As the world rushes to donate money and supplies to the Philippines in the wake of typhoon Haiyan, a debate is emerging over whether baby formula should be a part of that aid.
In an intense twist on the familiar breastfeeding-versus-formula debate, the government, which has been trying to promote breastfeeding, reportedly "has a policy to prohibit the donation of formula milk for babies in temporary shelters, during a calamity," according to Gulf News.
Of obvious concern is the long-standing problem of using formula in places that lack a clean water supply.
"Mixing formula with dirty water would be deadly for babies," Julie Hall, the Philippines' World Health Organization (WHO) country representative, told the Philippine Star.
But Hall and other health officials are not shying away from promoting benefits of breastfeeding in general. Hall went on to add: "Breastfeeding babies even at the best of times, even when there is no disaster, is the best thing you could do for a baby. It is absolutely vital that women are supported to breastfeed their babies fully for six months."
New mothers – the WHO estimates that 12,000 babies will be born next month – are encouraged to persist at breastfeeding if they've been interrupted by the disaster.
WHO tweets on Thursday included reminders such as "Even mothers who had stopped breastfeeding before #Haiyan may be able to reinitiate breastfeeding if they get the right support." And, "Stress during emergencies may temporarily interfere w/ breast milk flow, but not likely to have serious impact on breast milk production."
Nursing mothers are also being called on to donate milk for babies in affected areas and to consider wet-nursing.
"If you're a breastfeeding mom, you can help ease babies' plight in Visayas and other Yolanda (Typhoon Haiyan)-hit areas by sharing the milk you give your own children," Dr. Jessica Anne Dumalag, of Manila's Philippine General Hospital's (PGH) Human Milk Bank, told Gulf News. "Milk from lactating mothers is preferred over formula milk, which is basically processed cow's milk."
Blogger Suzanne Barston, the author of Bottled Up: How the Way We Feed Babies Has Come to Define Motherhood, and Why It Shouldn't says anti-formula messaging has no place in relief efforts.
"A policy that forbids powdered formula donations and encourages breast milk donations is simply replacing one easily contaminated substance with another," she writes, adding that donor milk needs to be screened for HIV and hepatitis B and refrigerated.
"There is, however, a substance that can be easily transported without refrigeration; that has a relatively stable and long shelf life; and which can be fed to babies in a perfectly sterile manner, at least in the short-term. That substance is ready-to-feed, pre-mixed formula, served in "nursette" bottles with pre-sterilized nipples (like these)," she writes.
For the moment, she writes, health and aid workers should put aside breastfeeding promotion.
"That cause may be noble and important, but right now, it's irrelevant. To put breastfeeding promotion ahead of feeding infants safely and in a timely manner is petty, short-sighted, and cruel."
The WHO appears to be on board with such an option, tweeting its approval later in the day for ready-made formula:
"Ready-to-use (liquid) milk substitute w/clean disposable spoon, under extraordinary circumstances like #Haiyan, can be considered #YolandaPH"