Why Formula Shouldn’t Be Donated During Times Of Crisis

During emergency situations, it’s natural for aid agencies to want to help those people affected, especially the most vulnerable, such as babies, by donating various supplies.

It’s therefore conceivable why some aid agencies think that donating formula is a helpful thing to do during emergency situations.

Unfortunately, donations of infant formula during times of crisis can actually be very harmful, as this article will explain.

Why Formula Donations Aren’t Appropriate In Times Of Crisis

There are three important reasons why donations of formula shouldn’t be sent during times of crisis:

#1: Donations Don’t Guarantee Formula Gets To Where It’s Needed

Experience from past disasters has shown that formula donations delivered to emergency areas are typically distributed in a disorganised way. This means there is no way of ensuring that the formula reaches only those who need it, and know how to use it.

Formula donation can also result in an epidemic of diarrhoea, since the lack of soap, potable water (safe for drinking) and fuel causes hygiene difficulties for formula feeding. Without access to adequate medical care, this could result in many deaths.

Targeted aid to all babies is what’s required. This includes discovering which babies can and cannot be breastfed.

It is necessary to identify babies who are being mixed fed, and to support their mothers so they can bring their babies back to full breastfeeding if they choose to do so.

For babies who are not breastfed, targeted aid can establish whether there are options for having them breastfed (e.g. through relactation or wet nursing).

For babies who have no chance of breastfeeding (e.g. mother/caregiver does not wish to relactate, and no wet nurse is available), then formula feeding is supported. In such situations, targeted aid can ensure caregivers are given formula, all of the necessary resources to use it, education about how to formula feed, and health monitoring, so that the babies can be fed with the highest possible degree of safety.

#2: Formula Donations Come Without Necessary Resources

Donations of formula are often distributed without necessary resources, such as cups, soap, water, and fuel to heat the water. Targeted distribution identifies families who will need formula supplies for what could be weeks or months, whereas random distribution cannot ensure that a formula fed baby continues to receive the appropriate amounts of formula.

Ready to use infant formula does not have the same contamination risks as powdered formula but it still increases the risk of diarrhoea and respiratory tract infections, when compared with exclusive breastfeeding (and that risk is much higher in emergency circumstances).

#3: Risk Of Breastfed Babies Being Fed Formula

In large scale catastrophic emergencies, babies who don’t have access to breastmilk are in grave danger. In such situations, it’s a priority to ensure that as many babies as possible are exclusively breastfed, as this gives them their best chance of survival.  Unfortunately, donations increase rates of formula feeding. Increased rates of formula feeding in emergency situations increase the risk of significant illness and death.

Despite this, previous experience from crises has shown that breastfeeding mothers who are given donations of infant formula in an emergency will commonly feed this formula to their babies. In addition, breastfeeding mothers will often request supplies of infant formula from aid organisations. There are many reasons for this. One common reason is that women believe their stress or lack of food might prevent them from making enough milk, even though research indicates that stress does not affect breastmilk supply or quality. The milk−making system is indeed very robust.

If a breastfeeding mother starts using formula, it not only increases the risk of her reducing or ceasing breastfeeding but it also creates a problem when the donated formula runs out. Can she afford to continue formula feeding when the donations run out? If a family cannot afford to buy formula, this increases the risk of formula being watered down, or of a substitute like diluted cow’s milk being used; this can cause serious health problems.

Exclusive breastfeeding is the safest way to feed babies in emergency situations. It helps protect babies against infections, which are more common in such situations. Donations of formula are not helpful and can be very harmful. Targeted aid, to establish babies’ needs, is the safest way to provide formula to those babies who need it.

You might be interested in watching this UNICEF documentary about formula donations in an emergency situation.

What Can I Do To Help Instead?

In disaster situations, people often want to know what they can do to help. Donating money to organisations that support mothers and babies through Infant Feeding in Emergencies (IFE) training helps support breastfed and formula fed babies. These agencies will support those who are able to breastfeed and return to breastfeeding. They will:

• buy and distribute formula that is labelled in the appropriate language
• also supply water, fuel and cups, to improve safety
• ensure families needing formula are identified, and will continue to be supported with appropriate amounts of formula

This sort of clear information can dispel some ideas about shaming, guilt, and helplessness.

For more information about infant feeding in emergency situations refer to Dr Karleen Gribble and Dr Nina Berry’s article, Emergency preparedness for those who care for infants in developed country contexts.

Special thanks to Yolanda Forster for her assistance with this article.