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

The Fed is Best Foundation’s Progress and Our One-Year Anniversary

From Christie del Castillo-Hegyi, M.D., Co-Founder of the Fed is Best Foundation

The Fed is Best Foundation is reaching its one-year anniversary July 11, 2017. One year ago, we became incorporated as a tax-exempt 501(c)(3) non-profit organization and have made tremendous strides in educating mothers and health professionals on safe infant feeding practices, particularly in the first days of life.  We want to celebrate by sharing with you the progress we have made in our first year.

Our Facebook Following

In one year, we increased our Facebook audience by over 258,000 and we are growing by 2000 to 10,000 followers every week.

The FedisBest.org Website

The FedisBest.org has been viewed over 4 million times over the past year since its creation.

 

The Fed is Best Foundation Advocates, Volunteers, health Professionals and Patient Advocates Grows

We have grown as an organization and currently have Fed is Best advocates, volunteers, nurses, physicians, other health professionals and attorneys that make up the core of the Fed is Best Foundation advocacy efforts.  Fed is Best Foundation Advisors and Volunteers keep the foundation running with on-going advocacy, parent support, literature review, outreach to health organizations and production of educational material for parents and health professionals. Meet the Founders of the Fed is Best Foundation and our core advisors!


The Fed is Best Parent Support Groups on Facebook

We have expanded our parent support network by opening up the Fed is Best Foundation Parent Support Group on Facebook and have added sister Fed is Best groups including Fed is Best U.K. and Fed is Best Canada with more groups on the way.

Raising Awareness on Failure to thrive in Breastfed Babies

We raised awareness of the dangers of failure to thrive and reached an international audience with the following post from one of our advisors and advocates. “Accidentally starving my baby broke my heart, but made me want to help other moms.” 

Fed is Best Gains International Media Attention

The Fed is Best Foundation and the #FedisBest movement has been covered by 86 different news articles across the globe including Forbes.com, the Washington Post, the BBC, CBS News, Slate Magazine, People.com, CNN, CBC News in Canada, Marie Claire, Grounded Parents, Romper, the New York Post and Huffington Post. We have been covered by Spanish, Chinese, Portuguese, Bosnian, Dutch, Indonesian and Polish news outlets. All these articles have been posted on the Fed is Best In the Media page.

The Fed is Best Message Reaches Moms All over the World

We have published our key campaign letters and stories in Spanish, Chinese, Japanese and Korean. Our campaign has reached millions, particularly in the Spanish speaking world.

Fed is Best and the Johnson Family Raise Awareness on the Dangers of Accidental Infant STarvation and REach millions Across the Globe

We reached millions of mothers and health professionals by making them aware of the dangers of the accidental starvation of newborns by sharing a blog written by Jillian Johnson, about the accidental death of her son Landon who was born in a Baby-Friendly hospital.

Jillian Johnson and Dr. Christie del Castillo-Hegyi are Interviewed on the Doctors Show

Jillian Johnson and Dr. Christie del Castillo-Hegyi were invited to an interview on the Doctors Show where we were able to tell our personal stories and send out a message to millions of viewers about the importance of knowing the signs of infant starvation and of timely supplementation to prevent newborn injury and death.

Dr. Christie del Castillo-Hegyi Presents Her REsearch on Accidental Infant Starvation at the First Coast Neonatal Symposium in Jacksonville, Florida on April 24, 2017

Dr. Christie del Castillo-Hegyi was invited to speak at the First Coast Neonatal Symposium for the University of Florida in Jacksonville where she spoke about the “Danger of Insufficient Breastfeeding” to a conference on neonatal health professionals .

Speaking at the First Coast Neonatal Symposium for the University of Florida, Jacksonville, April 24, 2017

The Fed is Best Parent Resource Page

We have expanded our Parent Resource Page by leaps and bounds making it a comprehensive parent and clinician guide for honest, evidence-based safe infant feeding education and support. It includes the Fed is Best Feeding Plan, a guide to preventing feeding complications in breastfed newborns, the Fed is Best weighing protocol, links to instructional videos on achieving a good breastfeeding latch, manual expression of breast milk, guides to knowing when a breastfed infant needs immediate evaluation, guides to supplementing breastfed newborns, formula feeding, power pumping and many more. If you have not visited it lately, please come and check out all the new resources we have added.

Fed is Best Continues to Share Stories from Mothers

We have received thousands of accidental starvation stories and continue to post these stories on our FedisBest.org blog.

The Fed is Best Obstetric health Provider Writing Campaign

We have launched a letter writing campaign to reach all obstetric-gynecologists, family practitioners, midwives and other obstetric care providers to ask them to counsel their mothers on the importance prioritizing the health and safety of their newborn babies over exclusivity in breastfeeding.

Advocating for National Policy Changes in Infant feeding

We gained the amazing addition of Julie Tibbets, Attorney and Partner at Alston & Bird in Washington, DC who is helping us reach out to prominent health organizations to change the infant feeding guidelines and make them safe for every newborn and infant. Together, we will make national change in infant feeding so that no child should ever be injured by accidental starvation and that no mother be uninformed of the risks of insufficient feeding to her child.

Informing Hospitals of the Risks of Accidental Infant Starvation and the Dangers of Strict Breastfeeding Policies

We have launched our effort to reach hospital CEOs and health organizations to make them aware of safe-infant feeding and the dangers of accidental infant starvation from strict breastfeeding-only protocols.

Jody Segrave-Daly’s Daily Support of Mothers and Babies

I want to take this opportunity to highlight the tireless commitment of my Co-Founder, Jody Segrave-Daly, who lives the mission of the Fed is Best Foundation in her daily work as an Infant Feeding Specialist and Lactation Consultant. She uses her 30+ years of experience as a newborn nursery/NICU nurse and IBCLC and cares for moms and babies, especially those who have experienced feeding complications and accidental starvation on a weekly basis. Not only does she witness the suffering of the mothers and babies who experience these breastfeeding tragedies in her clinical work, but she also supports mothers through social media, email and our parent support group. I could not do this without her.

 

Finally, Our Biggest accomplishment are the babies Our Outreach has saved from Feeding Complications

While we can’t estimate the number of babies whom we have saved from feeding complications  by teaching their mothers the signs of hunger/feeding complications and by supporting their mothers to proudly and confidently supplement to protect their life and brain, we have gotten many messages from appreciative mothers who have thanked us for helping them keep their babies safely-fed, happy and thriving. We have received messages of gratitude for saving their babies’ lives and for saving them from needless suffering and hospitalization. Here are some of a few…

Alison’s baby was supplemented when she began to cry and show signs of hunger in the first days of life. She is currently exclusively breastfed.

 

“If I had not found the Fed Is Best Foundation’s information and private support group, I may not be holding my sweet baby today.” — From a Fed is Best Mom and Supporter

 

From Bethany: The Fed is Best Foundation Support Group saved my sanity and more importantly my daughter. I felt the pressure to breastfeed from the beginning and it did start out nicely and she was over her birth weight by the first week! But that was where it stopped. I had to go to the hospital with my little one and was so distraught over the idea of needing formula because it wasn’t “best!” The foundation support group helped me realize that what is best for each baby is what works for each child individually! In just over a month you can clearly see a difference 🙂

 

From Liz: I’m really grateful that Fed is Best supported my decision to formula feed my baby because that was what was best for us. I’m also glad for all the resources because I was able to help my friend, who had her baby 8 weeks after mine was born, to feel confident in her decision to combo-feed. Parenting is hard enough, it just makes sense to support parents rather than judge them.

From Jessica Hickey, MS, OTR/L: The light at the end of the tunnel was being referred to your website by my husband’s aunt. With tears streaming down my face I sat and watched one of your presentations on infant feeding on YouTube and finally found the information I had been seeking. There was nothing wrong with me, I just didn’t have enough milk for my baby like the 20-40% of other first time mothers. I was completely normal! I cried again when I read about what could have happened to my son had I chosen not to supplement so early on, or if I had waited, blindly believing all the incorrect information that I had read that all mothers have enough milk for their babies.

 

“Thanks to the Fed is Best Foundation, I had the support to pump for my preemie twins the moment they were born, for seven weeks, which was one week longer than my goal. They are now exclusively formula fed and thriving.” — A Fed is Best Mom

 

From Mandy Dukovan (I may be crying): It’s incredibly hard to put into words all the things this foundation has done for me over the last 10 months. When I happened to stumble upon FIB, I was a first time mom, who was struggling with so many different feelings and wasn’t sure who or where to turn. My son was 2 months at the time, and was just beginning to thrive, thanks to supplementing with formula. While I was so happy to see my baby finally gaining weight and thriving, I had so many other emotions I was struggling to sort out. I had immense feelings of guilt that I didn’t see the signs that my baby was hungry, constantly. I was embarrassed that I could look at his 1 month picture and now see that he was obviously malnourished, but how on earth did I miss this at the time? I was angry that I didn’t follow my instincts that something was wrong with him and why did I buy into all the terrible things I was told would happen if I gave him formula. I had this image in my head of all the horrible things that would happen to him, such as him being obese, if I gave him formula, at the same time missing the fact that he was underweight and not getting the nourishment and nutrients that he so desperately needed. And I worried that we would not have the kind of bond that babies who were EBF experienced with their mothers. I now know that our bond is so much stronger because we bottle fed him and no longer experienced the immense stress that came each time I tried to breast feed my baby. I got to a point where I dreaded even trying to breast feed him, but I was told that was the best thing I could do for my baby, so I kept going, at the expense of my baby’s health and my well-being. This foundation provided a place I could go and not feel alone and feel accepted. I honestly believed I was the only mother who had experienced what we went through because I only heard the stories about how amazing breast feeding was.

 

We Want to Thank you…

We want to thank you, our supporters, for all the messages, the stories, the love and encouragement you have given us. We promise to give you safe, honest, evidence-based infant feeding support that prioritizes the health and safety of your child. We want to change the standards of infant feeding so that they truly protect the future potential of every single child.

How You Can Support Fed is Best

There are many ways you can support the mission of the Fed is Best Foundation. Please consider contributing in the following ways:

  1. Join the Fed is Best Volunteer group to help us reach Obstetric Health Providers to advocate for counseling of new mothers on the importance of safe infant feeding.
  2. Make a donation to the Fed is Best Foundation. We are using funds from donations to cover the cost of our website, our social media ads, our printing and mailing costs to reach health providers and hospitals. We do not accept donations from breast- or formula-feeding companies and 100% of your donations go toward these operational costs. All the work of the Foundation is achieved via the pro bono and volunteer work of its supporters.
  3. Share the stories and the message of the Fed is Best Foundation through word-of-mouth, by posting on your social media page and by sending our resources to expectant moms that you know. Share the Fed is Best campaign letter with everyone you know.
  4. Write a letter to your health providers and hospitals about the Fed is Best Foundation. Write them about feeding complications your child may have experienced.
  5. Print out our letter to obstetric providers and mail them to your local obstetricians, midwives, family practitioners who provide obstetric care and hospitals.
  6. Write your local elected officials about what is happening to newborn babies in hospitals and ask for legal protection of newborn babies from underfeeding and of mother’s rights to honest informed consent on the risks of insufficient feeding of breastfed babies.
  7. Send us your stories. Share with us your successes, your struggles and every thing in between. Every story saves another child from experiencing the same and teaches another mom how to safely feed her baby. Every voice contributes to change.
  8. Send us messages of support. We work every single day to make infant feeding safe and supportive of every mother and child.  Your messages of support keep us all going.

Thank you so much from the Founders of the Fed is Best Foundation!

Christie del Castillo-Hegyi, M.D.

Jody Segrave-Daly, RN, IBCLC

 

 

Open Letter to Obstetric Care Providers on Counseling Expectant Mothers on the Importance of Safe Infant Feeding

Dear Obstetrician-Gynecologist, Family Practitioner or Midwife,

I am writing to you as a mother and advocate for Fed is Best.

You may have seen the story of Landon Johnson, who was welcomed into the world by his parents in February 2012.  Like most new parents, Landon’s mom and dad were lead to believe that Jillian would produce enough breast milk to meet Landon’s caloric needs.  The hospital where they delivered was “Baby-Friendly” and would only provide formula with a doctor’s prescription.

While in the hospital, Landon cried whenever he was not latched onto his mom’s breast. Jillian described him as inconsolable.  She was told that this was normal.  At less than 3 days of life they were discharged from the hospital after having the appropriate number of wet and dirty diapers.  However, less than 12 hours later, Landon was readmitted to hospital after suffering cardiac arrest due to severe dehydration.  He suffered brain injury and ultimately died in the arms of his parents when life support was terminated.  His is a story that you cannot read without tears in your eyes. Continue reading

FedisBest.org Can Now Be Translated into Any Language!

We are excited to announce that the entire FedisBest.org website is available in every language translated by Google Translate.  Just look for the Translate button on the top right or the bottom right of the screen.

Top Right Translate Button

 

Bottom Right Translate Button

Jillian Johnson and The Fed is Best Foundation Interview on the Doctors Show

By The Doctors Staff on 12:00 AM PT, May 9, 2017

Questions to Ask Your Health Providers to See if They Believe that Fed is Best

Mothers have reported feeling unprepared for their birth and postpartum experiences and that their newborns experienced complications from underfeeding due to excessive pressure to exclusively breastfeed.  It is important to know your health providers, their perspectives on infant feeding, supplementation and keeping your baby safe from complications and hospitalization.  These are a list of questions to ask your health provider to see if they and their hospital believe that Fed is Best.

 

What do I do if my milk does not come in and my child is not getting enough milk?

If they are unwilling to discuss this possibility and are unwilling to tell you how to protect your child from complications, then they are not being honest with you and are violating a basic ethical obligation required of all health providers. They should be able to tell you that supplementation with formula or safe, tested donor breast milk can protect your child from complications if your breast milk is not enough.

 

Continue reading

Breastfeeding Before Babies: The Baby-Friendly Hospital Initiative’s Unwillingness to Change or Accept Responsibility

BY CHRISTIE DEL CASTILLO-HEGYI, M.D., Co-Founder of the FEd is Best Foundation

Every patient-healthcare provider relationship is governed by four central principles of medical ethics, which are the following:

  1. Beneficence – Health care providers have the duty to provide care in a way that benefits a patient, increases their safety, their immediate and long-term health, and their comfort.
  2. Non-maleficence – First, do no harm. This principle requires that health professionals do not intentionally harm or injure a patient either through acts of commission or omission. If an intervention causes more harm to a patient than doing nothing, you do not intervene.
  3. Respect for Patient Autonomy – With any health care decision, the patient has the right to full disclosure of the risks and benefits of any intervention, regardless of how rare, so that they may act in their own or their children’s best interests to get the best outcomes with the least risk involved. Patient autonomy can only be fully realized if they are given honest and complete information on any and all the risks and benefits, whether common or rare, so that they may voluntarily choose, free of coaxing or coercion, in order to optimize their own or their children’s health outcomes.
  4. Respect for Human Rights – In 1948, the United Nations published the Universal Declaration of Human Rights, which subsequently charged governments, doctors and health workers to protect the human rights and human dignity of all people. It provides special protection of the physical integrity of those who are unable to consent, which includes children. These human rights include the right to food and water to prevent starvation and the associated injury to the brain and vital organs.

The Baby-Friendly Hospital Initiative has violated all four of these core principles of medical ethics through its policies and has reiterated its commitment to defending its dangerous policies over their commitment to patient safety in their recent dismissive response to Landon Johnson’s accidental starvation death caused by the Baby-Friendly policies. Continue reading

From Dr. Brian Symon: Words of Advice on Early Supplemented Breastfeeding Until Full Milk Production

Given new scientific data that exclusively breastfed newborns are in fact at significant risk for brain-threatening hypoglycemia, jaundice and dehydration, mothers are asking how they can supplement in the first days of life without compromising their long-term breastfeeding success. What they don’t realize is that supplemented breastfeeding in the first days of life transitioning into full breastfeeding or combination feeding was in fact the norm before the WHO/UNICEF Baby-Friendly exclusive breastfeeding guidelines. In fact, the historical evidence shows that all native breastfeeding countries, before the Baby-Friendly guidelines, supplemented their newborns with the milk of wet nurses, sugar water and other forms of liquid nutrition, also called “pre-lacteal feeds,” almost universally until a mother’s milk came in. The reasons for supplementation were to prevent newborn hunger, starvation, jaundice, dehydration and hypoglycemia.  Despite widespread mother-led supplementation of newborns in places like Bangladesh, mothers successfully breastfed the vast majority of their babies up to one (98%) to two years (89%) of age.  We used common sense to feed our babies and that is how we protected them in the first days of life and beyond.  Sadly, since the publication of the exclusive breastfeeding guidelines, hospitalizations for jaundice and dehydration have steadily increased and are now the leading causes of newborn hospitalization worldwide.

Here is Dr. Brian Symon talking about supplemented breastfeeding in the early days and how to transition over to full or combination breastfeeding.

By Dr. Brian Symon, General (family) Practitioner, Adelaide, South Australia

My heart goes out to the mothers writing about their struggle to breast feed and in some cases, babies ‘failing to thrive‘.  Landon Johnson’s story is a tragedy.

As a Family Physician my work is largely focused on the care of pregnant women and newborn babies.

My stance is very simple.

1. The ONLY logical reason for having a child is ‘the joy of parenting’.

We don’t do it because it’s easy.

We don’t do it for the “life style”.

We don’t do it for the “money”.

We do it for the deep joy of raising a child and seeing that baby thrive and develop.

If it’s not being joyful for the mothers whom I care for I want to change things so that the pleasure and joy returns. Continue reading

From People.com, MOM SAYS PRESSURE TO BREASTFEED LED TO ACCIDENTALLY STARVING HER INFANT SON: ‘WE WERE SO BRAINWASHED’

Just 19 days after giving birth to a healthy baby boy, Jillian Johnson lost her son Landon due to accidental starvation.

“If I had given him just one bottle, he would still be alive,” Johnson writes in a blog post for the non-profit organization Fed Is Best. “If only I could go back in time.”

Fed is Best advocates for safe breastfeeding — including supplementing with formula when medically necessary or strictly formula feeding for those who want or need to — in response to the tragic stories of mothers accidentally starving their babies, according to co-founders Jody Segrave-Daily RN, and Dr. Christie Del Castillo-Hegyi.

Read more at People.com.

New Moms: You Are Not Alone. Please Don’t Suffer In Silence

On Tuesday, Kim Chen, a grieving father and widower, shared his late wife Florence Leung’s struggles with postpartum depression and breastfeeding on a Facebook page dedicated to her memory. He encouraged new moms to get help and to not succumb to pressures to breastfeed.

Chen wrote,

“For all the new moms experiencing low mood or anxiety, please seek help and talk about your feelings. You are Not alone. You are Not a bad mother. Do not EVER feel bad or guilty about not being able to “exclusively breastfeed”, even though you may feel the pressure to do so based on posters in maternity wards, brochures in prenatal classes, and teachings at breastfeeding classes. Apparently the hospitals are designated “baby-friendly” only if they promote exclusive-breastfeeding.”

Our thoughts are with Mr. Chen, his family, and their son, who now has to grow up without his mother. We’ve reached out to him to offer our support and resources during this impossible time.

Continue reading