During emergency situations, disease and death rates among under-five children are higher than for any other age group; the younger the infant the higher the risk. Mortality risk is particularly high because of the combined impact of a greatly increased prevalence of communicable diseases and diarrhoea and soaring rates of under-nutrition. Appropriate feeding and care of infants and young children is essential to preventing malnutrition, morbidity and mortality.

Major health problems among Haitian children, which have been exacerbated by this crisis, are acute and chronic malnutrition and communicable diseases. Given the structural damage caused by the earthquake to water supply systems, there is an additional risk of water borne diseases affecting large numbers of the urban, rural and displaced populations. Many infants and young children have been orphaned or separated from their mothers. Risks to children in Haiti are exacerbated by pre-earthquake poor infant and young child feeding practices and malnutrition. In this emergency situation, the lifeline offered by exclusive breastfeeding to children for the first six months of life and continued breastfeeding with complementary feeding for two years or more is of utmost importance and must be protected, promoted and supported as much as possible.

Most mothers initiate breastfeeding in Haiti, and the majority of infants less than six months of age were at least partially breastfed prior to the earthquake. At this stage it is critical to encourage and support mothers to initiate breastfeeding immediately after the delivery, exclusively breastfeed up to six months and for those with infants below six months who ‘mix feed’ to revert to exclusive breastfeeding. Nonbreastfed infants are at especially high risk and need early identification and targeted skilled support, including re-establishing breastfeeding (relactation).

Protection and support for breastfeeding women
No food or liquid other than breast milk, not even water, is needed to meet an infant’s nutritional and fluid requirements during the first six months of life. The valuable protection from infection that breastfeeding confers is all the more important in environments without safe water supply and sanitation. Therefore, creation of a protective environment and provision of skilled support to breastfeeding women are essential interventions. There is a common misconception that in emergencies, many mothers can no longer breastfeed adequately because of stress or inadequate nutrition. Concern for these mothers and their infants can fuel donations of breastmilk substitutes (BMS) such as infant formula. Although stress can temporarily interfere with the flow of breastmilk, it is not likely to inhibit breastmilk production, provided mothers and infants remain together and are supported to initiate and continue breastfeeding. Mothers who lack food or who are malnourished can still breastfeed. Provision of adequate fluids and food for mothers must be a priority as it will help to protect their health and well-being as well as that of their young children.

Basic interventions to facilitate breastfeeding include prioritising mothers with young children for shelter, food, security, and water and sanitation, enabling mother-to-mother support, providing specific space for skilled breastfeeding counselling and support to maintain or re-establish lactation. Traumatised and depressed mothers may have difficulty responding to their infants and require particular mental and emotional support. UNICEF, WHO and other organizations involved in infant feeding in emergencies will support training of staff on individual assessment of the best options for feeding infants, as well as education and support of caregivers on optimal infant feeding in these emergency circumstances.