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Infant Feeding Practices in Complex Emergencies: A Case Study Approach

Published online by Cambridge University Press:  28 June 2012

Mary E. O'Connor ,
Frederick M. Burkle Jr.  and
Karen Olness
Mary E. O'Connor*
Affiliation:
Associate Professor of Pediatrics, University of Colorado Health Sciences Center, Denver, Colorado, USA
Frederick M. Burkle Jr.
Affiliation:
Senior Scholar, Scientist and Visiting Professor, The Center for International Emergency, Disaster and Refugee Studies, Schools of Medicine and Public Health, Departments of Emergency Medicine and International Health,The Johns Hopkins University Medical Institutions, Baltimore, Maryland, USA
Karen Olness
Affiliation:
Professor of Pediatrics, Family Medicine and International Health, Case Western University, Cleveland, Ohio, USA
*
Westside Family Health Center, 1100 Federal Blvd., Denver, CO 80204, USA
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Abstract

The majority of deaths associated with complex emergencies are attributed to infants and children under the age of five years. Most of these deaths are related to preventable diseases such as malnutrition, diarrhea, and malaria. Infant feeding emergencies have emerged as a major factor in complex emergencies. This paper reviews the current information relative to infant feeding, and uses four case studies as educational tools for the management of infant feeding emergencies.

Child mortality rates in refugee population have been linked directly to protein-energy malnutrition (PEM). Breast feeding has many advantages over all other forms of feeding for children up to the age of two years of age. These advantages are discussed in detail in this paper. In addition, the appropriate and inappropriate uses of breast-milk substitutes (BMS) are discussed. Breast feeding also may play a role in the spread of HIV infections from the mother to the infant. However, in the setting of complex emergencies in the developing world, the risk of an infant dying of malnutrition and infection when not breastfed is likely to be greater than is the risk of death due to HIV acquisition through breastfeeding.

The physiology of lactation is reviewed with particular reference to the roles of prolactin, oxytocin, and the feedback inhibitor of lactation (FIL) hormone. No medications have been demonstrated to augment milk production that can be used in a practical sense in complex emergencies. Lastly, the principles promulgated by the WHO and UNHCR for the feeding of infants and children in emergencies and for milk powder distribution are summarized.

Keywords

breast feedingbreast-milk substituteschildrencomplex emergenciesinfantsinfectionlactationmalnutritionmortalityphysiologyprotein-energy malnutrition
Type
Part 1. Complex Emergencies: Lessons Learned
Information
Prehospital and Disaster Medicine , Volume 16 , Special Issue 4: Complex Emergencies , December 2001 , pp. 231 - 238
Copyright
Copyright © World Association for Disaster and Emergency Medicine 2001

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