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Subject:
From:
Susan Burger <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Mon, 30 Jan 2006 14:15:43 -0500
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I happen to beg to differ with the opinion that relactation is NOT possible during emergency 
conditions.  UNICEF has developed some pretty clear guidelines for the steps necessary to 
determine which mothers to encourage and which steps to take.  All one has to do was take a look 
at one of the new photos of a forlorn mother in New Orleans with a 3 day old baby (my colleague 
did the math to figure out how old the baby was from the article) with a nasty dirty bottle of 
formula to know that it is a no brainer to tell that mother to just keep putting her baby to the 
breast.  That is quite different from the steps that one would take to relactate a mother of a six 
month old.  That is not going to work during the initial phases of an emergency and anyone who 
has read any of the materials on management of infant feeding would realize that that is not what 
is proporsed.

Moreover it is quite important to encourage CUP FEEDING under these circumstances rather than 
bottle feeding.  You can clean out a cup much better than a bottle.

Anyone involved in developing guidelines for emergency feeding protocols should first go to the 
protocols that have already been published for developing countries and ADAPT these for use in 
developed countries.  Quite frankly the conditions in New Orleans are really not that dissimilar 
from emergency conditions elsewhere.  There is a track record.  There are people who have done 
the work on relactation and documents published by UNICEF and WHO and I'm sure La Leche 
League has good documents as well.  There is a sensible approach including one flow diagram 
that I picked up that shows the decision points for choosing feeding methods.  Of course, the 
protocols can be fine tuned and improved upon as with anything in life.

If I were stuck in some stadium with no clean water I would have no hesitation going up to that 
mom of the three day old and saying something along the lines of what Paula Meier's does with 
her moms of premies - that this is life or death situation and if she hates breastfeeding she can 
stop the instant she gets to someplace where the water is safe.

As for the pictures of the premie babies in the box, if I really could not have convinced the 
emergencies workers to not separate mom and baby - I would have at least made one of the 
emergency workers strip off his shirt and wrapped as many babies as possible around his body to 
keep them warm.

Best regards, Susan Burger
 

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