Breastfeeding practice during disasters: Challenges and barriers for public health
DOI:
https://doi.org/10.61511/andmej.v3i2.2026.2042Keywords:
breastfeeding, disasters, challenge, barrier, public healthAbstract
Background: Breastfeeding is essential for protecting infant and maternal health and fosters public health benefits, especially in disaster scenarios where health services are compromised. It crucially helps prevent infection, malnutrition, and infant mortality, yet rates remain low among vulnerable populations in emergencies. The aim of this study is to explore the enabling and inhibiting factors influencing breastfeeding practices during disasters while also assessing how structural, socio-economic, and cultural determinants shape these practices. Methods: A systematic literature review was conducted in this study. A systematic search was conducted using Google Scholar, PubMed, and Scopus for full-text articles published between 2019 and 2025. Keywords such as “breastfeeding and mitigation” and “breastfeeding and disasters” were used. We selected ten studies using either qualitative or quantitative methods for analysis after removing duplicate and ineligible articles (including reviews and opinion articles). Findings: Successful breastfeeding during disasters relies on understanding its benefits, community support, adherence to cultural practices, and mental health services for mothers. Barriers include a lack of awareness about breastfeeding support, unclear protocols for formula distribution, economic pressures, disrupted healthcare, and psychological stress. Quantitative studies indicate a decrease in exclusive breastfeeding rates, while qualitative research highlights the importance of coordinated support from multiple stakeholders. Conclusion: To protect and promote breastfeeding during emergencies, it is crucial to establish clear institutional guidelines and regulations on formula donations, enhance mental health support for mothers, and strengthen nutrition education and community outreach. Novelty/Originality of this article: This review uniquely integrates global evidence from 2019 to 2025 across various disaster contexts, offering practical insights for developing an effective and cost-efficient emergency response framework for breastfeeding support.
References
Adeoya, A. A., Sasaki, H., Fuda, M., Okamoto, T., & Egawa, S. (2022). Child Nutrition in Disaster: A Scoping Review. Tohoku Journal of Experimental Medicine, 256(2), 103–118. https://doi.org/10.1620/tjem.256.103
Amat Camacho, N., Chara, A., Briskin, E., Pellecchia, U., Kyi, H. A., de Rubeis, M. L., Hussain, F., Ahmed, T., Ogundipe, O. F., Burzio, C., Kamis, U., Bukar, L. M., Von Schreeb, J., Kolokotroni, O., Della Corte, F., & Sunyoto, T. (2023). Promoting and supporting breastfeeding in a protracted emergency setting—Caregivers’ and health workers’ perceptions from North-East Nigeria. Frontiers in Public Health, 11. https://doi.org/10.3389/fpubh.2023.1077068
Aros-Vera, F., Chertok, I. R. A., & Melnikov, S. (2021). Emergency and disaster response strategies to support mother-infant dyads during COVID-19. International Journal of Disaster Risk Reduction, 65, 102532. https://doi.org/10.1016/j.ijdrr.2021.102532
Azad, F., Rifat, M. A., Manir, M. Z., & Biva, N. A. (2019). Breastfeeding support through wet nursing during nutritional emergency: A cross sectional study from Rohingya refugee camps in Bangladesh. PLoS ONE, 14(10), 1–12. https://doi.org/10.1371/journal.pone.0222980
Babiszewska-Aksamit, M., Bzikowska-Jura, A., Kotlińska, A., Aduła, A., Chrobak, A., Domosud, J., Drążkowska, I., Gaweł, P., Jakimiuk, A., Kołodziej, J., Królak-Olejnik, B., Lisak-Gurba, K., Mozdyniewicz, K., Mołas, A., Piątkowska, A., Sinkiewicz-Darol, E., & Wesołowska, A. (2025). Good practice in lactation counseling for Ukrainian refugee mothers to ensure the health and mental benefits of breastfeeding – an observational study. Archives of Women’s Mental Health, 28, 257–269. https://doi.org/10.1007/s00737-024-01538-x
Bilgin, D. D., & Karabayır, N. (2024). Infant and Young Child Feeding in Emergencies: A Narrative Review. Turkish Archives of Pediatrics, 59(2), 135–143. https://doi.org/10.5152/TurkArchPediatr.2024.23184
Büke, Ö., & Karabayır, N. (2024). Protection of Child Health in Emergencies. Turkish Archives of Pediatrics, 59(3), 243–249. https://doi.org/10.5152/TurkArchPediatr.2024.23265
Camacho, N. A., von Schreeb, J., & Corte, F. Della. (2023). Interventions to support the re‐establishment of breastfeeding and their application in their humanitarian settings: A systematic review. Maternal and Child Nutrition, 19, e13440. DOI:10.1111/MCN.13440
Çaylan, N., Kiliç, M., Yalçin, S., Tezel, B., & Kara, F. (2022). Baby-friendly hospitals in Turkey: evaluation of adherence to the Ten Steps to Successful Breastfeeding. Eastern Mediterranean Health Journal, 28(5), 352–361. https://doi.org/10.26719/emhj.22.021
Cerceo, E., Saxer, K., Grossman, L., Shapley-Quinn, K., & Feldman-Winter, L. (2024). The Climate Crisis and Breastfeeding: Opportunities for Resilience. Journal of Human Lactation, 40(1), 33–50. https://doi.org/10.1177/08903344231216726
Dozio, E., Le Roch, K., & Bizouerne, C. (2019). Baby friendly spaces: an intervention for pregnant and lactating women and their infants in Cameroon. Intervention, 18(1), 78–84. https://doi.org/10.4103/INTV.INTV_61_18
Erat Nergiz, M., Barutçu, A., Güneş, B., Almış, H., Yılmaz Öztorun, Z., Tezol, Ö., Karabayır, N., Kabakoğlu Ünsur, E., Örün, E., & Yalçın, S. S. (2025). Breastfeeding problems and associated factors: a cross-sectional study after the 2023 Türkiye earthquake. International Breastfeeding Journal, 20(32). https://doi.org/10.1186/s13006-025-00724-6
Evans, J., Bansal, A., Schoenaker, D. A. J. M., Davis, D. L., Cherbuin, N., & Peek, M. J. (2022). Birth Outcomes, Health, and Health Care Needs of Childbearing Women following Wildfire Disasters: An Integrative, State-of-the-Science Review. Environmental Health Perspectives, 130(8), 086001-1-086001–086017. https://doi.org/10.1289/EHP10544
Fadjriah, R. N., Herman, Vidyanto, Putri, D. S., & Bohari. (2020). The behavior of exclusive breastfeeding after earthquake and liquefaction in palu city. International Journal of Advanced Science and Technology, 29(5s), 805–808.
Fadjriah, R. N., Salamah, A. U., Jafar, N., Nur, R., Dewi, N. U., Khairunnisa, & Mallongi, A. (2020). Practice of exclusive breastfeeding at evacuation site post-earthquake in palu city, indonesia. Medico-Legal Update, 20(2), 430–434. https://doi.org/10.37506/mlu.v20i2.1143
Gawrońska, M., Sinkiewicz-Darol, E., & Wesołowska, A. (2024). Emergency response and preparedness among Polish human milk banks: a comparison of the COVID-19 pandemic and the 2022 Ukrainian refugee crisis. Frontiers in Nutrition, 11(July). https://doi.org/10.3389/fnut.2024.1426080
Giusti, A., Marchetti, F., Zambri, F., Pro, E., Brillo, E., & Colaceci, S. (2022). Breastfeeding and humanitarian emergencies: the experiences of pregnant and lactating women during the earthquake in Abruzzo, Italy. International Breastfeeding Journal, 17(45), 1–13. https://doi.org/10.1186/s13006-022-00483-8
Gökçay, G., Keski̇Ndemirci, G., Özbörü Aşkan, Ö., & Tuğrul Aksakal, M. (2023). Child Health Protection During Emergency Situations. Istanbul Tip Fakultesi Dergisi, 86(3), 254–263. https://doi.org/10.26650/IUITFD.1267614
Gribble, K. D., & Palmquist, A. E. L. (2022). ‘We make a mistake with shoes [that’s no problem] but… not with baby milk’: Facilitators of good and poor practice in distribution of infant formula in the 2014–2016 refugee crisis in Europe. Maternal and Child Nutrition, 18(e13282), 1–12. https://doi.org/10.1111/mcn.13282
Gribble, K., Peterson, M., & Brown, D. (2019). Emergency preparedness for infant and young child feeding in emergencies (IYCF-E): An Australian audit of emergency plans and guidance. BMC Public Health, 19, 1–11. https://doi.org/10.1186/s12889-019-7528-0
Grubesic, T. H., & Durbin, K. M. (2022). Breastfeeding, Community Vulnerability, Resilience, and Disasters: A Snapshot of the United States Gulf Coast. International Journal of Environmental Research and Public Health, 19(19). https://doi.org/10.3390/ijerph191911847
Hirani, S. A. A., Richter, S., Salami, B., & Vallianatos, H. (2023). Sociocultural Factors Affecting Breastfeeding Practices of Mothers During Natural Disasters: A Critical Ethnography in Rural Pakistan. Global Qualitative Nursing Research, 10, 1–16. https://doi.org/10.1177/23333936221148808
Hirani, S., Richter, S., & Salami, B. (2021). Humanitarian aid and breastfeeding practices of displaced mothers: a qualitative study in disaster relief camps. Eastern Mediterranean Health Journal, 27(12), 1197–1202. https://doi.org/10.26719/EMHJ.20.087
Hwang, C. H., Iellamo, A., & Ververs, M. (2021). Barriers and challenges of infant feeding in disasters in middle- and high-income countries. International Breastfeeding Journal, 16(62), 1–13. https://doi.org/10.1186/s13006-021-00398-w
IDAI. (2013). IDAI _ Menyusui dalam keadaan bencana. https://www.idai.or.id/artikel/klinik/asi/menyusui-dalam-keadaan-bencana
Karnesyia, A. (2021). 9 Tips Menyusui Saat Bencana untuk Maksimalkan Nutrisi Anak. Haibunda. https://www.haibunda.com/menyusui/20210205093539-54-190251/9-tips-menyusui-saat-bencana-untuk-maksimalkan-nutrisi-anak
Okinarum, G. Y., & Rochdiat, W. (2022). Breastfeeding Experience During COVID-19 Pandemic in Indonesia: Strengthening and Weakening Elements. Malaysian Journal of Medical Sciences, 29(3), 110–121. https://doi.org/10.21315/mjms2022.29.3.11
Pramono, A., Hikmawati, A., Hartiningtiyaswati, S., & Smith, J. (2025). Breastfeeding Support and Protection During Natural Disaster and Climate-Related Emergencies in Indonesia: Policy Audit. Journal of Human Lactation, 4(2), 231–242. https://doi.org/10.1177/08903344251322770
Rahmi, N., & Amelin, F. (2025). Infant and young children’s mother profile related to breastfeeding practices during and after the flash floods disaster in Agam, West Sumatra, 2024. E3S Web of Conferences The 4th ICDM 2024, 604. https://doi.org/10.1051/e3sconf/202560405005
Russell, J. H., Haushalter, A., & Rhoads, S. J. (2025). Supporting Breastfeeding Women Amid Natural Disasters in the US: A Scoping Review. Disaster Medicine and Public Health Preparedness, 19(e24), 1–11. https://doi.org/10.1017/dmp.2024.323
Suzan, Ö. K., Topal, S., Çaka, S. Y., & Çınar, N. (2025). Investigation of the sustainability of breastfeeding and infant nutrition in the earthquake region based on mothers’ experiences: a qualitative study. BMC Public Health, 25(25). https://doi.org/10.1186/s12889-025-22137-0
UNICEF and WHO. (2023). Global Breastfeeding Collective. UNICEF and WHO. https://www.globalbreastfeedingcollective.org/
Vilar-Compte, M., Pérez Navarro, C., Burrola-Méndez, S., Sachse-Aguilera, M., & Veliz, P. (2021). Barriers and enablers of breast-feeding protection and support after the 2017 earthquakes in Mexico. Public Health Nutrition, 24(8), 2286–2296. https://doi.org/10.1017/S1368980020002359
Walters, C. N., Rakotomanana, H., Komakech, J. J., Kabahenda, M., Joyce, J. M., Hildebrand, D. A., Ciciolla, L., & Stoecker, B. J. (2023). Breastfeeding among South Sudanese refugees in protracted settlements in Adjumani district, Uganda: facilitators and barriers. International Breastfeeding Journal, 18(18), 1–12. https://doi.org/10.1186/s13006-023-00549-1
WHO, U. dan. (2024b). Ibu Membutuhkan Lebih Banyak Dukungan Menyusui Selama Masa Kritis Bayi Baru Lahir. In World Health Organization. https://www.who.int/indonesia/id/news/detail/01-08-2024-mothers-need-more-breastfeeding-support-during-critical-newborn-period
Yalçın, S. S., Erat Nergiz, M., & Yalçın, S. (2023). Evaluation of breastfeeding and infant feeding attitudes among syrian refugees in Turkey: observations of Syrian healthcare workers. International Breastfeeding Journal, 18(38), 1–10. https://doi.org/10.1186/s13006-023-00579-9
Published
How to Cite
Issue
Section
Citation Check
License
Copyright (c) 2026 Inke Malahayati, Safrina, Tengku Sri Wahyuni, Lenny Nainggolan

This work is licensed under a Creative Commons Attribution 4.0 International License.













