Disaster Preparedness

Disasters such as the COVID-19 pandemic, hurricanes, resource hoarding, and the infant formula shortage have had a devastating impact on breastfeeding. Learn how communities are preparing for and managing both the expected and unexpected.

CDC’s Infant and Young Child Feeding in Emergencies (IYCF-E) Toolkit

Erica Anstey, PhD, MA, CLC & Lauren O’Connor, MPH, CLC – Centers for Disease Control and Prevention

TRACKS: Disaster Preparedness; Southeast

Natural disasters such as hurricanes, floods, wildfires, earthquakes, and tornados, can make it difficult for parents or caregivers to feed their infants and young children safely and appropriately. CDC’s Division of Nutrition, Physical Activity, and Obesity (DNPAO) recently published an Infant and Young Child Feeding in Emergencies (IYCF-E) Toolkit, which provides information and resources for emergency preparedness and response personnel, families, and the public to ensure that children are fed safely when disaster strikes.

Addressing IYCF-E includes the promotion and prioritization of safe and appropriate feeding for infants and young children (0-2 years of age) during a natural disaster or other emergency. Effective IYCF-E planning and guidance considers the specific needs of infants and young children with the goal of protecting and maximizing the nutrition, health, and development of the child.

Learning Objectives:

Explain the risks associated with infant and young child feeding in emergencies.
Describe the purpose of CDC’s Infant and Young Child Feeding in Emergencies (IYCF-E) Toolkit and the resources included.

Providing Breastfeeding/Postpartum Support for Black Sickle Cell Birthing Persons in Disaster Preparedness and Response

Adrian Jones – UW Health/March for Moms

TRACKS: Disaster Preparedness; Midwest

Being pregnant with sickle cell can come with a host of potential complications for both mom and baby. For a mom, that can include premature labor, poor blood circulation to the placenta, pre-eclampsia, gestational diabetes, acute pain crisis and leg ulcers. The subsequent impact to the baby can include low birth weight, developmental delays, chronic conditions, and being born of below average length. (Jain, 2019). Care for sickle cell patients has made significant progress over the years to increase life expectancy and improve quality of life. More readily available vaccinations, antibiotics and the most prescribed prescription drug, Hydroxyurea. Hydroxyurea increases the amount of fetal hemoglobin in the body. The more fetal hemoglobin there is, the greater the capacity to produce healthier red blood cells to carry oxygen throughout the body. Thus, reducing the number of pain crises. (Jain, 2019)

While medical advancements continue to expand, these advancements can impact a postpartum sickle cell mom’s opportunity to breastfeed. With very limited studies that explore the interaction between hydroxyurea and breastmilk, there is a 1987 case report that discusses the likelihood of transmission of hydroxyurea into breastmilk. The study enrolled 16 lactating moms. Hydroxyurea was detected in the breast milk of 11 women within 1-2 hours after taking the medication. The concentration became smaller after 12 hours and nonexistent after 24 hours. Despite rates of transmission to babies via breastfeeding being somewhat low in quantity, it is advised that moms with sickle cell wait at least three hours after taking the medication to breastfeed and/ or pump. (Ware E. R. & Dong, 2020). Black postpartum sickle cell moms should not be deterred from breastfeeding, but made aware of the proposed waiting period for breastfeeding and pumping

Learning Objectives:

Describe a comprehensive approach to developing postpartum support for sickle cell birthing patients with lactation utilizing a disaster preparedness and response model.
Identify multi-sector partners in the public health system and community to address breastfeeding disparities for this patient population.

Navigating Category 4s during Covid: Lessons learned about infant feeding during emergencies from in Louisiana from Hurricanes Laura & Ida

Tyra Gross, PhD, MPH & Malaika Ludman – Birthmark Doulas

TRACKS: Disaster Preparedness, Data, Research and Storytelling, Community-based Doulas; Southwest

Breastfeeding is the safest infant feeding option during emergencies, according to the World Health Organization (WHO), Centers for Disease Control & Prevention (CDC), and other health authorities. Since the onset of the COVID-19 pandemic, Louisiana has experienced two Category 4 hurricanes. Hurricane Laura struck Southwest Louisiana on August 27, 2020 and Hurricane Ida struck Southeast Louisiana a year later on August 26, 2021. The New Orleans Breastfeeding Center (NOBC) mounted an emergency response to support pregnant and parenting people with children under 2 years affected by these storms as part of their Infant Ready emergency preparedness program. During Hurricane Laura, doulas and other staff did infant feeding assessments at an evacuee resource center. This also included mounting a free 24-hour perinatal emergency hotline in the wake of the storm. Callers were also supported through follow-up texts. For Hurricane Ida, NOBC partnered with Mom2Mom to train them to staff the perinatal hotline while NOBC staff and their families sheltered in place or evacuated to safety. Since Louisiana has some of the lowest breastfeeding rates in the United States, efforts to improve breastfeeding can promote resilience for future emergencies. NOBC received a pilot grant in partnership with Xavier University of Louisiana to research infant and young child feeding during emergencies in a low-breastfeeding population in Louisiana. To date, we have analyzed field notes from almost 100 hotline calls, analyzed 70+ infant feeding assessments from Hurricane Laura, and conducted interviews with families, birth workers and local stakeholders about their experiences navigating these storms. Experiencing a severe natural disaster during a pandemic compounded stress for mothers and their families. Most had to put COVID-19 pandemic concerns on the backburner as they tended to more pressing issues such as lack of food, water, utilities and property damage. Infant feeding assessments revealed a low rate of breastfeeding. Formula was the number one supply requested through the hotline for both disasters. Callers faced breastfeeding challenges such as mastitis, nipple pain and latching issues, plugged ducts, relactation, combination feeding, and weaning. Given the increasing frequency and intensity of natural disasters due to climate change, we are confident our project provides important lessons on IYCFE for communities beyond Louisiana.

Learning Objectives:

Review the current research on infant and young child feeding in emergencies (IYCFE)
Identify family-centered supports needed to respond to populations with low breastfeeding rates in an emergency
Describe Birthmark Doula Collective’s Infant Ready emergency preparedness program

Building an Infrastructure for Infant Nutrition Security

Amelia Psmythe Seger – U.S. Breastfeeding Committee (USBC)

TRACKS: Disaster Preparedness; National

The global pandemic of COVID-19 tested every system from public health response and supply chains to individual family and community resilience. The United States lacks a comprehensive infrastructure for infant and young child feeding in emergencies and, consequently, was unprepared for the immediate stresses at every level of the system. The historic infant formula shortage in 2022 further demonstrates the need to build an infrastructure for infant nutrition security. This session highlights the Four Pillars of Infant Nutrition Security: Parents, Programs, Policies, and a Plan for emergencies and describes the work every organization must prioritize in each of these realms, in order to collectively build the resiliency to support a community during a flood, a region during a power outage, or a nation during a pandemic or supply chain crisis. Together we must build a system worthy of parent’s trust.

Learning Objectives:

Explain infant nutrition security in a holistic way that includes all parents and all feeding methods
Describe the role of policy in impacting the lived experiences in communities
Name the three stages of emergency planning for infant and young child feeding and provide examples of activities to support each planning stage