Szoptatás katasztrófahelyzetben

Az UNICEF információs levele arról, miért szükséges az anyatejes táplálás fenntartása és segítése katasztrófa sújtotta területeken.

Részlet a levélből:

ll. INFANT AND YOUNG CHILD FEEDING IN EMERGENCY SETTINGS:

–UNICEF has a Core Corporate Commitment in the first 6-8 weeks of an emergency
to “Provide child and maternal feeding and nutritional monitoring: support infant and young child feeding, therapeutic and supplementary feeding programmes with WFP and NGO partners. Introduce nutritional monitoring and surveillance.” These activities should continue after 8 weeks as well.
As the lead UN Children’s Agency, this area remains UNICEF responsibility no matter
which agency is the lead.

Suggested actions:

A. Immediate attention must be given to the protection and support for breastfeeding,
especially exclusive breastfeeding.

1. This includes:

a. Support: immediate establishment of “safe havens”, or safe spaces, where stress is reduced,counselling provided, and appropriate rations and water can be assured for pregnant and lactating women. Also, ensure that pregnant women have access to iron/folate supplementation and iodized salt (or supplements).

b. Protection: follow guidance to stop acceptance in emergencies of powdered milks or other breastmilk substitutes. Donations of powder milk carry special concerns. Given poor infrastructure and living conditions in emergencies, and in other settings in need, all necessary measures must be taken to ensure the safe use of any donation. Lack of potable water, lactoseintolerance,and bacterial growth that occurs in powdered milks or formulas may result in increased risk of diarrhoeal disease and increased risk of fatalities amongst children.

c. Lactation maintenance and relactation support: skilled workers should be made available to ensure support, protection and relactation. “Supplementer” devices should be provided that allow supplementation during suckling.

2. Concerning donations of breastmilk substitutes
a. Donations of powder milk carry special concerns. There are at least 4 reasons that powdered milks and formulas remain dangerous in emergencies, even with trained staff:

• i. In populations with lactase-deficiency (most developing country settings), a sudden increase in milk as a percentage of intake can cause diarrhea in infants, children and adults.
• ii. Milk powders and prepared milks can serve as growth media for bacteria. Where storage is not optimal, there can be rapid increases in contamination of all sorts.
• iii. Where there is no guarantee of potable water for mixing or cleaning, or sterile water for younger infants, formula preparation and feeding cannot be carried out safely.
• iv. If powdered milks or formula are used to replace or substitute for breastmilk, the child loses protection against disease that is gained from breastfeeding, and the family becomes dependent on artificial feeding, with all its costs and risks.

b. Donations of breastmilk substitutes, infant formula, bottles and teats should be refused.
c. Dried skimmed milk should not be given as a single commodity or as part of a general food distribution, because of the risk that it will be used as breastmilk substitutes.
d. Ensure that there are available rations that may be used for complementary feeding for breastfed children 6 months to 2 years. These rations may include milks mixed with a milled staple food.
e. Every effort should be made to place unaccompanied young children with family or foster care.
f. Infant formula should be used only under strict conditions, when:

• i. Lactation status of mother has been assessed, in the case where relactation is not possible
• ii. An HIV-positive mother has chosen not to breastfeed.
• iii. Children no longer have access to breastmilk, e.g. orphaned children, unaccompanied children, etc, and where there is assurance of supply of infant formula or as long as the infant needs it.
• iv. Infant formula can be provided under close supervision, monitoring, and follow up by trained health staff, and mothers/caretakers are provided with adequate information and counseling on safe preparation of infant formula and appropriate infant feeding practices.

A teljes dokumentum letölthető a www.usbreastfeeding.org oldalról .pdf formátumban.