As I write this*, I’m taking note of the tornado warnings that have made my phone beep seemingly every hour for the past few days. The sound of rain pelting the windows. Bayous and reservoirs cresting over. I’m watching friends’ and neighbors’ homes flood in real time. Reading about pleas for rescue as families seek refuge from rising water in their attics and on their roofs. You could say things are out of control.
Amid all of this, babies still need to eat. Newborn babies who took their first breath at a Houston area birth center after tropical storm Harvey made landfall. Older babies who nurse around the clock or drink expressed or powdered milk or formula supplements.
The stores are closed and roads are crumbling or underwater. Formula is now largely inaccessible. But babies still need to eat.
Pumping moms need to continue pumping to avoid mastitis, supply issues, and maintain production. What about when the power goes out? Or when the house floods and the circuit board must be shut off? Hopefully they have a manual pump or have been taught how to hand express… because babies still need to eat.
New mothers, welcomed into motherhood with all the terrific drama Mother Nature herself could muster: I hope you have a (relatively) easy time getting started. The well-trained eye of a lactation consultant in your home, personally assessing latch and other tricky spots, cannot compare to scouring the internet for emergency breastfeeding help in the early days. But no one is risking travel across town for ‘work’ in a deluge. A lucky mother has her phone fully charged and ready to go with breastfeeding apps right now because, of course, babies still need to eat.
*(Flood waters have since receded from my neighborhood and we’re doing fine now. However, eleven million people in the southeast counties of Texas are still trying to get a grip on the continued consequences of this historic flooding).
Below are four important concerns raised by the massive 2014 flood in Kelantan, Malaysia. I feel this will be incredibly relevant to flood victims in Houston starting now and lasting well into rebuilding of our city and replenishing of vital resources:
“[F]irst, the negative impact of flood on infant nutritional status and their health;
[S]econd, open space and lack of privacy for the mothers to breastfeed their babies comfortably at temporary shelters for flood victims;
[T]hird, uncontrolled donations of infant formula, teats, and feeding bottles that are often received from many sources to promote formula feeding;
[L]astly, misconceptions related to breastfeeding production and quality that may be affected by the disaster.”
If you’re a breastfeeding mother, there are a few things you should know:
Continued breastfeeding is safer than formula feeding, if it’s an option. Breastfeeding provides all the nutrients and hydration your baby needs without needing to find a dependable, sterile water source to mix powder. Breast milk does not need to be rationed. In general, the more often you nurse, the more milk you produce. Access to uncontaminated water is a tenuous matter when a natural disaster strikes. Shelters may not have hygienic areas for safe infant formula preparation or washing of breast pump parts. No special apparatus or feeding utensils are needed to nurse at the breast.
Shelters and temporary refuges may not have private areas to feed babies. For some this is no issue, but for many it can cause added anxiety. Being forced to breastfeed in a crowd of strangers or among family or friends who are uncomfortable with breastfeeding can be stressful. When a mother is tense, ability to letdown can be negatively affected. This can be especially traumatic if the mother if separated from her usual breastfeeding support person (such as a partner or relative). Solutions include creating separating partitions for privacy or facing yourself and baby away from others so your baby can nurse without distraction and commotion.
“[I]n times of crisis, large donations of infant formula, teats, and feeding bottles are often received from many sources. Although the intentions are generally good, there is a lack of awareness that such donations can do more harm than good, as the basic infrastructure, and utensils may be inadequate to reduce the risks associated with the preparation of infant formula and other breast milk substitutes.When a crisis site has contaminated water, this means that the donations of infant formula do more harm than good and increase infant mortality and morbidity, as the uncontrolled distribution of infant formula exacerbates the risk of diarrhea among infants and young children in emergencies.Therefore, these donations should be avoided. Apart from that, the unregulated distribution of breast milk substitutes […] which include powdered milk provided in food rations, may reduce women’s efforts to breastfeed, andthey may subsequently stop breastfeeding.”
Learning the art of hand expression is an invaluable gift. If you get separated from your baby (for days or even hours), you’ll thank your lucky stars for this skill. Hand expression can help maintain your supply by triggering your breasts to continue making milk. Also remember your electricity may go out, leaving your pump without a working plug to power up. And your water may shut off or your area may be under boil notice, leaving you without a safe rinsing method for pump apparatus. Learn how to hand express here.
Infants of any age can learn to drink milk from a cup. In most cases there is no need to require a bottle to feed a baby when s/he’s separated from the mother. Learn how to cup feed here.
Breastfeeding can be negatively impacted even by a short-term hiatus. Transportation issues, (non-vital) formula supplementing, relocation, unexpected circumstances, separation of mother and baby, and other unusual events can disrupt the supply/demand process of sustainable breastfeeding. This is why continuing to empty breasts of milk is crucial if you become separated from your baby; doing so helps maintain production so supply is available when you’re reunited.
Consider wet nursing as a feeding option instead of artificial milks. A healthy wet nurse is recommended by WHO as the preferred method of infant feeding above commercial formula. Regardless who produces it, all breast milk contains antibodies that help protect babies from disease and illness such as diarrhea. These antibodies and other living antibacterial/antiviral components are not found in formula. According to USBC, nearly 95% of infant deaths in emergencies are attributed to cases of diarrhea and unsanitary conditions. Infant respiratory infections are also a concern, especially with limited access to medical services.
An infant or older child may increase nursing frequency during times of crisis. This is totally normal. Breastfeeding is nature’s intended pacifier during times of unexpected change and threat to security. Simply continue to respond to this need for extra comfort; it is just a phase. Comfort nursing is purposeful and important.
Learn about the possibility of relactation (if it applies to you). Learn about relactation here. According to La Leche League International:
“If a mother has not just recently given birth, but it is up to six months after birth she can relactate (produce milk again even if she never nursed her baby before) by putting the baby to the breast, or expressing the breast, every two hours. Initially she may be producing only drops per day.
In general, the more milk that is removed from a mother’s breasts one day, the more she will make the next day. Individual women have different experiences with how long the process takes. With younger babies, the milk supply increases more quickly. However, there have been reports of older babies and toddlers who have also returned to nursing. The only way to find out how much milk you will make is to try it.”
Prepare for natural disasters and emergency situations by learning how other breastfeeding families handled them. Here is a story that took place during Hurricane Katrina, in a strange place, here is a medical emergency, and a car accident.
Do you have breast milk in the freezer? Here’s what to do if the power goes out.
**How You Can Help Harvey Flood Victims Who Need To Breastfeed**
Donate milk and breastfeeding supplies. Reach out to your local birth centers, hospitals, midwives, and shelters to inquire about specific needs. Human Milk 4 Human Babies, North Houston Milk Sharing (Facebook group), and Eats 4 Feets are good places to connect with nursing dyads in Harvey-affected areas who need donor breast milk.
Items needed at donation centers may include:
- Pump parts
- Storage bottles, bottles with nipples
- Travel coolers
- Ice packs
- Cleaning supplies such as bottle brushes and wipes
- Disposable breast pads
- Nipple cream/balm
- Comfortable nursing bras
- Supplemental nursing system
- Breastfeeding pillows
- Babywearing wraps/carriers (keeping babies off floors with debris/glass/water is important)
- Postpartum hygiene items for a new mother
- Water and food for nursing mothers
Items that must be distributed with discretion and awareness:
- Formula samples
- Herbal supplements/galactogogues
If you have special lactation training, please offer lactation assistance in shelters! The more expert hands on deck, the better! The normal support networks will be limited to new mothers during times of crisis. Breastfeeding education classes and support meetings may be canceled or postponed across the city, and restricted travel will inhibit mothers from being able to seek in-person help.
New mothers may need extra reassurance about myths which should be dispelled (that underfed mothers cannot produce sufficient milk, stressful situations will make breastfeeding impossible or spoil breast milk, formula is more practical, newborns can’t drink from cups, etc).
Shelter volunteers also need education from experts about the needs of breastfeeding dyads and the importance of on-demand breastfeeding and skin-to-skin contact to protect babies from illness.
If a breastfeeding evacuee is staying with you, be sensitive and attentive. Offer the mother water so she stays hydrated. Set her up with a comfortable “nursing nest” (preferably with comfortable seating and dim lighting near a power source). They likely won’t need much, but do encourage her to speak up if any needs arise.
If you need lactation assistance, try these hotlines:
- La Leche League International – 877-4-LALECHE (452-5324)
- La Leche League of Kingwood – 832-786-0262
- Kingwood Breastfeeding Hotline – 281-348-8342
- Texas Breastfeeding Hotline – 855-550-6667
- Black Mothers’ Breastfeeding Association – 1-800-313-6141
- Nicole Hoff in Spring, TX – 956-245-1787 (or fill out this link)
“During emergencies, our 877-4-LALECHE (452-5324) phone line may be overwhelmed with calls, so using our Web site may be the quickest way to find breastfeeding help. If you need to call 877-4-LALECHE and want to find a Leader in the US, try using our automated system that gives the names and phone numbers of US Leaders using postal ZIP codes. Any Leader can answer questions. She does not have to be from the ZIP code entered. Leaders living in areas affected by emergencies may not be able to take phone calls.”
- Breastfeeding and Emergencies
- Breastfeeding During Emergencies
- Breastfeeding For Survival
- Breastfeeding in Emergencies
- Breastfeeding in Times of Chaos
- Child and adolescent health and development, documents on emergencies
- Disaster/emergency/crisis nursing (stories)
- Disaster Preparedness: Breastfeeding Matters During an Emergency
- Infant Feeding During Disasters
- Infant Feeding in Emergencies (IFE) Core Group
- Infant Feeding Support in Disasters: United States (Facebook page)
- Infant Nutrition During a Disaster: Breastfeeding and Other Options
- Resources for Breastfeeding During Emergencies
- Water Safety Guidelines