Infant feeding in the post Indian Ocean tsunami context: reports, theory and action

The recent Indian Ocean tsunami resulted in a largescale disaster in which millions of people required emergency assistance. Reports that some of the assistance provided included the disorganised or liberal distribution of breastmilk substitutes in relief aid are concerning. The reason for this concern is that in emergency situations children who are not breastfed are at a much greater risk of illness and death. Thus, the supply of breastmilk substitutes in such circumstances should be tightly controlled and provided only when absolutely necessary in order to prevent unnecessary weaning. Close supervision of the use of breastmilk substitutes should also be provided so as to minimise risk. In addition, breastfeeding should be protected promoted and supported with exploration of the options of relactation and wet nursing when an infant is not being breastfed. Each infant feeding situation is different and the appropriate solution to any challenge must be individually determined as seen in the examples presented. Those who have knowledge of the risk of breastmilk substitutes in emergency situations can assist by making aid agencies aware of the issues surrounding infant feeding in emergencies, reporting the inappropriate use of breastmilk substitutes and educating others on the value of protecting and supporting breastfeeding, regardless of the context.