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Bartick M, Zimmerman DR, Sulaiman Z, Taweel AE, AlHreasy F, Barska L, Fadieieva A, Massry S, Dahlquist N, Mansovsky M, Gribble K. Academy of Breastfeeding Medicine Position Statement: Breastfeeding in Emergencies. Breastfeed Med 2024; 19:666-682. [PMID: 39264309 DOI: 10.1089/bfm.2024.84219.bess] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/13/2024]
Abstract
Background: During emergencies, including natural disasters and armed conflict, breastfeeding is critically important. Breastfeeding provides reliable nutrition and protection against infectious diseases, without the need for clean water, feeding implements, electricity, or external supplies. Key Information: Protection, promotion, and support of breastfeeding should be an integral part of all emergency preparedness plans. Breastfeeding specialists should be part of plan development. Emergency protocols should include breastfeeding specialists among emergency relief personnel, provide culturally sensitive environments for breastfeeding, and prioritize caregivers of infants in food/water distribution. Emergency relief personnel should be aware that dehydration and missed feedings can impact milk production, but stress alone does not. Emergency support should focus on keeping mothers and infants together and providing private and/or protected spaces for mothers to breastfeed or express milk. Emergency support should also focus on rapidly identifying mothers with breastfeeding difficulties and breastfeeding mothers and infants who are separated, so their needs can be prioritized. Breastfeeding support should be available to all women experiencing difficulties, including those needing reassurance. Nonbreastfed infants should be identified as a priority group requiring support. Relactation, wet-nursing, and donor milk should be considered for nonbreastfed infants. No donations of commercial milk formula (CMF), feeding bottles or teats, or breast pumps should be accepted in emergencies. The distribution of CMF must be highly controlled, provided only when infants cannot be breastfed and accompanied by a comprehensive package of support. Recommendations: Protecting, promoting, and supporting breastfeeding should be included in all emergency preparedness planning and in training of personnel.
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Affiliation(s)
- Melissa Bartick
- Department of Medicine, Mount Auburn Hospital, Cambridge, Massachusetts, USA
- Department of Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | - Deena R Zimmerman
- Maternal Child and Adolescent Department, Public Health Division, Ministry of Health, Jerusalem, Israel
| | - Zaharah Sulaiman
- School of Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia
| | - Amal El Taweel
- Egyptian Lactation Consultants Association, Cairo, Egypt
| | - Fouzia AlHreasy
- General Administration of Nutrition, Therapeutic Services Deputyship, Ministry of Health, Riyadh, Saudi Arabia
| | - Lina Barska
- Pershyi HVfriendly, Ukrainian Academy of Breastfeeding Medicine, Kharkiv, Ukraine
| | - Anastasiia Fadieieva
- Pershyi HVfriendly, Ukrainian Academy of Breastfeeding Medicine, Kharkiv, Ukraine
| | - Sandra Massry
- Asociación de Consultores Certificados de Lactancia Materna (ACCLAM), Mexico City, Mexico
| | - Nan Dahlquist
- Hillsboro Pediatric Clinic, LLC, Westside Breastfeeding Center, Retired, Hillsborough, Oregon, USA
| | | | - Karleen Gribble
- School of Nursing and Midwifery, Western Sydney University, Parramatta, Australia
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Sanghvi TG, Godha D, Frongillo EA. Inequalities in large-scale breastfeeding programmes in Bangladesh, Burkina Faso and Vietnam. MATERNAL & CHILD NUTRITION 2024:e13687. [PMID: 39020511 DOI: 10.1111/mcn.13687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Revised: 05/21/2024] [Accepted: 05/29/2024] [Indexed: 07/19/2024]
Abstract
Inequalities in breastfeeding programmes and practices have slowed global progress in providing the life-saving protection of breastfeeding for millions of infants despite well-known life-long impacts. As breastfeeding interventions are scaled up, inequalities in coverage and breastfeeding practices should be tracked, particularly in disadvantaged groups, who are likely to suffer the most serious health and developmental impacts of poor childhood nutrition. The literature provides evidence of inequalities in breastfeeding practices, but research is limited on socioeconomic disparities in the coverage of breastfeeding interventions. This paper (1) compares inequalities in breastfeeding practices in intervention and nonintervention areas and (2) documents inequalities in programme coverage by type of intervention. We disaggregated endline evaluation surveys in Bangladesh, Burkina Faso and Vietnam, where rigorous evaluations had documented significant overall improvements, and analysed whether inequalities in breastfeeding practices and programme coverage differed by treatment areas. We used Erreygers index to quantify inequalities and found that breastfeeding practices were largely pro-poor; intervention coverage was not consistently pro-poor. While counselling coverage often favoured women from the poorest quintile, public education/media coverage consistently favoured better-off women. Inequalities favoured more educated mothers in the coverage of combined interventions. None of the programmes had explicit equality objectives. The results indicate the need for introducing specific actions to reduce inequalities in breastfeeding policies and programmes. This is a priority unfinished agenda for nutrition programming.
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Affiliation(s)
- Tina G Sanghvi
- Alive & Thrive initiative, FHI 360, Family Health International, Washington DC and Durham, North Carolina, USA
| | - Deepali Godha
- Consultant FHI 360, 406 Ghanshyam Castle, Khajrana Square, Indore, Madhya Pradesh, India
| | - Edward A Frongillo
- Department of Health Promotion, Education, and Behaviour, University of South Carolina, Columbia, South Carolina, USA
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Chetwynd E. Resiliency in Breastfeeding and Lactation Research: A Conversation About Scholastic Transparency, Bias, and Systems of Support. J Hum Lact 2024; 40:7-9. [PMID: 38078440 DOI: 10.1177/08903344231218280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2024]
Affiliation(s)
- Ellen Chetwynd
- Department of Family Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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