INFANT FEEDING DURING

INFECTIOUS DISEASE OUTBREAKS
A guide for decision makers and programmers working in emergency preparedness and response

In every emergency – including infectious disease outbreaks – assess and act to protect the nutrition needs
and care of both breastfed and non-breastfed infants and young children

1

Anticipate and assess the impact of the outbreak on Infant and Young Child Feeding (IYCF)
Understand the impact of the outbreak and be aware of the risks for infants and young children
Inappropriate or conflicting advice
from healthcare providers/advisors onbreastfeeding and separationX

IYCF counselling
services are disrupted'X

Donations and uncontrolled
distributions of Breastmilk
Substitutes (BMS)X

Spread of rumours andunreliable information
about transmission

Disrupted accessto health care

To save lives, appropriate andtimely support of IYCF is critical

Increased risk ofmalnutrition, morbidity
and mortality in infants
and young children!

ing
giv esre cticraDe
cap cline
acityellbeing
rnal w
andetaoitnpourfm isIYC cain nd dFpaEnsure clear infant feeding
recommendations are in place.
Refer to IFE CG infographic
on Infant Feeding during
Infectious Disease Outbreaks
1: A guide for national healthauthorities, health and nutrition
policymakers, professionals

2

Take action to mitigate risks!

All outbreaks
All actors

Nutrition sector; Coordinate and collaborate
on multi-sector actions; Actively avoid any general
distributions and donationsof breastmilk substitutes,
other milk products, bottles
and teats; Protect, promote andsupport breastfeeding in thegeneral population; Identify infants who are notbreastfed and/or dependent
on BMS; Identify and act to address
guidance that conflicts withsafe practice

Health sector

Health sector; Provide guidance on appropriate IYCF
practices during illness and recovery; Engage in development of treatment
protocols and health communication tools,
including messaging on vaccination (ifapplicable); Strengthen IYCF counsellor
competencies - see box 1; Determine and disseminate diseasespecic Infection Prevention Control (IPC)
measures for infant feeding (e.g. mask,hand hygiene); Where face -to-face services aredisrupted: provide remote IYCF
counselling services; Integrate IYCF into casemanagement, vaccination
and risk communication
protocols; Train health workers onIYCF; Support maternal mental
health and psychosocial
wellbeing.
; Ensure adequate
workplace support forbreastfeeding healthworkers (e.g. expression
breaks, breastmilk
storage facilities)

Food security; To support treatment andrecovery: provide safe,
nutritionally adequate
complementary foods forchildren 6 months - 2 yearsof age and support maternal
nutrition

Child Protection; Prevent sharing of feeding utensils
in orphanages, where this is
identified as a transmission risk.
; Coordinate to ensure there isappropriate IYCF support inplace for maternal orphans (e.g.
small-scale artificial feedingprogramme)

WASH; Support hygiene and access tosafe water and cooking equipment/
facilities for caregivers of children
under two years of age.

Education; Provide Early Childhood
Development (ECD) interventions
for families with infants and young
children

Outbreaks with guidance to continue breastfeeding

Nutrition sector

BOX 1: IYCF counsellingcompetencies; Tackle rumours and unreliable information about breastfeeding
and promote how important breastfeeding is to infants; Support mothers who wish to restart breastfeeding in order toprotect their infant against infectious diseases; Make provisions for breastfed infants to stay withhospitalized mothers; Provide breastfeeding support to mothers who areincapacitated by severe illness

The following may be especiallyrelevant, in addition to generalbreastfeeding support:

Outbreaks with guidance to resort to temporary alternatives
Health sector•••••

Breastmilk expression
Increasing milk supplyRelactation
Rapid cessation of breastfeeding
Hygienic handling and storage ofbreastmilk and BMS• Safe handling and disposal of
infectious breastmilk (e.g. Ebola)• Responsive cup/spoon feeding• Feeding during illness andrecovery

Nutrition sector; Ensure that counsellors are trained onneeded compentencies - see box 1.
; Provide practical/logistical support forbreastmilk expression (both to provide
infant with breastmilk and/or to sustain
milk production during separation),storage and transportation; Provide emotional support and trauma
informed care for caregivers who arefeeding during illness, separated (ifnecessary) or temporarily stopping
breastfeeding (if required); Identify at risk mothers and infants forreferral to nutrition and health services

Mother’s expressedbreastmilk

Child Protection
Wet nursing

Donor human milk

(Breastfeeding by another woman)in line with OG-IFE* key conditions

Breastmilk substituteFed by cup/spoon!

Invest in adequate capacity to provide artificial feeding support at scale (e.g.
procurement, caregiver counselling and education, monitoring and follow-up,
access to health services, etc). For further guidance on BMS management inemergencies, refer to the IFE Core Group infographic on BMS support

Part of the Infant Feeding in Emergencies Core Group infographic
series. Find out more at www.ennonline.net/ife* Operational Guidance on Infant and Young Child Feeding in Emergencies

Education; Give priority ECD support toseparated infants and young
children; Support sensitive caregiving andattachment upon reunification