P3.065: SAFE Infant Feeding in North Carolina Emergencies: Moving From Response to Resilience Post Hurricane Helene

Background: Families with infants and young children face significant and disproportionate challenges in accessing safe nutrition during disasters, heightened by infrastructure instability. Flooding presents added layers of difficulty as water is often unavailable; systems require testing and bacterial mitigation. Caregivers may inadvertently expose infants to contaminated water, increasing incidence of gastrointestinal illness due to neonatal gut and immune immaturity. Breast/chestfeeding families often require skilled feeding support, while non-nursing infants require clean water for safe formula preparation. Families relying on pumped milk are at risk as few parents have access to battery-operated pumps, further jeopardizing infant nutrition and increasing the risk of breast-related illnesses. Feeding tools require clean water for reuse, underscoring the essential role direct breast/chestfeeding plays in this setting. Where nursing is not employed, it’s crucial caregivers are aware of safe infant feeding hierarchies.

Project Description: Support and Advocacy in Feeding Emergencies (SAFE) was created to address unmet, critical infant and young child feeding needs and relieve systemic disparities identified following Hurricane Helene. SAFE mitigates water-borne pediatric and breast-related illnesses seen in crises, transforming all-cause disaster response by incorporating real-time, evidence-based training and feeding protocols throughout the disaster management cycle.

Currently operating in eleven Western NC counties, expected to expand state- and potentially nation - wide. SAFE employs broad dissemination of ‘Infant Feeding Sanitation Kits’ and, through collaboration with Carolina Global Breastfeeding Institute, culturally competent Infant and Young Child Feeding in Emergencies (IYCF-E) and trauma-informed Rapid Needs Assessment (RNA, CDC) education.

Discussion: Since September 2024, SAFE has distributed 7000+ sanitation kits, conducted 5000+ RNAs, trained 500+ emergency and perinatal personnel, directly supported ~260 feeding visits, and shared countless infant carriers, ensuring families remain close and warm. SAFE has established collaborations with 300 relief organizations, providing education in managing thousands of pallets of infant formula by frontlining ready-to-feed foods and discarding countless expired, harmful products. SAFE is engaging with federal and state agencies to integrate IYCF-E education into emergency preparedness plans, launching a national network of IYCF-E advocates, and accepting speaking engagements across the nation.
SAFE’s disaster gap analyses continue to drive development of multi-audience protocols for feeding support and safety and red-flag triaging methods, ensuring high-risk infants and parents are treated rapidly. Findings have prompted creation of shelters equipped with feeding areas, including sanitation stations and privacy spaces, and, above all, fuel mitigation of systemic inequities in emergency resource allocation, ensuring vulnerable populations have equitable access to education, support, and supplies.

Conclusion: SAFE insights will continue to elucidate gaps in IYCF-E including systemic challenges in formula distribution practices, highlighting critical needs for community-based lactation education, perinatal mental health support, and community-based participatory research.