Acute malnutrition is one of the main reasons infants die during violent conflicts and when families are displaced for long periods; interrupted breastfeeding is one of the main causes of such malnutrition. Thus, Professor Zulfiqar A. Bhutta and Assistant Professor Jai Kumar Das from Aga Khan University, together with the Hospital for Sick Children, set out to compile the most effective interventions that help mothers continue breastfeeding in crisis situations, as part of a larger project investigating how to best deliver reproductive, maternal, newborn, child and adolescent health and nutrition interventions in conflict settings.

“Many women stop breastfeeding when they are forced to flee their homes, while influxes of donated formula also discourage breastfeeding.”
– Zulfiqar A. Bhutta, MBBS, FRCPCH, FAAP, PhD; Chair, Department of Paediatrics and Child Health, Aga Khan University; Co-Director, Centre for Global Child Health, Hospital for Sick Children; and Founding Director, Centre of Excellence in Women and Child Health, Aga Khan University

Breastfeeding is a key component of health and nutrition, and in conflict settings, can make a major difference to the lives of infants. Breastfeeding provides nutritional, immunological and developmental benefits that formula does not provide. Furthermore, clean water, essential for safe formula feeding, is often unavailable in conflict settings, increasing the risk of diarrhoea among already vulnerable babies.

As many humanitarian agencies already promote appropriate infant and young child feeding through their relief efforts, and innovative techniques are being employed to encourage breastfeeding in emergencies, the project is compiling research-based evidence on the interventions and implementation guidelines that work best in conflict settings, particularly in the context of displaced populations. It will both synthesise existing information and collect new data to plug information gaps.

The translational research produced has the potential to help define new international standards, which can in turn assist United Nations agencies and NGOs in providing the best support to mothers in crises. These findings will be included in a larger project investigating how to best deliver reproductive, maternal, newborn, child and adolescent health and nutrition interventions in conflict settings.

FLRF donated approximately USD 300,000 in support of the project. The partners’ aim: increase rates of breastfeeding in populations affected by conflicts, and save babies’ lives.

References and further reading

Rabbani A, Padhani ZA, A Siddiqui F, Das JK, Bhutta Z. Systematic review of infant and young child feeding practices in conflict areas: what the evidence advocates. BMJ Open [Internet]. 2020;10(9):e036757. DOI: 10.1136/bmjopen-2020-036757

Mirzazada S, Padhani ZA, Jabeen S, Fatima M, Rizvi A, Ansari U, et al. Impact of conflict on maternal and child health service delivery: a country case study of Afghanistan. Confl Health. 2020;14(1):38. DOI: 10.1186/s13031-020-00285-x

Das JK, Padhani ZA, Jabeen S, Rizvi A, Ansari U, Fatima M, et al. Impact of conflict on maternal and child health service delivery - how and how not: a country case study of conflict affected areas of Pakistan. Confl Health. 2020;14(1):32. DOI: 10.1186/s13031-020-00271-3

Andersson N, Paredes-Solís S, Legorreta-Soberanis J, Cockcroft A, Sherr L. Breast-feeding in a complex emergency: four linked cross-sectional studies during the Bosnian conflict. Public HealthNutr. 2010;13(12):2097-2104.

Borrel A, Taylor A, McGrath M, Seal A, Hormann E, Phelps L et al. From Policy to Practice: Challenges in Infant Feeding in Emergencies During the Balkan Crisis. Disasters. 2001;25(2):149-163.

Campbell S. Global challenges in protecting and promoting breastfeeding. Prim Health Care. 2008;18(1):41-48.

McGrath M, Seal A, Taylor A. Infant feeding indicators for use in emergencies: an analysis of current recommendations and practice. Public Health Nutr. 2002;5(03).

Toole M, Waldman R. The public health aspects of complex emergencies and refugee situations. AnnuRev Public Health. 1997;18(1):283-312.

Webb P, Boyd E, Pee S, Lenters L, Bloem M, Schultink W. Nutrition in emergencies: Do we know whatworks?. Food Policy. 2014;49:33-40.

Young H, Borrel A, Holland D, Salama P. Public nutrition in complex emergencies. The Lancet. 2004;364(9448):1899-1909.