Emergency preparedness for formula-fed babies.

Infant Feeding Considerations for Emergency Situations

By Jody Segrave-Daly, RN, IBCLC, Co-Founder of the Fed is Best Foundation

During an emergency the sudden disruption of electrical power, clean water, and social relief services can impact the safe acquisition and storage of formula or human milk, as well as the ability to heat water for optimal cleaning practices. Consider the options below to help you prepare for and cope with a disaster:

Preparing Safe Food Items

PUMPED/EXPRESSED BREAST MILK

Pumped breastmilk can be stored in sterile (disposable) bags in a portable cooler with pre-frozen water bottles or ice packs for up to 24 hours. Thawing breastmilk may be refrozen if ice crystals are still evident once power returns. Pump dependent mothers should have 1-2 hand pumps in case all other options fail. External batteries or a vehicle charger/power supply for pumping in the car if its safe is helpful for a short period of time. Use the correct technique to maximize hand expression output.

FORMULA

Consider buying 4-7 days worth of pre-mixed, “ready to feed” bottles of formula, as well as a corresponding amount of clean bottles and nipples. Single use bottles of pre-mixed“nursettes” with disposable nipples or bottles with disposable liners may be especially useful for ease of storage and cleaning.

READY-TO-FEED BABY/TODDLER FOOD

To prepare, buy 4-7 days worth of pre-made baby/toddler meals, disposable utensils, cups, and plates. Opened food may be kept up to 24 hours in a portable cooler.

CLEAN WATER

Having an ample supply of clean water is a top priority in any emergency. A normally active person needs at least two quarts (half a gallon) of water each day. People in hot environments, children, nursing mothers, and ill people will require even more. Store at least one gallon per person, per day. You will also need water for food preparation and hygiene. Consider storing at least a two-week supply of water for each member of your family. If you are unable to store this quantity, store as much as you can.

Preparing Safe Feeding Supplies

HOW TO CLEAN FEEDING SUPPLIES (PUMP, BOTTLE, PACIFIER etc.)

In the absence of power or hot water you can still take steps to make sure your feeding supplies are sufficiently clean:

You will need:
  • High quality paper towels
  • liquid dish soap
  • antiseptic wipes
  • disposable gloves
  • hand sanitizer
  • 1 large plastic bowls for washing
  • 1 plastic bowl for rinsing
  • 1 large container with lid for storage of clean feeding supplies.
Steps:
  • Clean prep surface with antiseptic wipes and wash hands
  • Place parts in a clean wash basin (large plastic bowl) used only for washing infant feeding equipment.
  • Fill wash basin with CLEAN water and soap.
  • Wash and scrub using clean paper towels.
  • Rinse using CLEAN water
  • Pat dry with clean paper towel / let air dry completely
  • Store in clean and closed plastic bin.
REFRIDGERATOR / FREEZER

Consider filling the freezer by stacking one gallon zip-lock bags partially filled with water. This will help keep the freezer cold if power goes out, and will also give you extra water in case of emergency. Freeze individual water bottles to place in portable coolers and to drink when thawed.

BOILING WATER

Boiling is the safest method of treating water to kill microorganisms. In a large pot or kettle, bring water to a rolling boil for 1 full minute. Let the water cool before drinking. The taste of boiled, stored water will improve if you put oxygen back into it by pouring the water back and forth between two clean containers.

CHLORINATING WATER

When no other options are available, you can use household liquid bleach to kill microorganisms. Use only regular household liquid bleach that contains 5.25 to 6.0 percent sodium hypochlorite. Do not use scented bleaches, color safe bleaches, or bleaches with added cleaners. Use bleach from a newly opened or unopened bottle as the potency of bleach diminishes over time. It is not recommended to use chlorinated water for mixing infant formula, however it is still safer than preparing formula with untreated, contaminated water.

Add 16 drops (1/8 teaspoon) of bleach per gallon of water, stir, and let stand for 30 minutes. The water should have a slight bleach odor. If it doesn’t, then repeat the dosage and let stand another 15 minutes. If it still does not smell of bleach, discard it and find another source of water. Other chemicals, such as iodine or water treatment products (sold in camping or surplus stores) that do not contain 5.25 to 6.0 percent sodium hypochlorite as the only active ingredient are not recommended and should not be used.

Additional Resources:

https://www.cdc.gov/breastfeeding/recommendations/handling_breastmilk.htm
https://www.cdc.gov/healthywater/pdf/hygiene/breast-pump-fact-sheet.pdf
https://www.fema.gov/pdf/library/f&web.pdf?fref=gc&dti=217577232092793
https://www.qld.gov.au/emergency/dealing-disasters/formula-emergency
http://www.fearlessformulafeeder.com/2011/11/formula-feeding-in-disaster-situations-is-there-a-dose-of-reality-in-your-emegency-kit/

Click below for a printable version of this article
Infant Feeding Guide in Emergency Situations
Mother feeding newborn, toddler watching.

My Inability to Exclusively Breastfeed Was a Constant Destructive Force in My Life After My Son’s Birth – I Had a Suicide Plan

Written by: Allison Stillwell Young, RN, BSN, Graduate Student and Team leader of the fed is best foundation mental health advocacy team

is an oncology nurse at Vanderbilt-Ingram Cancer Center in Nashville, Tennessee. A graduate of Belmont University, she has spent her entire nursing career between research oncology and behavioral health. After the birth of her older son, she developed anxiety and depression directly related to difficulties she experienced with breastfeeding including low supply and feeding judgment. She discovered Fed Is Best during her recovery from PPD/A and found the Foundation to be indispensable when feeding her younger son. As a researcher and mother living with chronic mental illness, she believes that the treatment for perinatal mood disorders should have evidence basis, and she therefore co founded a large, online pro-science peer support group for those experiencing PMADs in 2016. She sits on the board for the Tennessee chapter of Postpartum Support International and functions as one of their state support coordinators for the Midstate.

I had our second child last Monday. Since that evening, we’ve been supplementing with formula due to the fact that I have insufficient glandular tissue (IGT) and I am not physically able to exclusively breastfeed. Yesterday, our older son wanted to help feed his baby brother a bottle and, while he was helping, my husband took this picture of them that I loved. I made it my profile picture, and the fact that I felt comfortable posting a picture of my sons with a bottle really shows a sea change in my feelings about infant feeding. Because of that picture, I wanted to post my story about lactivism, which is extremist exclusive breastfeeding advocacy, and how it affected my postpartum mental health after my older son’s birth. It’s pretty long, but I hope my story illuminates how The Fed is Best Foundations provides important support for new mothers. Continue reading

Landon's first day of kindergarten!

Dear Doctors: Just One Bottle Would Have Let Landon See His First Day of Kindergarten

Written by Jillian Johnson

Dear Doctors,

My name is Jillian Johnson and I am speaking to you on behalf of The Fed Is Best Foundation. I am mother to Landon Johnson of Landon’s Legacy. Landon was my firstborn son who died because he was starving while exclusively breastfeeding.

LandonP5

Today has been a very bittersweet day for me. My littlest babe turned two. And while we celebrated from the moment she awoke to the moment she laid her head down for the night, I couldn’t help but feel a bit sad. You see, today, my sweet Landon should have started his first day of Kindergarten. I should have been able to make him a special breakfast, pack his backpack, and walk him to his classroom for the first time. I should have been able to meet his teacher and new friends. Today, I should have packed his lunch and left a sweet note like, “You’re going to be amazing today!” But, I do not get to. As I made my daughter her birthday breakfast, my heart ached knowing we have an empty seat at the table that should be filled. As I baked her cake with her older sister, I knew there should be an extra set of hands helping me stir the batter and fight over who got to lick the spoon. I’ve always looked forward to being able to create the “my first day” sign for my children, and as I made Landon’s today, I couldn’t fill in the blanks. So I wrote this letter instead–requesting that medical professionals step up and help fight for change, and support the cause that would have saved my son’s life. Continue reading

Newborn baby wrapped in a white towel.

I See Myself in Other Mother’s Eyes: A Neonatologist’s Fed is Best Story

 by dr. Jessica Madden, M.D., Neonatologist

My oldest daughter, Grace, was born when I was 28 years old. She was our long-awaited first child, the one who I had postponed having for many years so that I could get through a good chunk of my medical training before becoming a mom.  I felt like I was prepared as much as one could possibly be to take care of and breastfeed a newborn.  I had spent years babysitting my siblings and neighbors and had over two years of intense pediatric/neonatal training under my belt. I had read every single “What to Expect” type of book, joined multiple online breastfeeding forums to learn from experienced mothers beforehand, and took all of the prenatal classes at the hospital where I delivered. I knew that breastfeeding was going to be difficult and exhausting at times, and that it might take several weeks for my baby and me to get into a “groove” with it, but I was ready to dive in headfirst.

“In my work as a neonatologist I have taken care of countless babies around the U.S. who have had to be admitted to the neonatal intensive care unit (NICU) for breastfeeding failures. The most common breastfeeding problems I encounter requiring hospital admissions are dehydration, hypernatremia (high sodium levels), hypoglycemia (low glucose levels), and jaundice (patients often have some combination of these 4 diagnoses).” Continue reading
Bags of donor breast milk.

Donor Breast Milk – Is It Worth It?

Written by Hillary Kuzdeba, MPH

Many women in developed countries like the U.S. find that despite their best efforts, they are unable to exclusively breastfeed due to supply problems or other circumstances. They may feel pressured into finding some other way of ensuring their babies are exclusively breastfed, even though they cannot produce enough for baby. Adoptive parents may also feel pressure to provide breast milk. A lot of this pressure to provide breast milk comes from the over-exaggeration or misinterpretation of the benefits of breast milk on long term health outcomes, or from unfounded fears about infant formula.

Currently, there are two types of donor breast milk available to moms in the US, but only one type that is supported and recommended by major medical bodies like the American Academy of Pediatrics (AAP)(1, 2) and by the Fed is Best Foundation. Donor milk obtained from a milk bank or hospital is a safe and healthy alternative to mom’s own milk. (2) Milk banks thoroughly screen their donor moms to ensure the safety of the milk and pasteurize it following strict food safety protocols to destroy bacteria that can make infants very ill. Milk banks are similar to blood banks. These organizations are designed to make sure human body fluids, whether breast milk or blood products are screened and safe before they are used by vulnerable people like newborns and sick patients. This is because human body fluids, including breast milk, can pass transmissible infections like HIV from person to person.(3-5) For more information on the milk bank process, please visit https://www.hmbana.org/. Continue reading