Ethical Issues in Infant Feeding After Disasters

Binns, Colin; Lee, Mi Kyung; Tang, Li; Yu, Chuan; Hokama, Tomiko; Lee, Andy

doi:10.1177/1010539512453253

Cited by 36 publications

(32 citation statements)

References 9 publications

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“…Additionally, TMFC often donate large quantities of MF to countries in post-disaster situations, potentially undermining breast-feeding in this context. This is most pertinent for the Asia-Pacific region, the world's most disaster prone (50) . Approximately 10 % of MF sales is spent on marketing and promotion (51) .…”

Section: Discussionmentioning

confidence: 99%

Global trends and patterns of commercial milk-based formula sales: is an unprecedented infant and young child feeding transition underway?

Baker

Smith

Salmon

et al. 2016

Public Health Nutr.

143

162

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Objective: The marketing of infant/child milk-based formulas (MF) contributes to suboptimal breast-feeding and adversely affects child and maternal health outcomes globally. However, little is known about recent changes in MF markets. The present study describes contemporary trends and patterns of MF sales at the global, regional and country levels. Design: Descriptive statistics of trends and patterns in MF sales volume per infant/ child for the years 2008-2013 and projections to 2018, using industry-sourced data. Setting: Eighty countries categorized by country income bracket, for developing countries by region, and in countries with the largest infant/child populations. Subjects: MF categories included total (for ages 0-36 months), infant (0-6 months), follow-up (7-12 months), toddler (13-36 months) and special (0-6 months). Results: In 2008-2013 world total MF sales grew by 40·8 % from 5·5 to 7·8 kg per infant/child/year, a figure predicted to increase to 10·8 kg by 2018. Growth was most rapid in East Asia particularly in China, Indonesia, Thailand and Vietnam and was led by the infant and follow-up formula categories. Sales volume per infant/ child was positively associated with country income level although with wide variability between countries. Conclusions: A global infant and young child feeding (IYCF) transition towards diets higher in MF is underway and is expected to continue apace. The observed increase in MF sales raises serious concern for global child and maternal health, particularly in East Asia, and calls into question the efficacy of current regulatory regimes designed to protect and promote optimal IYCF. The observed changes have not been captured by existing IYCF monitoring systems. Keywords Infant and young child feedingNutrition transition Formula Breast-milk substitutes Breast-feeding is important for infant and young child health and development, and for maternal health, in both developed-and developing-country settings (1)(2)(3) . It is ranked as the single most effective intervention for the prevention of deaths in children under 5 years of age (4) . To achieve optimal growth, development and health the WHO recommends that infants should be exclusively breast-fed for the first 6 months of life and thereafter receive nutritionally adequate and safe complementary foods while continuing breast-feeding for up to 2 years of age or beyond (5,6) . Although significant progress has been made in some countries, the global exclusive breast-feeding rate improved only marginally from 33 % in 1995 to 37 % in 2014 (7) . Every year an estimated 823 000 deaths, or 13·8 % of total deaths, in children under 2 years of age would be prevented if breast-feeding were scaled up to a near-universal level in high-mortality low-and middleincome countries. For mothers, a universal level of breastfeeding in all countries would prevent an estimated 20 000 deaths from breast cancer annually (8) . Suboptimal infant and young child feeding (IYCF) also incurs higher health system expenditures through increas...

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Section: Discussionmentioning

confidence: 99%

Global trends and patterns of commercial milk-based formula sales: is an unprecedented infant and young child feeding transition underway?

Baker

Smith

Salmon

et al. 2016

Public Health Nutr.

143

162

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“…As a preventive aspect, it is essential to consider interventions like mass vaccination, growth monitoring, breastfeeding promotion, prevention of micro‐ and macronutrient deficiencies, malaria prevention, and reproductive health services (Hirani, ). Considering the risks associated with formula feeding during displacement, focus must be placed on controlling the distribution of breast milk substitutes and feeding bottles (Binns et al., ; Gribble, McGrath, MacLaine, & Lhotska, ; World Health Organization, ). Curative aspects may include timely, accessible, and free treatment for communicable and noncommunicable diseases, sexually transmitted infections, and psychiatric disorders.…”

Section: Resultsmentioning

confidence: 99%

Maternal and Child Health During Forced Displacement

Hirani

Richter

2019

J of Nursing Scholarship

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Purpose To discuss the effects of forced displacement on maternal and child health, highlight the major pitfalls in delivering humanitarian services to this vulnerable group, and underscore the need for multilayered interventions to improve health, protect rights, and reduce vulnerabilities during forced displacements. Methods A comprehensive literature search was undertaken from databases including Medline, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), EBSCOhost, Google Scholar, Scopus, and ProQuest. No restrictions were placed on geographical region, type, and year of publication. The key words used were displacement, children, women, health, challenges, disaster response, emergency medicine, terrorism, maladjustment, morbidity, disaster response, cultural sensitivity, and interventions. Conclusions Forced displacement negatively affects maternal and child health. The key challenges during forced displacement include food insecurity, lack of shelter, unavailability of clean water and sanitation, poor infrastructure of healthcare services, unavailability of birth attendants and healthcare professionals to manage medical emergencies, inaccessibility to educational and training facilities, and lack of cultural sensitivity of humanitarian workers. The ultimate outcome of forced displacement is a sudden rise in maternal and child mortality and morbidity, maladjustment, psychological issues, altered familial roles, displaced parenting, and vulnerability to exploitation. In view of Bronfenbrenner's socio‐ecological framework, multilayered interventions are proposed to improve maternal and child health during forced displacements. Clinical Relevance In view of the effects of forced displacement on maternal and child health and considering the major pitfalls in the delivery of humanitarian services to this vulnerable group, the proposed multilayered interventions can improve health, protect rights, and reduce vulnerabilities surrounding maternal and child health during forced displacements.

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“…Breastfed infants and young children are food secure if their mother or another lactating woman is accessible and well enough [ 140 ], with little additional food, shelter and social support [ 141 ]. In emergency situations the food security of artificially fed infants and young children can change abruptly due to disruption to the supply and affordability of breast milk substitutes [ 142 ] or a lack of resources and equipment to feed powdered infant formula safely [ 143 ]. Guidelines have been developed for international aid agencies to support breastfeeding mothers in emergencies and prevent the donation and distribution of breast milk substitutes that destabilize breastfeeding practices [ 139 , 143 ].…”

Section: Discussionmentioning

confidence: 99%

“…Guidelines have been developed for international aid agencies to support breastfeeding mothers in emergencies and prevent the donation and distribution of breast milk substitutes that destabilize breastfeeding practices [ 139 , 143 ]. However these guidelines were not observed in the aftermath of earthquakes in the Asia Pacific region (Yogyakarta and Central Java in 2006, Sichuan Province in 2008 and the north-east Japan earthquake and tsunami in 2009) [ 142 ], Cyclone Nargis in Myanmar in 2008 [ 144 ] and the Haiti earthquake in 2010 when large amounts of infant formula were distributed despite the use of baby tents to maintain breastfeeding in the latter [ 145 , 146 ]. Outbreaks of Ebola virus in West Africa in 2014 present new challenges to breastfeeding [ 147 ].…”

Section: Discussionmentioning

confidence: 99%

Food security for infants and young children: an opportunity for breastfeeding policy?

Salmon

2015

Int Breastfeed J

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BackgroundIncreased global demand for imported breast milk substitutes (infant formula, follow-on formula and toddler milks) in Asia, particularly China, and food safety recalls have led to shortages of these products in high income countries. At the same time, commodification and trade of expressed breast milk have fuelled debate about its regulation, cost and distribution. In many economies suboptimal rates of breastfeeding continue to be perpetuated, at least partially, because of a failure to recognise the time, labour and opportunity costs of breast milk production. To date, these issues have not figured prominently in discussions of food security. Policy responses have been piecemeal and reveal conflicts between promotion and protection of breastfeeding and a deregulated trade environment that facilitates the marketing and consumption of breast milk substitutes.DiscussionThe elements of food security are the availability, accessibility, utilization and stability of supply of nutritionally appropriate and acceptable quantities of food. These concepts have been applied to food sources for infants and young children: breastfeeding, shared breast milk and breast milk substitutes, in accordance with World Health Organization (WHO)/United Nations Children’s Fund (UNICEF) guidelines on infant feeding. A preliminary analysis indicates that a food security framework may be used to respond appropriately to the human rights, ethical, economic and environmental sustainability issues that affect the supply and affordability of different infant foods.SummaryFood security for infants and young children is not possible without high rates of breastfeeding. Existing international and national instruments to protect, promote and support breastfeeding have not been implemented on a wide scale globally. These instruments need review to take into account the emerging trade environment that includes use of the internet, breast milk markets and globalised supply chains for breast milk substitutes. New approaches are required to handle the long-standing policy conflicts that surround infant and young child feeding. Placing breastfeeding in a food security framework may achieve the political attention and policy co-ordination required to accelerate breastfeeding rates in a range of economies.

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Ethical Issues in Infant Feeding After Disasters

Cited by 36 publications

References 9 publications

Global trends and patterns of commercial milk-based formula sales: is an unprecedented infant and young child feeding transition underway?

Global trends and patterns of commercial milk-based formula sales: is an unprecedented infant and young child feeding transition underway?

Maternal and Child Health During Forced Displacement

Food security for infants and young children: an opportunity for breastfeeding policy?

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