Challenges With Pediatric Mass Care Feeding

This page is a constant work-in-progress.  Please re-check back here again frequently, for more details and material. Current timeline or milestone status is at the end of this page. Thank you for viewing, learning more and hopefully joining our advocacy efforts. Big news - as of 1/6/25 Public Assistance on Declared Disasters now supports breast feeding / chest feeding in congregate care shelters under PA Category B - Emergency Protective Measures!

See our blog post on this, as a starting point and subscribe for updates.

Our Published Articles:

Prasad, M, Russell, JH. Challenges with pediatric mass care feeding. Dom Prep. 2023;19(5):27–31. https://www.domesticpreparedness.com/journals/may-2023 

Russell, J. H., Haushalter, A., & Rhoads, S. J. (2025). Supporting Breastfeeding Women Amid Natural Disasters in the US: A Scoping Review. Disaster Medicine and Public Health Preparedness, 19, e24. doi:https://doi.org/10.1017/dmp.2024.323

Our Published Book Chapter:

Issues for Infant and Toddler Feeding at Disaster Mass Care Sites: Paradigm Shifts for Strategic and Operational Planning - in  Current and Emerging Trends in the Management of International Disasters (2024)

IRB Research Approval at the end of this page.

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Disasters can disrupt daily life, affecting various facets of society, including food security and nutrition. The prevalence of food allergies is increasing. While there has been a general focus on improving infant and young child nutrition during disasters, the specific challenges faced by children with food allergies are often neglected in disaster preparedness and response. (Adeoya, A. A. (2024). Enhancing the Nutritional Well-Being of Children With Food Allergies During Disaster. Disaster Medicine and Public Health Preparedness, 18, e47. doi:10.1017/dmp.2024.37) https://pubmed.ncbi.nlm.nih.gov/35173109/

U.S. National Mass Care Strategy Items - See Downloads below

• NEWLY ADDED! Infant/Toddler Feeding Support Statement, as of May 2, 2024 
• Our Recommendations, what we want added to the NMCS website (see below):
  • Infant/Toddler Feeding Exercise Series - Exercise Facilitator Handbook EXPLAN
  • 'Before' (Preparedness/Prevention/Protection) - Sample Table Top Exercise (TTX)
  • 'During' (Response/Interim Recovery) - Sample TTX
  • 'After' (Long-Term Recovery/Mitigation) - Sample TTX
  • Logistics and Supply-Chain Management/Security - Sample TTX - TBD
  • Durable Medical Equipment (DME)
  • Consumable Medical Supplies (CMS)
    • Baby Bottle Nipple Compatibility Info (from The Glass Baby Bottle*)
    • Breast Pump Baby Bottle Compatibility Info (from The Glass Baby Bottle*)
  • Accessible Sites: Inclusive and Equitable Access to Emergency Sites - by Samantha Clements (includes references for support of breastfeeding in shelters)
    • 'Clean' PDF version
    • WORD version with commentary 

U.S. National Mass Care Exercise - NMCE (2024)

• Pediatric Feeding in Mass Care Webinar 2024-01-29 - State of Pennsylvania
• Commonwealth's Media Release on the exercise
• 2024 NMCE After-Action Report / Improvement Plan - State of Pennsylvania
  • Barton Dunant's comments on the 2024 NYCE which were not included
• See below for downloads of potential exercise MSEL Injects and EEGs

US HHS: ASPR/ACF/CDC

• Infant Feeding During Disasters
• Infant and Young Child Feeding in Emergencies Toolkit
• Pediatric Disaster Care Centers of Excellence (ASPR)

American Red Cross and other Disaster Shelter Operators (i.e., general population evacuation shelters, serving people with disabilities and access/functional needs)

• Working with their national leadership for updating/revising mass care feeding plans, organization, equipment, training, and exercises associated with pediatric mass care feeding
• This work is aligned to FEMA/DOJ guidelines for mass care shelter operators issued in 2010, which includes the need to support disabilities, access & functional needs within general population shelters (i.e., eliminating the segregation and separation of 'special needs' sheltering). 
• Support is need for nursing mothers with Durable Medical Equipment (DME), including high-quality breast pumps and medical refrigeration, Consumable Medical Supplies (CMS) (including pads and human milk storage containers, bottles, etc.), and Personal Assistance Services (PAS) (including lactation counseling).
• Work should be performed with a continuous improvement perspective, and one which includes a feedback loop from the shelter clients (i.e., the nursing mothers) themselves.
• Exercises should be designed along a stair-stepped approach and follow the HSEEP process.

US FEMA

• Public Assistance Program and Policy Guide v5  (now includes congregate care support for breast feeding / chest feeding, on p. 143)

US FDA

• What to Know When Buying or Using a Breast Pump
• Buying and Renting a Breast Pump

International Association of Emergency Managers (IAEM)

- TBD

Academy of Breastfeeding Medicine (ABM)

• Position Statement on Breastfeeding in Emergency Situations 

U.S. Breast Feeding Committee (USBC)

• Breastfeeding References and Links
• Infant and young child feeding in emergencies (IYCF-E)
• Alimentación Segura en Emergencia (en español)

U.S. National Association of County and City Health Officials (NACCHO)

• Breastfeeding Public Health Partners - Equity & Inclusive Language Toolkit June 2024

U.S. National Academies (NIH)

• Challenges in Supply, Market Competition, and Regulation of Infant Formula in the United States
  • Barton Dunant Commentary

Australia

• The Babies and Young Children in the Black Summer (BiBS) Study

World Health Organization (WHO)

• Marketing of breast milk substitutes: national implementation of the international code, status report 2020

Sphere

• Sphere Interactive Handbook (2018) English Version, see Vector Control Standard 4.2, p. 124
• Minimum Standards (EN) for child protection in humanitarian action (CPMS-2013), Standard 22, p. 190

Jefferson County, Colorado, US

• Infant and Young Child Feeding plans, kit lists, training, and more.

Academic Journal Articles (may require access)

• Dyck, S., R. J. Fraser, S. E. DeYoung, S. Leahy, and E. Pumo. “Including the Maternal and Infant Needs in Preparedness and Sheltering: A Case Study Emphasizing Hurricanes Ida and Ian”. Journal of Emergency Management, vol. 23, no. 2, Mar. 2024, pp. 341-50, doi:10.5055/jem.0907.

* non-governmental sites (commercial and non-profit) have not been fully researched, and may contain unverified and/or biased information. There may also be financial incentives towards specific products and/or services at those sites. Barton Dunant has no financial interest or connection, and makes no warranties for use.