Complementary Feeding in Emergencies: Options, challenges and the way forward

1. Complementary Feeding in Emergencies:Options, challenges and the way forward Victoria Sibson, SC-UK Emergencies Nutrition Adviser, March 2008

2. Main focus areas: • Typical ‘Basic’ interventions; rationale and challenges • ‘Technical’ interventions: Building on the Operational Guidance - SCUK’s view and emerging approach (some new response ideas)

3. Sphere General Nutrition Support Standard 2 for At Risk Groups: “Children 6-24 months must have access to nutritious, energy dense complementary foods. Efforts should be made to provide households with the means and skills to prepare appropriate complementary foods for children under 24 months. This may be through provision of specific food commodities or of utensils, fuel and water.” Infant and Young Child Feeding in Emergencies: Operational Guidance: “Food suitable to meet the nutrient needs of older infants and young children must be included in the general ration for food aid dependent populations”

4. Basic emergency complementary feeding support: • Fortified blended foods (e.g. CSB/WSB) in general ration • Addition of inexpensive locally available foods to the general ration • Addition of micronutrient rich foods to SFP rations • Sprinkles/micronutrients

5. Challenges and possible solutions for basic emergency complementary feeding support: Difficulties in assessing access/ availability of complementary food? Lack of awareness of need? Sectoral placement of the basic/non technical interventions (not managed by nutritionists?) Misuse of blended foods Reliance on UN for commodities Build in to initial assessments Organisational sensitisation Nutrition goal of food sec/livelihoods work Design, M&E EmPrep; alternative response

6. ‘Technical’ emergency complementary feeding interventions: • Training health/nutrition/ community staff on optimal IYCF practices • Integrating training and support in to health care • Setting up areas for mothers requiring individual support • Providing information on correct and hygienic preparation of unfamiliar complementary foods and on feeding children what is available

7. Save the Children UK’s view • There is a need to protect and promoteoptimal infant and young child feeding and caring practices in an emergency • Allows emergency programme to link with longer term developmental work… • …and Hunger Reduction work in Save the Children UK focuses on reducing stunting and wasting through addressing their causes, building a package of safety nets that ultimately addresses economic security

8. Some recent 2007-2008 Save the Children Alliance response examples: • Bangladesh cyclone response • Mozambique flood response • India flood response

9. New technical interventions? • Complementary food vouchers exchangeable for certain commodities suitable for complementary foods, for PLW/mothers of children under 2. Part of cash programme. • Blanket supplementary feeding for children of complementary feeding age with a Ready to Use Supplementary Food, as a preventative measure in areas of high acute malnutrition / chronic emergencies

10. Complementary Feeding response considerations: Initial context: Malnutrition prevalence, micronutrient deficiencies, quality of traditional complementary foods, degree of household food security, availability of micronutrient rich foods Operational context: Short/longer term response? Necessary scale/coverage? Sustainability? Cost effectiveness? Delivery mechanisms? No single best package – will depend on context, but don’t forget it!

11. Thank you!