How will we feed the babies?

As our world evolves over coming decades, facing climate change, global unrest, vulnerable supply chains and uncertain economies - has anyone asked this question?

The obvious answer is breastfeeding but it is not as straightforward as that. Increasingly, babies are being mixed-fed - breastfeeding and/or expressed milk plus infant formula. Many are exclusively formula fed before they are 6 months old.

This is not about your personal choices or circumstances: we are considering the options and challenges parents in the coming decades will have.

So let's look at the big picture of infant feeding as we head towards 2050. There are currently four ways we can feed infants six months and under:

Breastfeeding directly
Mothers own breastmilk, expressed
Donor breastmilk
Infant formula products

Breastfeeding directly

When a mother feeds her own baby at her own breast there are zero food miles, minimal environmental impact and high food security. Despite the mythology, there is little risk of a mother’s supply failing during stressful experiences like extreme weather events and other natural disasters. Even in poverty or famine, her body will prioritise her infant’s nutrition over her own. Mothers need the very best support and assistance when they face problems which risk the establishment and maintenance of breastfeeding: women do not fail to breastfeed but society regularly fails to enable them to reach their goals. During emergencies, mothers need access to safe and comfortable spaces to breastfeed, enough water to meet their needs and privacy where required.

Breastfeeding in evacuation or emergencies is most at risk from well-meaning but unnecessary concerns about milk supply from volunteers and staff, with donated infant formula offered to all mothers of infants, not just those who are not breastfed. “Just in case” is unnecessary and can lead to additional problems.

Information for families of breastfed babies in emergencies can be found here: Emergency resources for babies and toddlers

Mothers own milk, expressed

Mothers who are exclusively or regularly feeding their infant expressed breastmilk have an increased risk during events affecting electricity and water supply. Freezers and fridges may cease to be available in the short or long-term. Breastpumps relying on power to use or recharge are vulnerable as well. Evacuation centres may not have facilities available to support women who are expressing their milk. Learning to hand express and having access to manual breast pumps will be important as preparation for emergencies.

In Australia, resources for women who are expressing have been included in new information for families and the services who support them when evacuated.

It is important to have a plan in case you experience loss of power and have milk stored in your fridge or freezer. In the case of your own equipment failing, a neighbour might be your back-up option. Where a localised power outage occurs, there are guidelines for protecting or saving your frozen milk. But in the case of wide-spread outages due to extreme weather events or other disasters, you might need to relocate your freezer stash where possible. If your baby is exclusively expressed breastmilk fed, careful management of your pumping to feeding routine might allow you to use up the frozen milk during the thawing phase, if you can access fridge facilities to safely store your freshly expressed breastmilk for 72 hours. In extreme situations, you might need to access infant formula back up while you maintain expressing for immediate feeding only. Planning will allow you to feel prepared in advance. Your preparations might include purchasing a suitable sized cooler and freezing ice packs to have on hand.

Donor milk

Mothers express their own breastmilk for babies of other parents, facilitated by informal milk sharing and milk bank services run by hospitals or other organisations. These mothers face the same risks as mothers expressing for their own babies, with additional challenges of safe transport and storage. Mothers relying on donor milk are particularly at risk as the infrastructure of storage and delivery can be impacted by power failure, road closures, evacuation, civil unrest or war. However, access to donor milk can also become more important in all of these situations, as shown recently during the conflict in Israel.

Infant formula products

Babies who are exclusively formula fed are most at risk. Infant formula supply can be impacted by panic buying, contamination and supply chain issues as seen in recent years. In emergencies, accessing and safely preparing and feeding infant formula can be challenging. But it is when we look further into the uncertain future we see the greatest risks. The dairy industry on a global level has huge impact on our environment, as does the growing soy industry. Methane - a greenhouse gas excreted by cattle - may need limitation in a warming climate. Transport of livestock, processed milk powder and the end product all require freight services - sea, air, rail and road are all part of the chain. Packaging of infant formula products cannot always be recycled and relies on heavy industry for supply and construction.

Studies have shown one kilogram (kg) of infant formula adds between 11 and 14 kgs CO2 eq. of GHG (greenhousegas) to the planet by the time it is fed to babies and young children.

While we will always need an alternative for babies who are unable to access their own mother’s breastmilk, there may come a time when it is unsustainable to have a global dairy industry on the scale it is currently.

Information for families who use infant formula have also been made available for parents and the services supporting them during evacuation: Read more here: Emergency resources for babies and toddlers

Infant feeding equipment

The products used to feed babies any milk other than direct feeding are a factor for all families using them. Production and supply costs will increase as industry changes. Current reliance on plastics may need to change, with a return to glass bottles and natural rubber teats as more sustainable options. The use of electricity for disinfecting equipment - steam sterilisers, microwave units etc are uncertain options during emergencies or evacuation and chemical options rely on a safe water supply. Boiling clean water to disinfect equipment relies on a fuel source itself, which might not be accessible. Where safely cleaning and disinfecting infant feeding equipment like bottles and teats is not possible, cup-feeding is the safest alternative for both formula and breastmilk-fed babies, as cups can be washed more simply.

Information on cleaning infant feeding equipmen in emergencies can be found here: Emergency resources for babies and toddlers

Single-use plastic is increasingly being used by mothers storing expressed breastmilk. Reusable options are less convenient. As more mothers return to paid work while breastfeeding, workplaces need to provide better facilities for breastmilk management. As regulations around single-use plastics are implemented around the world, reliance on disposable breastmilk bags will not be viable.

Single-use plastic is convenient but unsustainable

Breastfeeding support must improve to provide sustainable infant feeding for future infants. Social barriers must be taken out of the equation - all babies who can be breastfed should be breastfed and communities must embrace this.

Reliance on infant formula supplementation in the early days can be tempered by improving access to milk banks and changing community attitudes to milk sharing.

Human breastmilk is the sustainable way to ensure babies and young children have food security now and in the future. Our global community needs to work together to protect that.

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