Deanne, what a tragic situation you describe for the orphaned babies in
Azerbaijan.

This is obviously a very special situation and, as far as Code requirements
pertain, I think that orphans fit that special category.  Certainly in
Zimbabwe the health authorities apply for, and receive, donations of formula
for orphans. Each case is carefully documented, a written application is
made for each baby and health staff handing out the formula are careful to
see that there is no "spillover" effect.  I know that ILCA people have also
been working on protocols for donations of formula in emergency situations
and perhaps you could obtain a copy of the document they drafted.

In the meantime, I wonder if anyone has thought of feeding the babies the
"home-made formula" described in the UNAIDS HIV and Infant Feeding
Guidelines: to make up 150 ml, mix and boil together 50 ml cow's or goat's
milk, 100 ml boiled water and 10g (2 teaspoons) sugar.  Babies fed in this
way should also receive "micronutrients" (a vitamin/iron preparation).  The
guidelines say that each baby would require 92 litres (500 ml per day) of
animal milk. Whilst I, personally, have difficulty believing that this
home-made formula is preferable to heated EBM for babies born to HIV+
mothers, it sounds like a better alternative than the yellow vegetable soups
that these orphaned babies are currently recieving.

What a tragedy that bureaucratic myopia prevents these little babies from
going to the loving adoptive homes that no doubt long for them in other
countries. Best wishes to your daughter as she tries to help them.

Pamela Morrison IBCLC, Zimbabwe

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