D. Food and Nutrition
10. Infant Feeding and Milk Products
Human milk is the best and safest food for infants and children under 2 years of age. Breast-feeding also provides a secure and hygienic source of food, as well as antibodies that protect against some infectious diseases. Therefore, promoting lactation, even among sick and malnourished mothers, is important. In some cases, mothers may need to receive extra food to encourage breast-feeding and provide the additional calories and nutrients required. This should be done through the SFP.
Problems associated with using infant formula and feeding bottles are exacerbated in a displaced population situation. Clean, treated water is essential but rarely available to dilute the formula. If local groundwater sources may contain elevated nitrate levels, water should not be treated by boiling, which increases the concentration of nitrates. Careful dilution of the formulas is also difficult to control as mothers are unlikely to be familiar with the use of infant formula and instructions are often in a foreign language. If unavoidable, infant formula should be distributed from health or feeding centers under strictly controlled conditions and proper supervision. Infant feeding bottles must never be distributed or used; they are almost impossible to sterilize and to keep sterile under such conditions. Babies should be fed by a clean cup and spoon if necessary.
Milk should not be distributed if it is not a traditional part of the DP’s diet. Some populations may even have lactose (milk sugar) intolerance.
The use of dried milk powder also has major practical problems. Both hygiene and proper dilution are difficult to ensure. Also, powdered milk mixed with unsafe water or exposed to dust or flies can easily become contaminated and provide an ideal environment for bacterial growth. For these reasons milk should not form part of the general ration, unless milk was used as a normal source of protein for the displaced population.
In addition to infant formula, products commonly offered in emergencies include dried whole milk, dried skim milk (DSM), sweetened and unsweetened condensed milk, and evaporated milk. Their appropriateness must be ascertained before acceptance. It should be noted that if the DSM is vitamin A fortified, the vitamin A has a shelf life of 6 months.
Milk products are useful in SFPs and TFPs when administered under supervision and controlled and hygienic conditions. For example, milk can be added to SFP cereal mixtures to boost their protein content. Milk powder is the usual basis for early stages of treatment in therapeutic feeding.