“You can’t just say you need to breastfeed” - identifying barriers and solutions to appropriate infant feeding in emergencies

Abstract The 2017 Operational Guidance for Infant and Young Child Feeding in Emergencies and other international policies aim to enhance infant and young child feeding during emergencies (IYCF-E). However, in practice these guidelines continue to be poorly implemented. This article investigates the underlying reasons that hinder their effective implementation. Semi-structured interviews with humanitarian professionals and a literature review lead us to identify three main barriers to effective IYCF-E: Structural, socio-economic and cultural factors; the prevalence and use of infant formula; and shortcomings in humanitarian practice and IYCF emergency preparedness. Based on these findings we argue that in order to ensure appropriate implementation of infant and young child feeding policies during emergencies, IYCF needs to be prioritised and localised in non-emergency settings and within humanitarian practice. Our novel recommendations for localised infant feeding support, emergency preparedness and response are likely to improve health outcomes for mothers and children both before and during emergencies.