Preparing babies for emergencies in storm and bushfire season
Heading into any natural disaster, you’re repeatedly told to do everything you can to be prepared.
Enough water — check. Food for three days — check. Enough thought paid to people with special needs — check.
But what happens if you’re a mother with a bottle-fed baby and the right advice for your particular situation is almost impossible to find?
I felt like a failure when I couldn’t breastfeed my first-born baby, Archie.
Looking for advice then about how to bottle-feed was frustrating.
I cried, I lost precious sleep. I spent hours trying to find advice from lactation consultations, from breastfeeding support groups and from maternity health nurses — but I felt that most were geared towards encouraging breastfeeding, even when it wasn’t working.
I learned from my GP that I was at risk of post-natal depression. Eventually I began to feel like my experience of early motherhood didn’t count.
But nothing could prepare me for the alienation I would feel trying to get ready for our first cyclone season in Darwin.
For mothers like me, the regime to formula feed and express milk is intensive at any time of the year.
You make time to wash and disinfect bottles and sterilise water in between pumping breast milk with an electric pump. When a natural disaster threatens those crucial supplies of power and water, it follows that being unable to do these things can quickly threaten your baby’s health.
Archie is two-and-a-half now, but only recently did I learn that my experiences are far from unique. In fact, a small movement of researchers agree current guidelines may be catching some young families out.
According to one leading expert, Karleen Gribble from Western Sydney University, the gap in policy is staggering.
“So we have a massive problem.”
Not all guidelines consider everyone
What led Dr Gribble to believe our pets may be better off?
Recently the adjunct associate professor undertook an audit of the guidelines provided by state and territory emergency bodies around Australia and found many are riddled with gaps when it comes to babies with various feeding needs — even here in the cyclone-prone Top End.
The Northern Territory Emergency Service guidelines says that an emergency kit should include special needs for infants.
But the same document advises packing just 10 litres of bottled water per person for three days. (They also provide a detailed pet emergency kit telling people to prepare things like drinkable water in plastic bottles, medical records and medications, and even current photos in case your pet gets lost.)
Dr Gribble says this fails to consider the immense amount of water mothers like me need — not only to mix formula, but to properly wash bottles and avoid any risk of contamination from unsafe water.
“There’s no allowance in there for formula-fed infants,” Dr Gribble says.
“Really you’re going to want to look at having 25 litres of water per day at a minimum for a formula-fed infant.
“That’s a lot of water.”
Make clean feeding containers a priority
In the rush of bunkering down for a disaster, doing something like making sure you’ve set aside a mountain of clean feeding containers might not seem like a priority.
But there is research that suggests families are vulnerable — and that a lack of preparation is having very real consequences.
Ruth Newby, a lecturer in sciences for nursing at the University of the Sunshine Coast, has spoken to more than 130 mothers about their experiences with infants during Cyclone Yasi and the 2010/2011 Queensland floods.
Her research showed a correlation between babies that were formula-fed and those that had to see a doctor after those events.
“I found that families who had babies that were fed with formula, their infants were more likely — in fact, 9.5 times more likely — than babies who were not using formula to need to visit a GP after the emergency,” Dr Newby says.
“We found that people had difficulty sourcing clean water to make up formula, and also difficulty in properly cleaning the bottle, the teats, and so on.
“They were presenting with coughs and runny noses, with feeling unwell, with sore ears and also particularly with vomiting and diarrhoea.”
Prepare, prepare, prepare
Ultimately, according to Simone Braithwaite, a lot of these risks can be avoided with thorough preparation — even if some of the information can be hard to find.
Ms Braithwaite is the manager of health and wellbeing policy in Queensland Health’s preventive health branch, and back in 2011 she was part of a statewide working group focusing on food requirements during natural disasters.
The working group brought together experts from all kinds of fields: water, food safety, nutrition.
“We realised that very few people actually addressed the needs of infants,” she says.
“Particularly of concern is that issue of when babies are under 12 months.”
The pantry lists Ms Braithwaite went on to help develop are among the most thorough provided by state and territory authorities, according to Dr Gribble.
Looking through the incredibly specific guidelines, you might be surprised by just how much of everything you need.
Twenty-four 250ml bottles of water and 27 feeding bottles and teats are just the beginning of what’s required to keep a six-month-old infant healthy for a three-day emergency period.
“Now that seems like quite a large amount, but we’re still only recommending people use them once and then keep them until they have access to power and water and they can actually go through a full sterilisation again,” Ms Braithwaite says.
“We’re not suggesting people reuse those bottles during that three-day period because the risk of infection and having your baby become very unwell very quickly is just too great.
“[While] some people … might think, ‘Oh, I wouldn’t need that much’, there’s been a huge amount of thought and expertise gone into that list, and I think it’s as tight as it can be.”
Some things to think about
According to Dr Gribble, breast-fed babies are the easiest to plan for, because as long as mum has access to water and stays hydrated, baby gets fed.
(That said, stress can slow or interrupt the flow of milk. She says calmness and persistence are key.)
But that doesn’t mean getting ready with a formula-fed or breastfed baby has to be difficult, and there are some things you can do to avoid disaster if you’ve left things a little late.
Dr Gribble offers these tips:
- Put expressed milk in the freezer. Some freezers can stay cold for days without power — especially if it’s full and the door stays closed. It helps to put containers of ice around milk to keep it frozen for longer. Then you can defrost it and feed your baby.
- Learn to hand express. It’s a skill, according to Dr Gribble, but it can actually be faster than using a pump. There are tutorials online, or the Australian Breastfeeding Association can offer advice. As long as you have hot water to clean it afterwards, a hand pump may be a good alternative.
- Have a stove, gas bottle and pot for boiling water. If you need to boil water to sterilise it before preparing formula, you won’t get far without these.
- Wait until after the emergency season to wean your baby. It’s an already stressful time, so don’t add to it by changing your feeding routines. Likewise, don’t leave it to this period to change from breast to formula feeding or vice versa.
- Focus on your baby. No matter how your baby is fed, if their caregiver is calm and responsive, babies will pick up on it. That protects them from a lot of the trauma of emergencies.
‘We assume clean water will be available’
Looking back at what we packed into our cyclone kit, I realise we dodged a bullet.
If a severe cyclone had have hit Darwin that season, we could’ve become stranded without a way to feed Archie, or a lack of things to feed him with.
Dr Newby and Dr Gribble’s research suggests that even in resource-rich environments such as Australia, we need to think more thoroughly about the conditions we encounter in natural disasters.
“But in the case of a natural disaster or emergency, we become similar to an emerging country, where clean water is not always available.
“The nature of a disaster, the nature of an emergency means that even best-laid plans can not be sufficient.”
Liz Trevaskis is an ABC broadcaster based in Darwin.