Breastfeeding for Refugee Mothers | World Refugee Week
Last week (20th - 26th June), it was World Refugee Week. A week where organisations, charities and support networks raise awareness of how innocent lives are effected by violence and conflict. This week is designed to share how we can help those who need it. Statistics show that 89 million people are displaced and according to UNHCR, 80% of these are women and children.
This percentage got me thinking about how many of these people are breastfeeding. It got me thinking about how almost all parents find breastfeeding difficult, healing from birth frustrating and babies exhausting. However, refugee mothers have to deal with all of this and so much more. I wanted to share the resources a found which try and outline the difficulties faced by refugee breastfeeding mothers however, I know there will be so much to say. Please, if you feel that I haven't talked about enough, add more of what you find out about this situation in comments below. Let's really get the conversation going.
According to IYCF-E breastfeeding is often the most overlooked aspect of crisis management but actually breastfeeding should be one of the first ways to support refugees as a baby with a good latch will essentially save a baby's life as it provides immune boosting nutrients and nourishment at a time when resources are hard to find. Breastfeeding can be stress relief for both mother and baby. It also decreases mortality rates and improves mothers health.
Refugees & Asylum Seekers' situations are chaotic, traumatic & often dangerous and this can make breastfeeding difficult but there's more to it than this. The barriers to breastfeeding are invisible and I wanted to share some of those today.
When the place you call home is no longer safe, necessities like food become scarce meaning your next meal isn't guaranteed. It's not uncommon for Mothers to become malnourished. Malnourishment is a barrier faced by refugee mothers as it causes low mood, lack of energy and poor health. Alongside the physiological effects this has on someone, it can also cause stress if the Mother is worried her milk isn't good enough to nourish baby. Stress can cause a decrease in breastmilk supply which could lead mothers opting for another feeding style.
Breastmilk supply decreasing due to stress is often a short term change which will return to normal after a week or so. However, some of this worry is valid as research from Oxford Uni has shown that babies of malnourished mothers show signs of inflammation and therefore have an increased likelihood of stunted growth (Rockers, 2019).
Millions of refugees reside in refugee camps across the world. These are places which are built to provide short-term safety for those who's homes are destroyed or are no longer safe. Refugee camps may provide a place to live however, they are crowded, lack resources and offer little privacy. This is because they are built for short term solution but often become a long term home as many refugees become stranded between borders and have no where else to go.
These barriers to breastfeeding are trying to be overcome by humanitarian charities.
In the places that Save the Children can go, they set up Mother-Baby areas which allow for a safe and quiet space for breastfeeding. Their teams provide breastfeeding counselling which can help with a number of breastfeeding issues as well as provide moral support for breastfeeding as well as encouragement and education on the benefits of this choice.
Lack of resources aka power would eliminate a mother from being able to use any powered breast pump. This is why breastfeeding item donation initiatives like Emily's from Mama's Milk are a great idea as items helped breastfeeding mothers continue with their journies after war broke out in Ukraine. One item donated was a silicone breast pump which enables pumping breastmilk.
The pros to a silicone breast pumps are that they do not need power or assembly as they consist of one piece of food grade silicone. They can handle the 'boiled water method' of sterilisation too. Bottles may be scarce and are a hygiene risk when water is not available to wash them so instead, a baby can be fed directly from the silicone pump using the 'cup method'
Donations are a lifeline and often, Infant formula is the first thing to be donated. The intention is pure, as formula is sent as no one wants a baby to go hungry, however, it has to be acknowledged that it's availability increases the likelihood of formula being used and therefore decreases the likelihood of breastfeeding.
In some camps, it's been observed that formula is offered to all mothers and it's often taken by everyone as things are scarce so they want to stock up whatever they can, understandably. A problem with formula, is that stock can be unpredictable, stock can decrease or become expensive. One mother paid 14 euro in an article I read. When things become uncertain, mothers have been known to dilute the formula to make it go further. Diluting formula is not recommended and does not make it go further, it actually decreases the nutrients per portion and therefore baby can become unwell.
One article reported a mother spending 14 euro on a packet of formula!
Baby can become sick when bottles are not prepared or washed properly with formula too. This risk is higher in Refugee camps as they have limited water and often no washing up liquid or soap. Often mothers only have one bottle and one teat and rely on boiling before each use to sterilise it. As touched on earlier, I have found an article which explains how human rights groups have been encouraging refugee mothers who bottle feed to use cups or the bottle without the teat as the teat is the part of the bottle which has the most bacteria when not properly washed.
Human Rights groups are working on the balance of protecting parents from formula companies' marketing whilst ensuring babies are not going hungry. Midwives and lactations consultants visit refugees where they can and when they see new mothers they will assess the breastfeeding and offer advice where they can. Mothers will be supported and encouraged to continue breastfeeding for as long as possible.
Applying this to pumping
You can only imagine how mentally and physically difficult all of this would be for a mother to go through. From the stresses all lactation brings with the added stress and trauma of being a refugee.
I have searched for anything referring to refugee mothers breast pumping but I cannot find anything but I can understand why. The barriers to breast pumping are intuitive after reading about the barriers to nursing.
It wouldn't be hygienic. Breastmilk is antibacterial and therefore it's much easier to clean bottles which have been used for breast milk as apposed to formula but bottle feeding still requires a teat and as I referenced before, teats need to be cleaned thoroughly for best practice. There is little or no soap available to properly clean them so it's not practical.
There is little or no power meaning all powered pumps are not practical either and would be off limits. Electric items have an added element of impracticality because they are easier to break in transit and bad weather, one wrong move with a bag and crunch, the pump is broken. Thinking of bags and being on the move, a breast pump, plus flanges and a bottle would take up a lot of space and are just generally be impractical when you're only able to carry one bag, plus your child when travelling to get to a safer place.
The only way I can think some mothers would be able to express some milk for baby is with a silicone breast pump. They could cup feed or someone else could do it for them. The pump would fit into a bag and could be cleaned with boiled water. However, I can understand that many mothers have plenty of other things to be dealing with that the devotion to pump even for ten minutes would be difficult.
We can reflect and understand that in this context. Pumping is a privilege. It allows many of us who cannot nurse, to offer breast milk in another way so baby can continue to reap benefits of breastmilk when nursing is not an option.
With this thought, let's be mindful of others in less fortunate position and use our privilege for good by showing support. If we all show supporting for breastfeeding refugee mothers i'd hope they receive more help and recognition by organisations and our government.
What can we do?
Reading this blog post is one way we can help refugee mothers, as taking time to learn about how others live allow us to learn different opinion and lifestyles. We can become an ally by learning about the context of others and their situations.
You may want to take further steps in wanting to show your support for refugees.
It often feels like we can't do anything but @RefugeeWeek have curated #SimpleActs which are small acts of kindness that if we all do, will contribute to positive change.
You can donate to a cause which you feel is helping refugee mothers to breastfeed their babies and your money will help them to continue .
You could write a letter to refugee child and wish them hope and happiness.
You can write to your MP, demanding change. For example, writing to demand they stop flights to Rwanda and instead, provide safety in the UK for refugees.
You can watch a film which focuses on breastfeeding refugee mothers to learn more about their lives (see links below!).
You can share what you think on social media, share with a coworker how you feel or talk to a friend about what you've found out. Show others what you support and get the conversation flowing.
You can show your love for other nursing & pumping mothers by attending an infant feeding group. Bring something with you to bring the group closer like a cake or some biscuits. Food is a way to show love.
Find more: https://refugeeweek.org.uk/simple-acts/
I've taken some simple acts to show my support for refugee mothers. I hope you do too.
Any who needs support with pumping should DM or visit LittlePumpling.com
Breastfeeding in Emergency situations - video - https://ne-np.facebook.com/AMURTEL.Greece/videos/%E2%84%B9%EF%B8%8F-breastfeeding-in-emergency-situations-1-didi-the-director-of-amurtel-greece-h/3155040528144232/
The hidden obstacles for breastfeeding refugees - @unicef
How one group stopped the spread of formula in a Refugee Camp
Infant feeding in the Refugee Crisis - Association of Breastfeeding Mothers
Maternal Malnutrition, Breastfeeding, and Child Inflammation in India (P11-025-19)
Mother Sends Breastfeeding Products to Ukraine
Refugee Camps Explained - UNHCR
Refugees Magazine Issue 95 (The international year of the family) - Help for single-parent refugee families
Responding to breastfeeding complications amongst breastfeeding refugee mothers - Youtube - https://www.youtube.com/watch?v=FL5sPckQbbw
Syrian refugee breastfeeding practises
Why we're helping refugee mothers to breastfeed in refugee camps - Save the Children