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<p class=MsoNormal><b><u><span style='font-size:14.0pt;font-family:"Calibri","sans-serif";
color:#1F497D'>JOINT STATEMENT ON APPROPRIATE FEEDING FOR INFANTS AND YOUNG CHILDREN
IN HAITI<o:p></o:p></span></u></b></p>
<p class=MsoNormal><span style='font-family:"Calibri","sans-serif";color:#1F497D'><o:p> </o:p></span></p>
<p class=MsoNormal><span style='font-family:"Calibri","sans-serif";color:#1F497D'>Please
find below and attached a recent statement aimed at preventing illness in
infants and young children in Haiti due to unsafe feeding practices.<o:p></o:p></span></p>
<p class=MsoNormal><span style='font-family:"Calibri","sans-serif";color:#1F497D'><o:p> </o:p></span></p>
<p class=MsoNormal><span style='font-family:"Calibri","sans-serif";color:#1F497D'>The
conclusion to the statement is: <o:p></o:p></span></p>
<p class=MsoNormal style='margin-left:.5in'><b><span style='font-family:"Calibri","sans-serif";
color:#1F497D'>UNICEF, WHO and WFP strongly urge all who are involved in
funding, planning and implementing the emergency response in Haiti to avoid unnecessary
illness and death by promoting, protecting and supporting breastfeeding and
appropriate complementary feeding and by preventing uncontrolled distribution
and use of breast-milk substitutes. Public and private sector entities and
individuals who wish to support infants and young children and their mothers
and caregivers in this emergency should donate funds rather than send goods. We
further urge governments and partners to include capacity building for
breastfeeding and infant and young child feeding as part of emergency
preparedness and planning, and to commit financial and human resources for
appropriate and timely protection, promotion and support of optimal infant and
young child feeding in this and other emergencies.<o:p></o:p></span></b></p>
<p class=MsoNormal><span style='font-family:"Calibri","sans-serif";color:#1F497D'><o:p> </o:p></span></p>
<p class=MsoNormal><span style='font-family:"Calibri","sans-serif";color:#1F497D'>This
statement highlights the following points:<o:p></o:p></span></p>
<p class=MsoListParagraph style='text-indent:-.25in;mso-list:l0 level1 lfo1'><![if !supportLists]><span
style='font-size:11.0pt;font-family:Symbol;color:#1F497D'><span
style='mso-list:Ignore'>ˇ<span style='font:7.0pt "Times New Roman"'>
</span></span></span><![endif]><span style='font-family:"Calibri","sans-serif";
color:#1F497D'>Chronic and acute malnutrition and communicable diseases put Haitian
children under five at risk even before the earthquake. The current situation
increases this risk tremendously for many reasons including decreased access to
safe water and poor sanitary conditions, and the fact that many children are
orphaned or separated from their families. </span><span style='font-size:11.0pt;
font-family:"Calibri","sans-serif";color:#1F497D'><o:p></o:p></span></p>
<p class=MsoListParagraph style='text-indent:-.25in;mso-list:l0 level1 lfo1'><![if !supportLists]><span
style='font-size:11.0pt;font-family:Symbol;color:#1F497D'><span
style='mso-list:Ignore'>ˇ<span style='font:7.0pt "Times New Roman"'>
</span></span></span><![endif]><span style='font-family:"Calibri","sans-serif";
color:#1F497D'>Attention to appropriate feeding and care of infants and young
children is essential during this time of emergency.</span><span
style='font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D'><o:p></o:p></span></p>
<p class=MsoListParagraph style='text-indent:-.25in;mso-list:l0 level1 lfo1'><![if !supportLists]><span
style='font-size:11.0pt;font-family:Symbol;color:#1F497D'><span
style='mso-list:Ignore'>ˇ<span style='font:7.0pt "Times New Roman"'>
</span></span></span><![endif]><span style='font-family:"Calibri","sans-serif";
color:#1F497D'>All children under six months should be exclusively breastfed
and all efforts to encourage this should be made, including encouraging mothers
who have decreased or stopped breastfeeding to begin again (relactation). </span><span
style='font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D'><o:p></o:p></span></p>
<p class=MsoListParagraph style='text-indent:-.25in;mso-list:l0 level1 lfo1'><![if !supportLists]><span
style='font-size:11.0pt;font-family:Symbol;color:#1F497D'><span
style='mso-list:Ignore'>ˇ<span style='font:7.0pt "Times New Roman"'>
</span></span></span><![endif]><span style='font-family:"Calibri","sans-serif";
color:#1F497D'>Breast-feeding mothers should be given skilled support necessary
to enable them to continue to breastfeed as long a possible, including shelter,
food, security, and water and sanitation; enabling mother-to-mother support;
providing specific space for skilled breastfeeding counseling and support.</span><span
style='font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D'><o:p></o:p></span></p>
<p class=MsoListParagraph style='text-indent:-.25in;mso-list:l0 level1 lfo1'><![if !supportLists]><span
style='font-size:11.0pt;font-family:Symbol;color:#1F497D'><span
style='mso-list:Ignore'>ˇ<span style='font:7.0pt "Times New Roman"'>
</span></span></span><![endif]><span style='font-family:"Calibri","sans-serif";
color:#1F497D'>Non-breastfed infants under six months need to be identified and
closely monitored. If breastfeeding is not an option, breast-milk substitutes
are necessary and must be accompanied by training on hygiene, preparation and
use to minimize their associated risks. These supplements should be given to
infants in a cup or spoon because bottles and nipples are more difficult to
sterilize. Any needed breast-milk substitutes should adhere to Codex
Alimentarius Standards and should be procured in an efficient and rapid manner,
in coordination with UNICEF, the nutrition coordinating agency in Haiti. The
preferred type of breast-milk substitute is ready-to-use formula.</span><span
style='font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D'><o:p></o:p></span></p>
<p class=MsoListParagraph style='text-indent:-.25in;mso-list:l0 level1 lfo1'><![if !supportLists]><span
style='font-size:11.0pt;font-family:Symbol;color:#1F497D'><span
style='mso-list:Ignore'>ˇ<span style='font:7.0pt "Times New Roman"'>
</span></span></span><![endif]><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";
color:#1F497D'>Children from the age of six months require nutrient-rich,
age-appropriate and safe complementary foods in addition to breast milk.
Priority should be placed on locally available, culturally acceptable, nutritionally
adequate and age-appropriate foods. Micronutrient powders that can be added to
local foods, emergency rations or blended foods will also improve dietary
quality.<o:p></o:p></span></p>
<p class=MsoListParagraph style='text-indent:-.25in;mso-list:l0 level1 lfo1'><![if !supportLists]><span
style='font-size:11.0pt;font-family:Symbol;color:#1F497D'><span
style='mso-list:Ignore'>ˇ<span style='font:7.0pt "Times New Roman"'>
</span></span></span><![endif]><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";
color:#1F497D'>Mothers known to be HIV-infected should be supported to
exclusively breastfeed their infants for the first six months of life, to
introduce appropriate complementary foods thereafter, and to continue breastfeeding
for the first 12 months, along with provision of ARVs. (additional guidance is
being prepared)<o:p></o:p></span></p>
<p class=MsoListParagraph style='text-indent:-.25in;mso-list:l0 level1 lfo1'><![if !supportLists]><span
style='font-size:11.0pt;font-family:Symbol;color:#1F497D'><span
style='mso-list:Ignore'>ˇ<span style='font:7.0pt "Times New Roman"'>
</span></span></span><![endif]><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";
color:#1F497D'>Treatment of severely malnourished children, whether facility or
community based, should be implemented in accordance with international
standards and best practice and closely monitored.<o:p></o:p></span></p>
<p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";
color:#1F497D'><o:p> </o:p></span></p>
<p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";
color:#1F497D'>------------------------------------------------------------------------------------<o:p></o:p></span></p>
<div>
<p class=MsoNormal><span style='font-size:10.0pt;font-family:"Arial","sans-serif";
color:black'> <o:p></o:p></span></p>
</div>
<div>
<p class=MsoNormal><b><span style='font-size:18.0pt;color:black'>Call for
support for appropriate<o:p></o:p></span></b></p>
<p class=MsoNormal><b><span style='font-size:18.0pt;color:black'>infant and
young child feeding in Haiti<o:p></o:p></span></b></p>
<p class=MsoNormal><b><span style='font-size:18.0pt;color:black'> <o:p></o:p></span></b></p>
<p class=MsoNormal><b><span style='color:black'>UNICEF, WHO and WFP call for
support for appropriate infant and young child feeding in the</span></b><span
style='font-size:10.0pt;font-family:"Arial","sans-serif";color:black'><o:p></o:p></span></p>
<p class=MsoNormal><b><span style='color:black'>current emergency, and caution
about unnecessary and potentially harmful donations and use of</span></b><span
style='font-size:10.0pt;font-family:"Arial","sans-serif";color:black'><o:p></o:p></span></p>
<p class=MsoNormal><b><span style='color:black'>breast-milk substitutes</span></b><span
style='font-size:10.0pt;font-family:"Arial","sans-serif";color:black'><o:p></o:p></span></p>
<p class=MsoNormal><b><span style='color:black'> </span></b><span
style='font-size:10.0pt;font-family:"Arial","sans-serif";color:black'><o:p></o:p></span></p>
<p class=MsoNormal><span style='color:black'>During emergency situations,
disease and death rates among under-five children are higher than for any</span><span
style='font-size:10.0pt;font-family:"Arial","sans-serif";color:black'><o:p></o:p></span></p>
<p class=MsoNormal><span style='color:black'>other age group; the younger the
infant the higher the risk. Mortality risk is particularly high because of</span><span
style='font-size:10.0pt;font-family:"Arial","sans-serif";color:black'><o:p></o:p></span></p>
<p class=MsoNormal><span style='color:black'>the combined impact of a greatly
increased prevalence of communicable diseases and diarrhoea and</span><span
style='font-size:10.0pt;font-family:"Arial","sans-serif";color:black'><o:p></o:p></span></p>
<p class=MsoNormal><span style='color:black'>soaring rates of under-nutrition. <b>Appropriate
feeding and care of infants and young children is</b></span><span
style='font-size:10.0pt;font-family:"Arial","sans-serif";color:black'><o:p></o:p></span></p>
<p class=MsoNormal><b><span style='color:black'>essential to preventing
malnutrition, morbidity and mortality</span></b><span style='color:black'>.</span><span
style='font-size:10.0pt;font-family:"Arial","sans-serif";color:black'><o:p></o:p></span></p>
<p class=MsoNormal><span style='color:black'> </span><span
style='font-size:10.0pt;font-family:"Arial","sans-serif";color:black'><o:p></o:p></span></p>
<p class=MsoNormal><span style='color:black'>Major health problems among
Haitian children, which have been exacerbated by this crisis, are acute and</span><span
style='font-size:10.0pt;font-family:"Arial","sans-serif";color:black'><o:p></o:p></span></p>
<p class=MsoNormal><span style='color:black'>chronic malnutrition and
communicable diseases. Given the structural damage caused by the earthquake</span><span
style='font-size:10.0pt;font-family:"Arial","sans-serif";color:black'><o:p></o:p></span></p>
<p class=MsoNormal><span style='color:black'>to water supply systems, there is
an additional risk of water borne diseases affecting large numbers of the</span><span
style='font-size:10.0pt;font-family:"Arial","sans-serif";color:black'><o:p></o:p></span></p>
<p class=MsoNormal><span style='color:black'>urban, rural and displaced
populations. Many infants and young children have been orphaned or</span><span
style='font-size:10.0pt;font-family:"Arial","sans-serif";color:black'><o:p></o:p></span></p>
<p class=MsoNormal><span style='color:black'>separated from their mothers.
Risks to children in Haiti are exacerbated by pre-earthquake poor infant</span><span
style='font-size:10.0pt;font-family:"Arial","sans-serif";color:black'><o:p></o:p></span></p>
<p class=MsoNormal><span style='color:black'>and young child feeding practices
and malnutrition. In this emergency situation, the lifeline offered by</span><span
style='font-size:10.0pt;font-family:"Arial","sans-serif";color:black'><o:p></o:p></span></p>
<p class=MsoNormal><span style='color:black'>exclusive breastfeeding to
children for the first six months of life and continued breastfeeding with</span><span
style='font-size:10.0pt;font-family:"Arial","sans-serif";color:black'><o:p></o:p></span></p>
<p class=MsoNormal><span style='color:black'>complementary feeding for two
years or more is of utmost importance and must be protected, promoted</span><span
style='font-size:10.0pt;font-family:"Arial","sans-serif";color:black'><o:p></o:p></span></p>
<p class=MsoNormal><span style='color:black'>and supported as much as possible.</span><span
style='font-size:10.0pt;font-family:"Arial","sans-serif";color:black'><o:p></o:p></span></p>
<p class=MsoNormal><span style='color:black'> </span><span
style='font-size:10.0pt;font-family:"Arial","sans-serif";color:black'><o:p></o:p></span></p>
<p class=MsoNormal><span style='color:black'>Most mothers initiate
breastfeeding in Haiti, and the majority of infants less than six months of age
were</span><span style='font-size:10.0pt;font-family:"Arial","sans-serif";
color:black'><o:p></o:p></span></p>
<p class=MsoNormal><span style='color:black'>at least partially breastfed prior
to the earthquake. At this stage it is critical to encourage and support</span><span
style='font-size:10.0pt;font-family:"Arial","sans-serif";color:black'><o:p></o:p></span></p>
<p class=MsoNormal><span style='color:black'>mothers to initiate breastfeeding
immediately after the delivery, exclusively breastfeed up to six months</span><span
style='font-size:10.0pt;font-family:"Arial","sans-serif";color:black'><o:p></o:p></span></p>
<p class=MsoNormal><span style='color:black'>and for those with infants below
six months who ‘mix feed’ to revert to exclusive breastfeeding.
Nonbreastfed</span><span style='font-size:10.0pt;font-family:"Arial","sans-serif";
color:black'><o:p></o:p></span></p>
<p class=MsoNormal><span style='color:black'>infants are at especially high
risk and need early identification and targeted skilled support,</span><span
style='font-size:10.0pt;font-family:"Arial","sans-serif";color:black'><o:p></o:p></span></p>
<p class=MsoNormal><span style='color:black'>including re-establishing breastfeeding
(relactation).</span><span style='font-size:10.0pt;font-family:"Arial","sans-serif";
color:black'><o:p></o:p></span></p>
<p class=MsoNormal><span style='color:black'> </span><span
style='font-size:10.0pt;font-family:"Arial","sans-serif";color:black'><o:p></o:p></span></p>
<p class=MsoNormal><b><i><span style='color:black'>Protection and support for
breastfeeding women</span></i></b><span style='font-size:10.0pt;font-family:
"Arial","sans-serif";color:black'><o:p></o:p></span></p>
<p class=MsoNormal><span style='color:black'>No food or liquid other than
breast milk, not even water, is needed to meet an infant’s nutritional
and</span><span style='font-size:10.0pt;font-family:"Arial","sans-serif";
color:black'><o:p></o:p></span></p>
<p class=MsoNormal><span style='color:black'>fluid requirements during the
first six months of life. The valuable protection from infection that</span><span
style='font-size:10.0pt;font-family:"Arial","sans-serif";color:black'><o:p></o:p></span></p>
<p class=MsoNormal><span style='color:black'>breastfeeding confers is all the
more important in environments without safe water supply and sanitation.</span><span
style='font-size:10.0pt;font-family:"Arial","sans-serif";color:black'><o:p></o:p></span></p>
<p class=MsoNormal><span style='color:black'>Therefore, creation of a
protective environment and provision of skilled support to breastfeeding women</span><span
style='font-size:10.0pt;font-family:"Arial","sans-serif";color:black'><o:p></o:p></span></p>
<p class=MsoNormal><span style='color:black'>are essential interventions. There
is a common misconception that in emergencies, many mothers can no</span><span
style='font-size:10.0pt;font-family:"Arial","sans-serif";color:black'><o:p></o:p></span></p>
<p class=MsoNormal><span style='color:black'>longer breastfeed adequately
because of stress or inadequate nutrition. Concern for these mothers and</span><span
style='font-size:10.0pt;font-family:"Arial","sans-serif";color:black'><o:p></o:p></span></p>
<p class=MsoNormal><span style='color:black'>their infants can fuel donations
of breastmilk substitutes (BMS) such as infant formula. Although stress</span><span
style='font-size:10.0pt;font-family:"Arial","sans-serif";color:black'><o:p></o:p></span></p>
<p class=MsoNormal><span style='color:black'>can temporarily interfere with the
flow of breastmilk, it is not likely to inhibit breastmilk production,</span><span
style='font-size:10.0pt;font-family:"Arial","sans-serif";color:black'><o:p></o:p></span></p>
<p class=MsoNormal><span style='color:black'>provided mothers and infants
remain together and are supported to initiate and continue breastfeeding.</span><span
style='font-size:10.0pt;font-family:"Arial","sans-serif";color:black'><o:p></o:p></span></p>
<p class=MsoNormal><span style='color:black'>Mothers who lack food or who are
malnourished can still breastfeed. Provision of adequate fluids and</span><span
style='font-size:10.0pt;font-family:"Arial","sans-serif";color:black'><o:p></o:p></span></p>
<p class=MsoNormal><span style='color:black'>food for mothers must be a
priority as it will help to protect their health and well-being as well as that
of</span><span style='font-size:10.0pt;font-family:"Arial","sans-serif";
color:black'><o:p></o:p></span></p>
<p class=MsoNormal><span style='color:black'>their young children.</span><span
style='font-size:10.0pt;font-family:"Arial","sans-serif";color:black'><o:p></o:p></span></p>
<p class=MsoNormal><span style='color:black'> </span><span
style='font-size:10.0pt;font-family:"Arial","sans-serif";color:black'><o:p></o:p></span></p>
<p class=MsoNormal><span style='color:black'>Basic interventions to facilitate
breastfeeding include prioritising mothers with young children for</span><span
style='font-size:10.0pt;font-family:"Arial","sans-serif";color:black'><o:p></o:p></span></p>
<p class=MsoNormal><span style='color:black'>shelter, food, security, and water
and sanitation, enabling mother-to-mother support, providing specific</span><span
style='font-size:10.0pt;font-family:"Arial","sans-serif";color:black'><o:p></o:p></span></p>
<p class=MsoNormal><span style='color:black'>space for skilled breastfeeding
counselling and support to maintain or re-establish lactation. Traumatised</span><span
style='font-size:10.0pt;font-family:"Arial","sans-serif";color:black'><o:p></o:p></span></p>
<p class=MsoNormal><span style='color:black'>and depressed mothers may have
difficulty responding to their infants and require particular mental and</span><span
style='font-size:10.0pt;font-family:"Arial","sans-serif";color:black'><o:p></o:p></span></p>
<p class=MsoNormal><span style='color:black'>emotional support. UNICEF, WHO and
other organizations involved in infant feeding in emergencies</span><span
style='font-size:10.0pt;font-family:"Arial","sans-serif";color:black'><o:p></o:p></span></p>
<p class=MsoNormal><span style='color:black'>will support training of staff on
individual assessment of the best options for feeding infants, as well as<o:p></o:p></span></p>
<p class=MsoNormal><span style='color:black'>education and support of
caregivers on optimal infant feeding in these emergency circumstances.<o:p></o:p></span></p>
<p class=MsoNormal><span style='color:black'> <o:p></o:p></span></p>
<p class=MsoNormal><b><i><span style='color:black'>Feeding of the non-breastfed
child less than six months of age</span></i></b><span style='font-size:10.0pt;
font-family:"Arial","sans-serif";color:black'><o:p></o:p></span></p>
<p class=MsoNormal><span style='color:black'>Infants less than six months of
age who are not breastfed need urgent identification and targeted skilled<o:p></o:p></span></p>
<p class=MsoNormal><span style='color:black'>support. The priority to feed
these infants should be relactation. If this is not possible or when artificial<o:p></o:p></span></p>
<p class=MsoNormal><span style='color:black'>feeding is indicated by skilled
staff such as health providers or infant feeding counsellors, breast-milk<o:p></o:p></span></p>
<p class=MsoNormal><span style='color:black'>substitutes are necessary and must
be accompanied by training on hygiene, preparation and use to<o:p></o:p></span></p>
<p class=MsoNormal><span style='color:black'>minimise their associated risks.
Artificial feeding in an emergency carries high risks of malnutrition,<o:p></o:p></span></p>
<p class=MsoNormal><span style='color:black'>illness and death and is a last
resort only when other safer options have first been fully explored.<o:p></o:p></span></p>
<p class=MsoNormal><span style='color:black'>Any needed breast-milk substitutes
should adhere to Codex Alimentarius Standards and should be<o:p></o:p></span></p>
<p class=MsoNormal><span style='color:black'>procured in an efficient and rapid
manner, in coordination with UNICEF, the nutrition coordinating<o:p></o:p></span></p>
<p class=MsoNormal><span style='color:black'>agency in Haiti. The preferred
type of breast-milk substitute is ready-to-use formula. Any distribution<o:p></o:p></span></p>
<p class=MsoNormal><span style='color:black'>and use of breast-milk substitutes
should be carefully monitored to ensure that only the designated<o:p></o:p></span></p>
<p class=MsoNormal><span style='color:black'>infants receive the product. For
further information UNICEF should be contacted (see contact below).<o:p></o:p></span></p>
<p class=MsoNormal><span style='color:black'>When breast-milk substitutes are
used caregivers should be encouraged and taught to feed with a cup and<o:p></o:p></span></p>
<p class=MsoNormal><span style='color:black'>spoon. Bottles and teats should
not be provided as they are more difficult to clean. Skilled support by<o:p></o:p></span></p>
<p class=MsoNormal><span style='color:black'>appropriately trained staff should
be provided to caregivers on how to use the breast-milk substitute<o:p></o:p></span></p>
<p class=MsoNormal><span style='color:black'>safely. Because infants’
receiving breast-milk substitutes are at increased risk for illness, a mechanism<o:p></o:p></span></p>
<p class=MsoNormal><span style='color:black'>to monitor their health should be
established.<o:p></o:p></span></p>
<p class=MsoNormal><span style='color:black'> <o:p></o:p></span></p>
<p class=MsoNormal><b><i><span style='color:black'>Donations and procurement of
breast-milk substitutes and other milk products</span></i></b><span
style='font-size:10.0pt;font-family:"Arial","sans-serif";color:black'><o:p></o:p></span></p>
<p class=MsoNormal><span style='color:black'>In accordance with internationally
accepted guidelines, donations of infant formula, bottles and teats and<o:p></o:p></span></p>
<p class=MsoNormal><span style='color:black'>other powdered or liquid milk and
milk products should not be made. Experience with past emergencies<o:p></o:p></span></p>
<p class=MsoNormal><span style='color:black'>has shown an excessive quantity of
products, which are poorly targeted, endangering infants’ lives. Any<o:p></o:p></span></p>
<p class=MsoNormal><i><span style='color:black'>procurement </span></i><span
style='color:black'>of breast milk substitutes should be based on careful needs
assessment and in coordination</span><span style='font-size:10.0pt;font-family:
"Arial","sans-serif";color:black'><o:p></o:p></span></p>
<p class=MsoNormal><span style='color:black'>with UNICEF. Human milk donations
while safe when processed and pasteurized in a human milk bank</span><span
style='font-size:10.0pt;font-family:"Arial","sans-serif";color:black'><o:p></o:p></span></p>
<p class=MsoNormal><span style='color:black'>also require fully functioning
cold chains. Such conditions are not currently met in Haiti and human milk</span><span
style='font-size:10.0pt;font-family:"Arial","sans-serif";color:black'><o:p></o:p></span></p>
<p class=MsoNormal><span style='color:black'>donations cannot be used at
present. All queries and any donations that do appear should be directed to</span><span
style='font-size:10.0pt;font-family:"Arial","sans-serif";color:black'><o:p></o:p></span></p>
<p class=MsoNormal><span style='color:black'>UNICEF, the designated nutrition
coordinating agency in Haiti.</span><span style='font-size:10.0pt;font-family:
"Arial","sans-serif";color:black'><o:p></o:p></span></p>
<p class=MsoNormal><span style='color:black'> </span><span
style='font-size:10.0pt;font-family:"Arial","sans-serif";color:black'><o:p></o:p></span></p>
<p class=MsoNormal><b><i><span style='color:black'>Complementary feeding of
children above six months of age</span></i></b><span style='font-size:10.0pt;
font-family:"Arial","sans-serif";color:black'><o:p></o:p></span></p>
<p class=MsoNormal><span style='color:black'>Children from the age of six
months require nutrient-rich, age-appropriate and safe complementary foods<o:p></o:p></span></p>
<p class=MsoNormal><span style='color:black'>in addition to breast milk.
Priority should be placed on locally available, culturally acceptable,<o:p></o:p></span></p>
<p class=MsoNormal><span style='color:black'>nutritionally adequate and
age-appropriate foods. When cooking facilities are non existent or severely<o:p></o:p></span></p>
<p class=MsoNormal><span style='color:black'>limited, ready-to-use fortified
foods are an option. Micronutrient powders that can be added to local<o:p></o:p></span></p>
<p class=MsoNormal><span style='color:black'>foods, emergency rations or
blended foods will also improve dietary quality. In addition, once cooking<o:p></o:p></span></p>
<p class=MsoNormal><span style='color:black'>facilities have been set up,
provision of fortified blended food is recommended. A monitoring system to<o:p></o:p></span></p>
<p class=MsoNormal><span style='color:black'>ensure the appropriate targeting,
distribution and use of food and food products for infants and young<o:p></o:p></span></p>
<p class=MsoNormal><span style='color:black'>children should be established.<o:p></o:p></span></p>
<p class=MsoNormal><span style='color:black'> <o:p></o:p></span></p>
<p class=MsoNormal><b><i><span style='color:black'>Feeding infants and young
children in the context of HIV</span></i></b><span style='font-size:10.0pt;
font-family:"Arial","sans-serif";color:black'><o:p></o:p></span></p>
<p class=MsoNormal><span style='color:black'>Mothers known to be HIV-infected
should be supported to exclusively breastfeed their infants for the<o:p></o:p></span></p>
<p class=MsoNormal><span style='color:black'>first six months of life, to
introduce appropriate complementary foods thereafter, and to continue<o:p></o:p></span></p>
<p class=MsoNormal><span style='color:black'>breastfeeding for the first 12
months, along with provision of ARVs, as per current WHO<o:p></o:p></span></p>
<p class=MsoNormal><span style='color:black'>recommendations on HIV and infant
feeding (see references below). If an HIV-positive mother was<o:p></o:p></span></p>
<p class=MsoNormal><span style='color:black'>already giving her child
commercial infant formula, she should receive an adequate supply of ready-touse<o:p></o:p></span></p>
<p class=MsoNormal><span style='color:black'>formula and support. A separate
guidance is being prepared for the situation in Haiti.<o:p></o:p></span></p>
<p class=MsoNormal><span style='color:black'> <o:p></o:p></span></p>
<p class=MsoNormal><b><i><span style='color:black'>Treatment of severe acute
malnutrition</span></i></b><span style='font-size:10.0pt;font-family:"Arial","sans-serif";
color:black'><o:p></o:p></span></p>
<p class=MsoNormal><span style='color:black'>Treatment of severely malnourished
children, whether facility or community based, should be<o:p></o:p></span></p>
<p class=MsoNormal><span style='color:black'>implemented in accordance with
international standards and best practice and closely monitored.<o:p></o:p></span></p>
<p class=MsoNormal><span style='color:black'>Specially formulated therapeutic
milks F75 and F100 and ready to use therapeutic food are required.<o:p></o:p></span></p>
<p class=MsoNormal><span style='color:black'> <o:p></o:p></span></p>
<p class=MsoNormal><b><i><span style='color:black'>Conclusion</span></i></b><span
style='font-size:10.0pt;font-family:"Arial","sans-serif";color:black'><o:p></o:p></span></p>
<p class=MsoNormal><span style='color:black'>UNICEF, WHO and WFP strongly urge
all who are involved in funding, planning and implementing the<o:p></o:p></span></p>
<p class=MsoNormal><span style='color:black'>emergency response in Haiti to
avoid unnecessary illness and death by promoting, protecting and<o:p></o:p></span></p>
<p class=MsoNormal><span style='color:black'>supporting breastfeeding and
appropriate complementary feeding and by preventing uncontrolled<o:p></o:p></span></p>
<p class=MsoNormal><span style='color:black'>distribution and use of
breast-milk substitutes. Public and private sector entities and individuals who<o:p></o:p></span></p>
<p class=MsoNormal><span style='color:black'>wish to support infants and young
children and their mothers and caregivers in this emergency should<o:p></o:p></span></p>
<p class=MsoNormal><span style='color:black'>donate funds rather than send
goods. We further urge governments and partners to include capacity<o:p></o:p></span></p>
<p class=MsoNormal><span style='color:black'>building for breastfeeding and
infant and young child feeding as part of emergency preparedness and<o:p></o:p></span></p>
<p class=MsoNormal><span style='color:black'>planning, and to commit financial
and human resources for appropriate and timely protection, promotion<o:p></o:p></span></p>
<p class=MsoNormal><span style='color:black'>and support of optimal infant and
young child feeding in this and other emergencies.<o:p></o:p></span></p>
<p class=MsoNormal><span style='color:black'> <o:p></o:p></span></p>
<p class=MsoNormal><b><span style='color:black'>For more information please
contact:</span></b><span style='font-size:10.0pt;font-family:"Arial","sans-serif";
color:black'><o:p></o:p></span></p>
<p class=MsoNormal><span style='font-size:10.0pt;color:black'>UNICEF Nutrition
Section, New York:</span><span style='font-size:10.0pt;font-family:"Arial","sans-serif";
color:black'><o:p></o:p></span></p>
<p class=MsoNormal><span style='font-size:10.0pt;color:black'>Ilka Esquivel, </span><span
style='font-size:10.0pt;color:blue'><a href="mailto:iesquivel@unicef.org">iesquivel@unicef.org</a>,
</span><span style='font-size:10.0pt;color:black'>tel: + 1 212 326 7756,</span><span
style='font-size:10.0pt;font-family:"Arial","sans-serif";color:black'><o:p></o:p></span></p>
<p class=MsoNormal><span style='font-size:10.0pt;color:black'>Nune Mangasaryan,
</span><span style='font-size:10.0pt;color:blue'><a
href="mailto:nmangasaryan@unicef.org">nmangasaryan@unicef.org</a></span><span
style='font-size:10.0pt;color:black'>, tel: +1 212 326 7159</span><span
style='font-size:10.0pt;font-family:"Arial","sans-serif";color:black'><o:p></o:p></span></p>
<p class=MsoNormal><span style='font-size:10.0pt;color:black'>UNICEF office in
Port-au-Prince:</span><span style='font-size:10.0pt;font-family:"Arial","sans-serif";
color:black'><o:p></o:p></span></p>
<p class=MsoNormal><span style='font-size:10.0pt;color:black'>Mija-Tesse
Ververs, Nutrition Cluster Coordinator in Haiti, </span><span style='font-size:
10.0pt;color:blue'><a href="mailto:mijaververs@hotmail.com">mijaververs@hotmail.com</a></span><span
style='font-size:10.0pt;font-family:"Arial","sans-serif";color:black'><o:p></o:p></span></p>
<p class=MsoNormal><span style='font-size:10.0pt;color:black'>Marie-Claude
Désilets, </span><span style='font-size:10.0pt;color:blue'><a
href="mailto:desilets26@hotmail.com">desilets26@hotmail.com</a> </span><span
style='font-size:10.0pt;color:black'>and </span><span style='font-size:10.0pt;
color:blue'><a href="mailto:mdesilets@unicef.org">mdesilets@unicef.org</a></span><b><span
style='font-size:7.5pt;font-family:"Verdana","sans-serif";color:#00C0FF'>, </span></b><span
style='font-size:10.0pt;color:black'>tel: (509 ) 2245 3525</span><span
style='font-size:10.0pt;font-family:"Arial","sans-serif";color:black'><o:p></o:p></span></p>
<p class=MsoNormal><span style='font-size:10.0pt;color:black'>WFP office in
Rome:</span><span style='font-size:10.0pt;font-family:"Arial","sans-serif";
color:black'><o:p></o:p></span></p>
<p class=MsoNormal><span style='font-size:10.0pt;color:black'>Tina van den
Briel, </span><span style='font-size:10.0pt;color:blue'><a
href="mailto:Tina.VanDenBriel@wfp.org">Tina.VanDenBriel@wfp.org</a></span><span
style='font-size:10.0pt;color:black'>, tel. +39 06 6513 2171</span><span
style='font-size:10.0pt;font-family:"Arial","sans-serif";color:black'><o:p></o:p></span></p>
<p class=MsoNormal><span style='font-size:10.0pt;color:black'>WHO offices in
Geneva and Washington DC (PAHO):</span><span style='font-size:10.0pt;
font-family:"Arial","sans-serif";color:black'><o:p></o:p></span></p>
<p class=MsoNormal><span style='font-size:10.0pt;color:black'>Zita Weise
Prinzo, </span><span style='font-size:10.0pt;color:blue'><a
href="mailto:weiseprinzoz@who.int">weiseprinzoz@who.int</a></span><span
style='font-size:10.0pt;color:black'>, tel: + 41 22 791 4440</span><span
style='font-size:10.0pt;font-family:"Arial","sans-serif";color:black'><o:p></o:p></span></p>
<p class=MsoNormal><span style='font-size:10.0pt;color:black'>Chessa Lutter</span><span
style='font-size:10.0pt;font-family:Courier;color:black'>, </span><span
style='font-size:10.0pt;color:blue'><a href="mailto:lutterch@paho.org">lutterch@paho.org</a></span><span
style='font-size:10.0pt;font-family:Courier;color:black'>, </span><span
style='font-size:10.0pt;color:black'>tel: + 1 202 974-3871</span><span
style='font-size:10.0pt;font-family:"Arial","sans-serif";color:black'><o:p></o:p></span></p>
<p class=MsoNormal><span style='font-size:10.0pt;color:black'>WHO office
Port-au-Prince:</span><span style='font-size:10.0pt;font-family:"Arial","sans-serif";
color:black'><o:p></o:p></span></p>
<p class=MsoNormal><span style='font-size:10.0pt;color:black'>Montserrat
Escruela, </span><span style='font-size:10.0pt;color:blue'><a
href="mailto:Mescruela@yahoo.com">Mescruela@yahoo.com</a> </span><span
style='font-size:10.0pt;color:black'>and </span><span style='font-size:10.0pt;
color:blue'><a href="mailto:montserrates@hai.ops-oms.org">montserrates@hai.ops-oms.org</a></span><span
style='font-size:10.0pt;color:black'>, tel: +501 244 7675</span><span
style='font-size:10.0pt;font-family:"Arial","sans-serif";color:black'><o:p></o:p></span></p>
<p class=MsoNormal><span style='font-size:10.0pt;color:black'> </span><span
style='font-size:10.0pt;font-family:"Arial","sans-serif";color:black'><o:p></o:p></span></p>
<p class=MsoNormal><b><span style='color:black'>References</span></b><b><span
style='font-size:7.5pt;color:black'>1</span></b><span style='font-size:10.0pt;
font-family:"Arial","sans-serif";color:black'><o:p></o:p></span></p>
<p class=MsoNormal><span style='font-size:10.0pt;color:black'>Operational
Guidance on Infant and Young Child Feeding in Emergencies, v2.1, Feb 2007<o:p></o:p></span></p>
<p class=MsoNormal><span style='font-size:10.0pt;color:blue'><a
href="http://www.ennonline.net/ife/view.aspx?resid=6">http://www.ennonline.net/ife/view.aspx?resid=6</a><o:p></o:p></span></p>
<p class=MsoNormal><span style='font-size:10.0pt;color:black'>Messages for the
media in Haiti:</span><span style='font-size:10.0pt;color:blue'><a
href="http://www.ennonline.net/resources/735">http://www.ennonline.net/resources/735</a></span><span
style='font-size:10.0pt;font-family:"Arial","sans-serif";color:black'><o:p></o:p></span></p>
<p class=MsoNormal><span style='font-size:10.0pt;color:black'>Guide for the
media on infant and young child feeding in emergencies:<o:p></o:p></span></p>
<p class=MsoNormal><span style='font-size:10.0pt;color:blue'><a
href="http://www.ennonline.net/pool/files/ife/ife-media-guide-french%281%29.pdf">http://www.ennonline.net/pool/files/ife/ife-media-guide-french(1).pdf</a><o:p></o:p></span></p>
<p class=MsoNormal><span style='font-size:10.0pt;color:black'>Module 2 on
Infant Feeding in Emergencies, v1.1, Dec 2007, for health and nutrition workers
in emergency</span><span style='font-size:10.0pt;font-family:"Arial","sans-serif";
color:black'><o:p></o:p></span></p>
<p class=MsoNormal><span style='font-size:10.0pt;color:black'>situations. </span><span
style='font-size:10.0pt;color:blue'><a
href="http://www.ennonline.net/ife/view.aspx?resid=4">http://www.ennonline.net/ife/view.aspx?resid=4</a></span><span
style='font-size:10.0pt;font-family:"Arial","sans-serif";color:black'><o:p></o:p></span></p>
<p class=MsoNormal><span style='font-size:10.0pt;color:black'>HIV and Infant
Feeding: Revised Principles and Recommendations. Rapid Advice. WHO. 2009.<o:p></o:p></span></p>
<p class=MsoNormal><span style='font-size:10.0pt;color:blue'><a
href="http://www.who.int/child_adolescent_health/documents/9789241598873/en/index.html">http://www.who.int/child_adolescent_health/documents/9789241598873/en/index.html</a><o:p></o:p></span></p>
<p class=MsoNormal><span style='font-size:10.0pt;color:black'>International
Code of Marketing of Breastmilk Substitutes and subsequent relevant World
Health Assembly</span><span style='font-size:10.0pt;font-family:"Arial","sans-serif";
color:black'><o:p></o:p></span></p>
<p class=MsoNormal><span style='font-size:10.0pt;color:black'>Resolutions. WHO
(1981): </span><span style='font-size:10.0pt;color:blue'><a
href="http://www.unicef.org/nutrition/files/nutrition_code_english.pdf">http://www.unicef.org/nutrition/files/nutrition_code_english.pdf</a></span><span
style='font-size:10.0pt;font-family:"Arial","sans-serif";color:black'><o:p></o:p></span></p>
<p class=MsoNormal><span style='font-size:10.0pt;color:black'>and: </span><span
style='font-size:10.0pt;color:blue'><a
href="http://www.ibfan.org/site2005/Pages/list2.php?iui=1&cat_id=46">http://www.ibfan.org/site2005/Pages/list2.php?iui=1&cat_id=46</a></span><span
style='font-size:10.0pt;font-family:"Arial","sans-serif";color:black'><o:p></o:p></span></p>
<p class=MsoNormal><span style='font-size:10.0pt;color:black'>Global Nutrition
Cluster Toolkit on Nutrition in Emergencies :<o:p></o:p></span></p>
<p class=MsoNormal><span style='font-size:10.0pt;color:blue'><a
href="http://www.humanitarianreform.org/humanitarianreform/Portals/1/cluster%20approach%20page/clusters%20pages">http://www.humanitarianreform.org/humanitarianreform/Portals/1/cluster%20approach%20page/clusters%20pages</a><o:p></o:p></span></p>
<p class=MsoNormal><span style='font-size:10.0pt;color:blue'>/Nutrition/Global_Nutrition_Cluster_Nutrition_Emergencies_Toolkit_June_2008.pdf<o:p></o:p></span></p>
<p class=MsoNormal><span style='font-size:10.0pt;color:blue'> <o:p></o:p></span></p>
<div>
<p class=MsoNormal><span style='font-size:7.5pt;color:black'>1 </span><span
style='font-size:10.0pt;color:black'>Contributions to this joint statement were
made by the ENN/IFE Core Group</span><span style='font-size:10.0pt;font-family:
"Arial","sans-serif";color:black'><o:p></o:p></span></p>
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