Generous donations can do more harm than good, says Rebecca Norton in the International Baby Food Action Network (IBFAN).
Infant formula should only be given to infants who cannot breastfeed, and this should be carefully monitored. Under normal circumstances in resource poor settings, children who are not breastfed have six times higher risk of death the first months of life compared to children who are breastfed. During crises this number will be much higher, says Norton, who has also worked for Doctors Without Borders.
She is in Oslo to participate in a seminar under the direction of the Norwegian Resource Centre for Breast-Feeding at Oslo University Hospital, where one of the topics is breastfeeding knowledge in humanitarian organisations. In a chaotic situation, Norton explains, it is difficult to keep an overview and lack of knowledge is a widespread problem. In a crisis situation we often don’t know where donations come from. It can be from military agencies, companies or small charity organisations who collect and distribute whatever they can get hold of. The bottom line is that in such situations one should not ask for or accept donations of infant formula. If people want to help, they can donate money so that humanitarian organisations can make controlled purchases of infant formula when it is needed. If infant formula is available to everyone it will be used.
Misconceptions. Victoria Sibson will also be attending the seminar. She has spent a good deal of time in Haiti recently, working as a nutritional adviser for Save the Children, UK. An important aspect of the job was to combat misconceptions.
Many thought the milk they produced was ”spoilt” by the earthquake, or that they could not breastfeed because they were stressed, says Sibson.
She explains that even under-nourished women can breastfeed, and that it is a myth that stress will cause milk production to cease.
Powerful forces. There are several reasons why breast milk is especially important during a disaster. The danger of infection is often high, and with limited access to clean water and cooking possibilities it is difficult to keep milk and bottles clean. In addition, breast milk contains anti-bodies, which can strengthen the infant’s immune system.
In Indonesia, Farahdibha Terrilemba in the Indonesian Breastfeeding Mothers Association (IBMA) experiences how commercial forces influence mothers to give children infant formula – a problem both Sibson and Norton are familiar with in other parts of the world.
There is intense advertising for this in the media. The advertisements say that infant formula contains ingredients that the child needs, that it will make the child more intelligent etc.
Tenrilemba relates that this misinformation makes it especially difficult when disasters like fires and earthquakes occur. During crises, lots of infant formula is distributed. This makes it difficult to get women with infants to understand that they should not use it, but instead continue to breastfeed.
Heath personnel contribute. All of these three women have experienced that there are health personnel who do not encourage breastfeeding. These personnel can therefore contribute to promoting harmful use of infant formula. In this regard, Norway is exceptional.
If a humanitarian disaster occurred in Norway, there would be many health personnel to help breastfeeding mothers. If something similar were to happen in France or Ireland – where breastfeeding is much less prevalent, one would have to start from scratch, just as we must in many disaster areas today. And it takes time to teach people.
By Ingrid Synnøve Torp - ingrid.synnove.torp@aftenposten.no