Infant Feeding in Emergencies Celebrating the Innocenti 15 Florence, Italy 2005

1. Infant Feeding in EmergenciesCelebrating the Innocenti 15Florence, Italy 2005 Lída Lhotská Geneva Infant Feeding Association

2. Global Strategy and IFE • § 23 points out the vulnerability of infants and children in natural and human-induced emergencies • Emphasizes the need for appropriate infant and young child feeding • Highlights the dangers of uncontrolled distribution of breastmilk substitutes and the need for protection, promotion and support of breastfeeding

3. Why is IBFAN involved in IFE? IBFAN put the protection of breastfeeding in emergencies on policy agenda: • prevent that any type of emergency – manmade or natural - is misused for commercial purposes by the infant food industry • Code, incl. WHA 47.5 (1994) on donations, is respected Indonesia, January 2005

4. IFE Core Group - since 1999 IBFAN part of the Core group since its creation SCN Working Group for Nutrition in Emergencies IFE Core Group: ENN, IBFAN, Terre des Hommes, CARE USA, UNHCR, UNICEF, WFP, WHO IFE Thematic Group

5. Point of departure Much depends on: • Perceptions and understanding of breastfeeding in the emergency setting • Existing policies and their implementation by key actors • Levels of knowledge and practical skills among those actors

6. Breastfeeding – the natural way?…OR... Discussion with flood victimes (Venezuela, 2005) DRC 2003,Kent Oage UNICEF

7. …breastfeeding - the last resort? • Still weak from the birth, she was forced to breastfeed her 21-month-old child. "I had to, I couldn't give him anything else.“ [Mark Coultan, The Age, New Orleans, September 6, 2005]

8. Approach adopted by the Core Group • policy development and implementation • capacity building in programme management • capacity building in practical knowledge and skills which translate into implementation of interventions that support optimal infant feeding practices Balkan crises brought to light how poorly and piecemeal all the levels were addressed first policy statements developed in 90s

9. Policy basis – Operational Guidance • Set of basic “dos” and “don’ts” for emergency relief staff and policy makers to ensure that breastfeeding is protected, promoted and supported in emergencies. • Key audience: all agencies working in emergency programs (30+ endorsements) • Used as basis for institutional policy updates (UNHCR, IFRC) • Update will be available in early 2006

10. Building Capacity • Two training Modules to date: “living documents” • Key principles: - Do no harm - Do not interfere with good practices -build on them - Provide active support for breastfeeding Assess Look Analyse Think Act Do

11. Module 1 1- 2 hour course for all emergency relief staff : -policy makers -managers -logisticians -coordinators and -other non technical relief workers Update already once after initial experience

12. Module 2 – Version 1.0 3-5 hour course

13. Recent experiences • Tsunami (2004): Modules just published, copies sent to the field, evaluation of the impact yet unclear • Pakistan (2005): 60 Module 1 and 300 Module 2 sent to UNICEF, ongoing interaction with the field, training starting on 22 November, organized by skilled and experienced staff • Distribution over past 6 months: Module 1: 146 copies (overall total over 1000) Module 2: 713 copies CD-Rom: 59 copies

14. Key challenges • Putting IFE on the global agenda at a policy, strategic and donor levels, and promotion of appropriate use in the field orientation workshop in 2006 • Interactive and timely engagement with the field with follow up and feedback to identify field-relevant issues, learn from experiences and inform further development of the modules • Translation into other languages • Module 3: Complementary Feeding