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close this bookGuiding Principles for Feeding Infants and Young Children During Emergencies (WHO; 2004; 96 pages) View the PDF document
View the documentAcknowledgements
View the documentGuiding principles for feeding infants and young children during emergencies
View the documentForeword
View the documentIntroduction
open this folder and view contentsBreastfeeding
open this folder and view contentsBreast-milk substitutes
open this folder and view contentsComplementary feeding
open this folder and view contentsCaring for caregivers
open this folder and view contentsProtecting children
open this folder and view contentsMalnutrition
open this folder and view contentsThe acute phase of emergencies
open this folder and view contentsAssessment, intervention and monitoring
View the documentConclusion
View the documentANNEX 1. Recommended reading
View the documentANNEX 2. Practical steps to ensure appropriate infant and young child feeding in emergencies1
View the documentANNEX 3. Feeding in exceptionally difficult circumstances1
View the documentANNEX 4. WHO Technical Consultation on Behalf of the UNFPA/UNICEF/WHO/UNAIDS Inter-Agency Task Team on Mother-to-Child Transmission of HIV
View the documentANNEX 5. Ten steps to successful breastfeeding1
View the documentANNEX 6. Article 9 (labelling) from the International Code of Marketing of Breast-milk Substitutes1
View the documentANNEX 7. Examples of rations for general food distribution providing 2100 kcal per person per day
View the documentANNEX 8. Policy of the UNHCR related to the acceptance, distribution and use of milk products1 in feeding programmes in refugee settings
View the documentANNEX 9. Guiding principles for complementary feeding of the breastfed child1
View the documentANNEX 10. Framework for implementing selective feeding programmes
View the documentANNEX 11. Determining initial assessment priorities at an emergency site
View the documentANNEX 12. Core indicators for assessing infant feeding practices

Guiding principles for feeding infants and young children during emergencies


Principle 1

Infants born into populations affected by emergencies should normally be exclusively breastfed from birth to 6 months of age.

1.1 Every effort should be made to identify alternative ways to breastfeed infants whose biological mothers are unavailable.

Principle 2

The aim should be to create and sustain an environment that encourages frequent breastfeeding for children up to two years or beyond.

Breast-milk substitutes

Principle 3

The quantity, distribution and use of breast-milk substitutes at emergency sites should be strictly controlled.

3.1 A nutritionally adequate breast-milk substitute should be available, and fed by cup, only to those infants who have to be fed on breast-milk substitutes.

3.2 Those responsible for feeding a breast-milk substitute should be adequately informed and equipped to ensure its safe preparation and use.

3.3 Feeding a breast-milk substitute to a minority of children should not interfere with protecting and promoting breastfeeding for the majority.

3.4 The use of infant-feeding bottles and artificial teats during emergencies should be actively discouraged.

Complementary feeding

Principle 4

To sustain growth, development and health, infants from 6 months onwards and older children need hygienically prepared, and easy-to-eat and digest, foods that nutritionally complement breast milk.

Principle 5

Caregivers need secure uninterrupted access to appropriate ingredients with which to prepare and feed nutrient-dense foods to older infants and young children.

5.1 Adequate feeding of infants and young children cannot be assured if the food and other basic needs of households are unmet.

5.2 Blended foods provided as food aid, especially if they are fortified with essential nutrients, can be useful for feeding older infants and young children.

However, their provision should not interfere with promoting the use of local ingredients and other donated commodities for preparing suitable complementary foods.

5.3 Complementary foods should be prepared and fed frequently, consistent with principles of good hygiene and proper food handling.

Caring for caregivers

Principle 6

Because the number of caregivers is often reduced during emergencies as stress levels increase, promoting caregivers’ coping capacity is an essential part of fostering good feeding practices for infants and young children.

Protecting children

Principle 7

The health and vigour of infants and children should be protected so they are able to suckle frequently and well and maintain their appetite for complementary foods.


Principle 8

Nutritional status should be continually monitored to identify malnourished children so that their condition can be assessed and treated, and prevented from deteriorating further. Malnutrition’s underlying causes should be investigated and corrected.

8.1 Special medical care and therapeutic feeding are required to rehabilitate severely malnourished children.

The acute phase of emergencies

Principle 9

To minimize an emergency’s negative impact on feeding practices, interventions should begin immediately. The focus should be on supporting caregivers and channelling scarce resources to meet the nutritional needs of the infants and young children in their charge.

Assessment, intervention and monitoring

Principle 10

Promoting optimal feeding for infants and young children in emergencies requires a flexible approach based on continual careful monitoring.


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