I see one big flaw in this, but not about the breastfeeding. The suggestion to offer offices, and hospitals as shelters is not practical in a large scale emergency, and may cause further stress on resources and systems. If every pediatrician office has a few clients sheltered in each, then the Red Cross, Baptist Feeding teams, Hearts with Hands, etc is not going to able to efficiently deliver food, and supplies to those many different locations. Delivering supplies over flooded, damaged roads, would create a strain on gas supplies, manpower, and law enforcement who sometimes has to act as escorts. The offices may not have access to showers, and toilets if water supplies are cut off. These offices will not be accessed with the Red Cross computer system so the shelterees may not be able to be found by their families and friends. Electricity and phones will probably be inaccessable unless the peds office uses a generator, which will further stress limited resources such as gasoline. The office also will need to have someone trained in proper use, refueling, etc of the generator. Resources such as FEMA, Emergency food stamps, emergency clothing, driver license and social security card replacements, etc will not be accessable as it would at a shelter (shelters may have resources and applications available on site). The offices also may not pass shelter building codes, or may be located in damaged areas. It is always a better use of resources to shelter large numbers of persons together. A better solution is for the AAP to work with local EMS planning to ensure that health staff at the shelters be trained in supporting breastfeeding, and family members be grouped together. At the shelter which I managed during hurricanes, we put families together, single men in a different hall and single women in another hall. Most shelterees appreciated this arrangement.

Barbara Whitehead, BS, IBCLC, RLC
eastern NC
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