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Press Centre (1/2013)

UN agencies and NGOs call for appropriate feeding of infants and young children in the Syria emergency


AMMAN/NEW YORK, 28 Jan 2013 - Four UN agencies and two NGOs today strongly urged those involved in the response to the Syria crisis and for those people displaced in Jordan, Lebanon, Iraq and Turkey, to avoid unnecessary illness and death in children by promoting breastfeeding and appropriate complementary feeding and strongly discouraging the uncontrolled distribution and use of breast-milk substitutes (e.g. infant formula), bottles and teats and other powdered or liquid milk and milk products.

UNICEF, the UN refugee agency, the World Health Organization, World Food Programme, International Medical Corps, and International Organization of Christian Charities/Greek Orthodox Patriarchate of Antioch said that statistics showed that in serious emergency situations, such as the one currently facing those affected by the Syria crisis, disease and associated death rates among under-5 children are higher than for any other age group.

The risk of dying is particularly high because of the combined impact of communicable diseases and diarrhea together with possible increases in rates of under-nutrition as people flee their homes. The people inside Syria and those displaced may find themselves often in very difficult and unsanitary conditions thus can be at major risk of serious water-borne diseases. Breastfeeding confers critical protection from infection especially where safe water is unavailable and there is poor sanitation- breastfeeding saves lives. .

Artificial feeding with breast-milk substitutes in an emergency carries high risks of malnutrition, illness and death and is a last resort only when other safer options have first been fully explored and deemed unavailable.

Where the use of breast-milk substitutes is unavoidable, the partners only recommend ready-to-use formula that should adhere to the International Code for Marketing of Breastmilk Substitutes. Any distribution and use of breast-milk substitutes should be carefully monitored to ensure that only infants who have no possibility to breastfeed receive them and that they are used safely.

The nutrition partners said that, in line with internationally accepted standards, donations of infant formula, bottles and teats and other powdered or liquid milk and milk products should not be made. Past emergencies show that an excessive quantity of poorly targeted products can actually endanger infants’ lives.

Misconception: During emergencies, mothers can no longer breastfeed adequately because of stress or inadequate nutrition

Although stress can temporarily interfere with the flow of breast milk in some women, it is not likely to inhibit breast milk production, provided mothers and infants remain together and are supported to initiate and continue breastfeeding. Mothers who lack food or who are malnourished can still breastfeed well. Support to mothers (to ensure access to health services, food security, nutrition security and privacy) must be a priority to help protect their health and well-being.

Donations and procurement of breast-milk substitutes and other milk products

In accordance with internationally accepted standards and guidelines, donations of infant formula, bottles and teats and other powdered or liquid milk and milk products should not be made. Experience with past emergencies has shown an excessive quantity of products, which are poorly targeted, endangering infants’ lives. Anyuse and procurement of breast-milk substitutes (BMS) should be based on careful needs assessment according to strict protocol set out in the Operational Guidance on Infant and Young Child Feeding in Emergencies - UNICEF and WHO can provide technical assistance. Breast-milk substitutes should adhere to International Standards and the International Code of Marketing of Breastmilk Substitutes. Ready-to-use infant formula consumed using a cup is recommended in this context. Any distribution and use of breast-milk substitutes should be carefully monitored to ensure that only the targeted infants receive the product.

Feeding of the non-breastfed child less than six months of age

The priority to feed infants less than six months of age who are not breastfed should be relactation (re-starting breastfeeding). If this is not possible wet feeding (breastfeeding of the infant by another mother) could be explored. Artificial feeding should only be undertaken following a needs assessment by a qualified health/nutrition staff trained in breastfeeding and infant feeding issues. If BMS is necessary, it must be accompanied by training on hygiene, preparation and use to minimize their associated risks and may require the provision of additional resources as well as the essential regular follow-up. BMS provision must continue for as long as the infant concerned requires it. Artificial feeding in an emergency carries high risks of malnutrition, illness and death and is a last resort only when other safer options have first been fully explored.

Complementary feeding of children above six months of age

Children from the age of six months require nutrient-rich, age-appropriate and safe complementary foods in addition to breast milk. If culturally-acceptable, nutritionally adequate and age-appropriate foods are available and accessible these should be prioritized for assistance. If such foods are not available, specialized nutrition products should be provided with appropriate training and support for preparation and use. These options represent a much more appropriate form of assistance than sending milk products. In rations for general food distribution pulses, meat, or fish are preferable to powdered milk.

UNICEF, UNHCR, WHO, WFP, IMC, GOPA/ IOCC strongly urge all who are involved in funding, planning and implementing the emergency response in Syria and neighboring countries to avoid unnecessary illness and death and to protect their infants and children by promoting, protecting and supporting breastfeeding and appropriate complementary feeding and by preventing uncontrolled distribution and use of breast-milk substitutes and other milks.

All queries and any information about donations should be directed to UNICEF, the designated nutrition coordinating agency in the Middle East and North Africa emergency operation. 

For more information please contact:

UNICEF Nutrition Section, New York:

Nune Mangasaryan, nmangasaryan@unicef.org, tel: +1 212 326 7159

Erin Boyd, eboyd@unicef.org, tel: + 1 212 326 7348

UNICEF office in Amman:

Mahendra Sheth, Regional Health Advisor, msheth@unicef.org, +962796663399

James King’ori, Regional Nutrition Specialist, jkingori@unicef.org, +962799499729

UNHCR office in Geneva:

Caroline Wilkinson, Senior Nutritoin Officer, wilkinso@unhcr.org, + 41 22 739 74 86

WFP office in Rome:

Margot Van Der Velden, margot.vandervelden@wfp.org, tel. +39 06 6513 2171

WFP Regional Bureau in Cairo:

Michele Doura, Michele.doura@wfp.org, +202 2528 1730 Ext 2451, mobile- +20 101 761 6387

WHO office in Geneva:

Zita Weise Prinzo, weiseprinzoz@who.int, tel: + 41 22 791 4440

Carmen Casanovas, casanovasm@who.int, tel: +41 22 791 2968

WHO Eastern Mediterranean Regional Office in Cairo: +202 670 2535

Ayoub Eid Al-Jawaldeh , Regional Nutrition Advisor, ALJAWALDEHA@emro.who.int

International Medical Corps Caroline Abla, Director, Nutrition and Food Security Unit Tel + 961 70 15 90 66 cabla@InternationalMedicalCorps.org

International Orthodox Christian Charities (IOCC) / Greek Orthodox Patriarchate of Antioch (GOPA):

Linda Shaker Berbari, Program Manager and Nutritionist (IOCC) / Lana Loutfi, Program Coordinator (GOPA)

lberbari@iocc.org tel: +961-1-688509

lanaloutfi.iocc@yahoo.com.uk, tel: +963-11-5414490

References:

Sphere (2011) Humanitarian Charter and Minimum Standards in Humanitarian Response.

Includes standards on infant and young child feeding in emergencies

Available in English, Arabic, French and other languages at: http://www.sphereproject.org/handbook/language-versions/

The Operational Guidance on Infant and Young Child Feeding in Emergencies – sets out the dos and don’ts during an emergency response. Endorsed by WHA resolution 63.23, 2010 and referred to in Sphere. Available in English, Arabic, French and other languages at: http://www.ennonline.net/resources/6

Guide for the media on infant and young child feeding in emergencies: http://www.ennonline.net/pool/files/ife/ife-media-guide-french(1).pdf

International Code of Marketing of Breast-milk Substitutes and subsequent relevant World Health Assembly Resolutions. WHO (1981): http://www.unicef.org/nutrition/files/nutrition_code_english.pdf and: http://www.ibfan.org/site2005/Pages/list2.php?iui=1&cat_id=46

Global Nutrition Cluster Toolkit on Nutrition in Emergencies : http://www.unicef.org/nutritioncluster/index_iycf-e.html

Additional orientation, training and other materials on infant and young child feeding in emergencies is available free at: www.ennonline.net/ife

UNICEF Turkey Country Office, Yukarı Dikmen Mah. Alexsander Dubçek Cd. 7/106, 06450 Çankaya/Ankara. Telephone: +90 312 454 1000 Fax: +90 312 496 1461 E-mail: ankara@unicef.org