Dear Molly and lactnet colleagues: Thank goodness that
an interested person, you husband, Molly, will be at
the scene and watching out for breastfeeding.
While I am no expert in emergencies and relactation, I
would think that triaging BF mothers would be the
first thing:
Nursing mothers get food and fluids. If there is
formula being passed around mom gets it (without a
nipple)not the baby....and she needs to understand
that she needs extra fluid and nutrition.
Nursing moms with problems: stabalize mother, food and
fluids, correct BF problem like cracked nipples, poor
supply, impaired MER. Formula for her too, if if will
get more calories and fluid into her.
Non-nursing moms 1-2 weeks post partum. They might be
engorged, leaking what ever. They get help learning
how to latch, evaluate the nursing and count diapers.
Oh yes, formula for them too...their babies ????
Same for 2-4 weeks post partum dyads but might need
more formula for babies.
Personally, I don't know how easy and successful
relactation would be in this dire emergency without
strong committment from the medical team and peole who
know how to supervise BF. I say this because speedy
recovery, with a return to weight gain will be on the
minds of many.
The old relactation articles I have read, describing
techniques in refugee settlements, in Pakistan,
Unganda, and Cambodia, the phiopsophy seemed "as long
as the baby does not lose weight" we will keep BF. I
am not sure that is the attitude that would be found
today. Dyads were in camps, and were not going
anywhere so supervision was available. The mothres
were fed high protein foods, and babies rehydrated and
put to breast.
I would like to ask Molly's husband to look for effect
of shock (physical and mental) on MER, and maternal
dehydration on the milk supply. The women who were
waiting for rescuse, were probably adequately
nourished and hydrated until 2-3 days after the
disaster...in what way does the sudden, intense
deprivation impact the mother's supply?
It would be gimportant if successful relactation
anecdotes could be recoderd so we could publicize them
and learn from them ourselves.
Again, I agree with Janette's post that if we are
really sincere about relactation efforts, we need to
start educating ourselves about the topic and
implimentation. We need to contact and engage the
emergency managers (and they might have a different
attitude in the US after this), now and groups like
ILCA. We need to do our homework and be able to
present a cogent plan for implemetation, etc.
Emergency training for LCs is necessary, too.
We might also want to think about mass donation of
human milk in times of emergency. What do the milk
bank people think about this?
Anne Andrianos
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