is a protective food for infants to guard against infections which are common during emergencies. Infants who are not breastfed are more at risk to diarrhea, acute respiratory tract infection, malnutrition and even death. This is why the practice of exclusive breastfeeding for at least the first six months of the baby’s life should be promoted.

Benefits of breastfeeding / breastmilk:

  • Contains antibacterial and antiviral agents to protect infants against disease and death
  • Reduces dehydration, the severity and duration of diarrhoea, and the risk of malnutrition
  • Hygienic source of food with the right amount of energy, protein, fat, vitamins, minerals, and other nutrients for infants in the first six months
  • Meets all water requirements
  • Optimizes a child’s physical and mental growth and development
  • Provides a nutritious, easily digestible food when a sick child loses her or his appetite for other foods
  • Bonds mother and child
  • Reduces the mother’s risk of fatal postpartum haemorrhage and premenopausal breast and ovarian cancer
  • Exclusive breastfeeding saves money
  • Protects the environment
  • Naturally renewable, sustainable resource that requires no fuel for preparation, packaging, shipping, or disposal

Feeding infants with breastmilk substitutes such as milk formula increases the risk of illness or even death because of possible contamination caused by poor hygiene and sanitation conditions.

Under Executive Order 51 or the Milk Code, donation of products covered by the law including infant formula, bottles and teats is not allowed. The Department of Health also issued Administrative Order 2007-0017 “Guidelines on the Acceptance and Processing of Local and Foreign Donations during Emergencies and Disasters”. The order provides that infant formula, breastmilk substitutes, feeding bottles, artificial nipples and teats shall not be items for donation. (Downloadable at Violations should be reported to the Food and Drug Administration (telephone number (02- 807-8386) or to the DOH Regional Offices.

Risks of artificial feeding:

  • Infant formula itself is not sterile and may be contaminated
  • Lack of access to safe and clean water to prepare the formula and wash the bottles
  • Feeding bottles are hard to sterilize with limited or no available cleaning utensils, water, fuel and other equipment
  • Insufficient knowledge on proper use and preparation risks over or under diluting infant formula
  • Infant formula does not contain protective properties such as antibodies found in breastmilk
  • Poor sanitation increases risk of contamination of infant formula during preparation
  • Supplies of infant formula are often not sustainable

Wet nursing, tandem nursing of older children, cross nursing, feeding with donated breastmilk by cup are options only in situations where mothers are not capable of breastfeeding their infants. Only after these options have been exhausted can breastmilk substitutes (preferably in ready-to-drink form) be given to infants but it should be under the supervision of trained health staff.