When and how to give formula to the developing world

Every new disaster in the developing world seems to bring e-mails to my inbox with appeals for donations, and every time one lists "infant formula" that I cringe, and ponder whether or not I should try to start a dialogue around the dangers of those donations and importance of providing them correctly.

Via the Motherwear Breastfeeding Blog, here's an example of when and how to offer infant formula appropriately: in a setting of acute medical need, under medical supervision, prepared safely and accurately by professionals, and - so importantly - in a way that is supportive of breastfeeding:

Helping Hospitals Treat Malnutrition in D.R. Congo from Action Against Hunger USA on Vimeo.

Watching the baby's eyes light up as it nursed away using the improvised supplemental nursing system reminded me so much of babies I've worked with in the hospital. We sometimes need to provide a supplement for babies who have lost more than 10% of birth weight. Often this is because the mom's milk is delayed coming in for some reason - very long labor and/or long pushing stage, or a lot of postpartum blood loss. Of course, taking the baby off the breast and giving the supplement by bottle has the potential to confuse the baby, demoralize the mom, and creates extra work for her having to pump to continue stimulating her breasts in order to get the milk in ASAP. We always prefer to use an SNS, assuming the baby is latching and nursing well - just put the baby to breast, get the suck going and then slide the tube in the corner of the mouth.

When you start the SNS you just see the babies' eyes fly open as they nurse away hungrily thinking "Hey! This is new!" A day or two of SNSing, and with all this continued stimulation mom's milk comes in, we pull the tube, and they're good to go. It feeds the baby while keeping everyone - baby and parents - breast-focused, and protects the milk supply. It's so neat to see it used half a world away for not-dissimilar purposes.

Infant feeding and disaster relief

Like everyone else, I've been reading/listening/watching the news reports from Haiti and it is just heart-wrenching to see so much need and be able to do so little. The impulse, of course, is to do something, not just donate - but the message seems to be getting through that what Haitians need right now is MONEY, given directly to the aid agencies that are on the ground. (Or as one story I saw put it, "Nobody needs your old shoes." At the very least, they might not mind your old shoes if you could teleport them there, but nobody wants to collect, sort, pack, ship, and distribute your old shoes when for a fraction of the time and the money they could just buy shoes and hand them out.)

With that in mind, Elita at Blacktating talks about how to help Haiti - especially why NOT to take part in any efforts that donate infant formula. While there may be some babies in Haiti who need infant formula, that should be provided in a systematic way by relief organizations that follow protocols around infant nutrition and help ensure that formula goes only to infants who truly cannot survive otherwise - not to breastfeeding infants who will be placed at greater risk.

The Emergency Nutrition Network has information about the dangers of infant formula provision in emergencies, and a list of Core Group members who are collaborating to improve infant and young child nutrition emergency response. From that list, I'm contributing to CARE, an organization which was already in Haiti at the time of the earthquake and is working to deliver immediate and long-term relief. I'm also contributing to Partners in Health, which was founded to target health problems in Haiti and has deep roots there (and yes, because I read "Mountains Beyond Mountains" and, like every public health student I know, idolize Paul Farmer/Partners in Health).

Thinking of all the people in Haiti and wishing fervently for the international outpouring of aid to make a difference for them.