PREVENTING AND MANAGING
INAPPROPRIATE DONATIONSBREASTMILK SUBSTITUTES AND OTHER PROHIBITED PRODUCTS
A guide for emergency relief staff, donors, and governments

During emergencies:
Do not solicit, donate, accept, or distribute donations of breastmilk substitutes (BMS) and other products*!

*Prohibited donations

What’s the risk?
Donated products are often:

Donations and uncontrolled distributions of
the following products put infants at risk:• In violation of the WHO Code.
• Unsafe (expired, the wrong type, unreliable quality etc.).
• Excessive in quantity.
• Labelled in the wrong language.
• Not supplied in a reliable manner.
• Not possible to hygienically use in an emergency context.
• Used by breastfeeding mothers, disrupting their milk supply.
• Lacking the instructions, supplies and support that caregivers offormula dependent infants need to feed safely.

• Breastmilk substitutes, including infant
formula, follow-on formula and growing-up milk.
• Other milk products, e.g. dried or liquid cow’s
milk, soya milk, evaporated or condensed milk,fermented milk or yoghurt.
• Baby teas, juices and waters marketed as
suitable for infants under six months.
• Bottles, teats, breast pumps.
• Any commercial complementary foodmarketed for use for infants under six months.

!

1

Donations and uncontrolled distributions directly decreasebreastfeeding, increase formula feeding, malnutrition, illness and death.

Prevent donations
Do you know your role?

X Never call for donations of these products.

Be aware of relevant policies.

Report any calls for, offers of or actual donations (including online media) to the designated authority.
Food security sector

Government, health and nutrition cluster coordinators and partners• Endorse and disseminate a policy clearly stating that donations will not be accepted.
• Ensure Violation/Donation Alert and Monitoring System is in place.
• Repeatedly sensitise key actors, including other sectors and potential donors, on the dangers of donations and blanket distributions.
• Systematically share information, including reports of violations, for action (e.g. enforcement) at a national level and global level (e.g. NetCode).
• Establish a Donation Prevention and Management Taskforce.
• Develop and widely disseminate a joint statement to key stakeholders, including media, communications, logistics, donors and partner agencies.

Customs• Ensure rations include safe andappropriate complementary foods.
• Ensure food aid is compliant with
the WHO Code and that prohibited
products are never part of a blanket
distribution.

DonorsChild protection and social welfare sector

Army, logistics and camp management• Fund lifesaving services and supplies
e.g. nutritious food for mothers, skilled
breastfeeding support and appropriately
managed artificial feeding support services.

• Never include BMS in standard family kits.
• Coordinate with the nutrition sector to secure appropriate
infant feeding support for separated and orphaned children.

• Adopt policy on donations and distributions.
• Reject requests for procurement, storage,transportation and distribution of restricted products
without official approval.

• Put in place customs and importation
control measures to implement
government policy.
• Keep clear records and communicate
regularly on confiscated relief items(source, type, quantity).

Media• Do not call for donations of these products.
• Disseminate information that encourages
helpful aid and discourages harmful aid.

2Detect and manage unprevented donations
Donations can arrive early in an emergency. Preparedness is critical: it saves money, time and lives.

2. Intercept, transport and securely store

1. Detect and report• Activate a Violation/Donation Alert System (e.g. online reporting form).
• Sensitise all stakeholders on why and how to report donations,
uncontrolled distributions and other Code violations.
• Rapidly share incoming alerts with the IYCF-E Coordination Authority/Donation Prevention and Management Taskforce.

3. Sort and handle• Establish a Donation Management Plan to guide decision-making on
what to do with intercepted products.
• Secure resources to implement the plan, including funding, expertise, HR(including sorting and handling teams), storage facilities, transportationand equipment (e.g. for lifting/destruction).
• Handle donations according to the Donation Management Plan.

• Activate the Taskforce to handle incoming alerts.
• Assign a designated agency (ideally the Ministry of Health) to rapidly intercept
prohibited products.
• Implement security measures to ensure stored products are not stolen or re-used.

Donation Management PlanStart
Is the product considered adequate
complementary food?
Yes

Can the product be returned?

Product meets nutritional and safety standards
and does not undermine local food use.

No

Suitable BMS includes products that are
not nearing expiry, are the correct typeand meet quality standards.

Yes

It is important to cost whether the intervention can bejustified (e.g. consider cost of relabelling, distribution, costof additional supplies etc.)

Yes

NoYes

Can the intervention be justified and funded?

Is the product a BMS that issuitable for use?

NoNo

Yes

Consider reusing while abiding by nationalstandards and recommendations.

Is the product suitable for re-use?
Unsuitable products include feeding bottles, products thatare expired, the wrong type, do not meet Codex Alimentarius
standards etc.

Consider re-using suitable milk
PROCEED WITH CAUTION AND ENCOURAGE A DECISION-MAKINGPROCESS THAT IS SENSITIVE TO THE CONTEXTNo

ReturnDispose

Re-useReturn the product to thedonor at their expense.

Remove milk products from packaging before disposing of them.
Make bottles and teats useless e.g. through cutting off the top.

Suitable uses:• Use in preparation of bread, biscuits and cakes that can be distributed.
• Institutional nutrition support, e.g. for the elderly, orphans.
• Prepare a fortified blended food for use as complementary food for infants over six months.
• Use for school feeding programmes.
• Use in animal feed.
• Other acceptable local solutions that are in line with the OG-IFE.

!

Keep the media and public informed to prevent uninformed
journalists and politicians from sensationalising andpoliticising the storage and destruction of donations.

Part of the Infant Feeding in Emergencies Core Group infographic series.
Find out more at www.ennonline.net/ife