Supporting NICU Mothers’ Breastfeeding Goals During Climate-Related Disasters Using Kumpfer’s Resilience Framework and CMIST

BACKGROUND: Breastfeeding mothers and their infants face unique risks during climate-related disasters, including disrupted access to protective factors such as healthcare, communication, and social support systems. Although breastfeeding provides critical immunological and nutritional benefits, early weaning often occurs due to stress, inadequate preparedness, poorly coordinated relief efforts, operational barriers, dislocation, and prolonged adversity. PURPOSE: This paper proposes a structured approach to enhance neonatal intensive care unit (NICU) preparedness for, and breastfeeding support during, climate-related disasters by integrating Kumpfer's Resilience Framework with the Communication, Maintaining Health, Independence, Safety, Support, and Self-determination, and Transportation (CMIST) Framework. RESULTS: Kumpfer's Resilience Framework illustrates how mothers adapt their breastfeeding goals during climate-related disasters, shaped by responses to the surrounding environment and internal resiliency factors. The CMIST Framework guides NICU nurses in assessing disaster-related needs and functional considerations for mothers and infants. Integrating these frameworks enables NICU nurses to identify preparedness gaps, assess available resources, and implement contextually tailored interventions. This approach promotes critical thinking within disaster contexts and supports individualized adaptation of breastfeeding goals by addressing disaster-related needs. IMPLICATIONS FOR PRACTICE AND RESEARCH: The combined use of Kumpfer's Resilience Framework and CMIST offers a nonprescriptive, adaptable guide for NICU nurses to enhance climate-related disaster response strategies that support breastfeeding mothers. NICU nurses can contribute to disaster planning within hospitals, governmental agencies, and nongovernmental organizations to address the needs of breastfeeding mothers and infants. Future research should examine which NICU-specific climate-related disaster preparedness efforts strengthen and optimize maternal resilience and breastfeeding outcomes across diverse settings.