# Accommodations for the Dietary Requirements of Infants, by L.C.

Infants have specific nutritive needs that at the present moment may be met in two ways: breast milk and formula. In a collapse or post-collapse scenario, the supply of formula may dry up and no longer be an option. There are several strategies to cope with this as well as breastfeeding supplies that can easily be acquired now.

I’m the mother of five kids under the age of six with the youngest being six weeks old, so for the past six years I’ve been pregnant, nursing, or both. I breastfed my first four exclusively, until we started solids between 6-7 months of age, but I continued breastfeeding until their first birthday. My newest little girl has been struggling to gain weight, so at the doctor’s advice we’ve been supplementing with an ounce of formula after every breastfeeding session, which is every two hours during the day and every three hours at night. She is making progress, but it is slow. I have no affiliation with any of the companies of the products I mention, but I have personally found them very useful.

If you anticipate that you might be needing to provide for the future needs of an infant, please understand that having a few cans of formula isn’t sufficient. I’m not saying that you shouldn’t store some for that “just in case” scenario, but it is a stop gap measure that will run out quickly. The healthy newborn infant needs approximately *120 kcal/kg/day (1)* to gain weight at the desired rate *of 15-30 gm per day*. Both infant formula and breast milk have the same average calories per ounce: 20 kcal/ounce. (Note: 30 ml=1 ounce; 2.2 lb =1 kg) So, for an 8 lb baby: 8/2.2= 3.64kg; 3.64kg x 120 kcal/kg = 436kcal; 436kcal / 20 kcal/oz = 21.8 oz daily

A measurement of 8.8 grams of formula makes 2 ounces, so my 8 lb baby would take 96 gram of formula a day. That means that a 22.2 oz (629 g) container of formula, which costs \$26, would only last my baby 6½ days, and that changes daily to be even less time as my baby gains weight.

With this in mind, the best and possibly only option for babies in a post-collapse world will be breastfeeding. In order to make the transition from the bottle back to the breast will take some work, strategy, and perhaps thinking outside the box for many mothers, their infants, and their families.

As I see it, there are two overarching strategies for a return to breast milk:

1. The mother re-attempts to nurse her child. (“Relactation” is the term for beginning to breastfeed again after a period of not breastfeeding), or
2. Another, lactating woman “wet nurses” the child.

#### Relactation

In a collapse scenario, there will still be women out there who have made it their life’s work to help other women breastfeed successfully. These are lactation consultants and La Leche League leaders and volunteers. Making contact with them and seeking out their wisdom and experience would be enormously helpful for the process of relactation. They have seen and helped hundreds, if not thousands, of moms struggle with breastfeeding, and they have an arsenal of tips and tricks to get it to work. Compiling a list now of local contacts would be a good idea. This list could also include the contact information of doulas, midwives, and the maternity ward of a local hospital or birthing center. Where possible, get addresses as well.

“Nature is a very clever thing. Breast stimulation alone sends important hormonal signals to switch milk production back on. It is a common misconception that once a woman’s milk has ‘dried up’ she is no longer able to breastfeed. But this needn’t be the case, in fact, some grandmothers have been known to relactate in order to feed their grandchildren.” (2)

In stimulating the production of milk, a pump is crucial. This hand pump doesn’t require electricity and is very highly reviewed. (I have one, and I love mine more than the electric pump I have.) In addition to helping increase supply, it is easier for a baby to take milk from a bottle than a breast, so a hand pump would make easy work of filling up bottles to help feed babies who have trouble latching, difficulty sucking, or poor transfer of milk.

A supplemental nursing system (SNS) can also be useful to train a baby to take the breast. It works by providing a supplement through a tube that is taped to the breast so that the baby breastfeeds and formula feeds simultaneously. It stimulates the mother’s body to produce more milk, gets baby used to the breast, and gives as much supplement as is needed in addition to the breast milk.

Nipple cream such as Lansinoh lanolin ointment or Medela’s lanolin nipple cream is crucial for helping heal sore nipples if baby has had a bad latch or two. The good thing about these creams is that they are safe for baby to ingest, so there is no need to wash them off before feeding.

A nipple shield is also something that can come in useful, if baby is having difficulty latching. (I’ve never used one myself, but I have known close friends who used them with success.)

The three main reasons breastfeeding doesn’t work out for moms are issues with:

• the establishment of a robust milk supply,
• effective attachment (latch-on and transfer of milk), and
• maternal confidence.

“These are the three most common issues, accounting for the largest drop off in breastfeeding, which occurs within the first several post-partum weeks.” (3)

So far we have addressed the first two issues, but in all of this, it is important to encourage the mom as much as possible, and give her support in whatever way you can: emotionally, helping reduce her other responsibilities (cook a meal for her, help watch her other kids, help clean) and get her a glass of water. Spiritual support shouldn’t be overlooked either; let her know you are praying for her and baby.

In considering maternal confidence, one very significant thing that can be done is to give her the perception that she has a degree of control over the situation, that you trust her maternal instincts, and encourage her to trust them as well. This might mean that even though you might be the patriarch of the group and have amassed knowledge and supplies to help her feed her infant, you discern that all of this nursing advice might be best received by the mother if it doesn’t come from the leader or his wife with a strong personality; maybe this information had better reach her through her sister or another gentle but empowering woman of the group. It is about her making the decisions and struggling with the challenges of feeding her infant; the more she arrives there on her own, the more confidence she will gain. That woman providing her with information might also help her recognize the progress she is making; all progress is good progress as she helps baby back to the breast.

#### Wet Nurse

In most situations, option A would be the best course of action, but if for whatever reason option B is necessary, then locating a suitable wet nurse becomes the first challenge. (Keeping in mind that suitability includes not only a willingness but also integrity, health, and physical proximity.)

Some places to begin searching for a lactating mom might be:

• A local breastfeeding support group (“breastfeeding is beautiful” or BIB is one nearby to where I live, but your local hospital/maternity ward would have that information) or La Leche League chapters
• Church- young families at your church who might have babies or friends with babies. The added benefit of sourcing a wet nurse through a church community is a level of moral accountability. Perhaps looking into other local churches might be helpful too; some Christian churches do infant baptisms, christenings, and/or dedications, and the bulletins of these churches might list these infants.
• Local newspapers might have birth announcements
• Midwives, doulas, maternity nurses, and pediatricians might know of somebody and be able to make a recommendation.

The second challenge becomes working out acceptable terms for both parties, including remuneration for the nursing mother, a schedule, and perhaps a change in living arrangements to accommodate the necessary proximity. How all of this influences the larger family and group’s movements and allocation of supplies becomes a legitimate question that would need to be addressed.

In times past, having a wet nurse wasn’t taboo, as it is now. One of the additional challenges of this course of action may be emotionally getting over the awkwardness of the situation as it exists to our modern sensibilities.

On the flip side of this whole conversation is the potential that an already nursing mom has to help another mom out. It might be that breastfeeding becomes an asset to barter with or an opportunity for charitable giving. Either way, recognizing the life-nurturing capability that a breastfeeding woman has, and its vital importance to the health and well being of an infant is something worth considering. It’s value will only increase as other feeding possibilities become unavailable.

It is not without reason that artists would personify the virtue of charity as a breastfeeding mother, as it is a true gift of self and life to the smallest and most vulnerable human among us.

P.S. Not totally related to the topic of feeding but to babies in general, it is, in my opinion, useful to have extra receiving blankets for swaddling and burping, extra hats, socks, and warm fleecy onesies. All are useful for keeping baby warm and comfortable. In colder weather I have my baby sleep in layers and a warm, outer fleecy jacket onesie rather than use blankets in the crib. Also, consider a white noise machine, fan, or even a CD of white noise to help baby settle. My favorite parenting book for moms of infants is The Baby Whisperer. Two important topics she discusses are: getting baby on a rhythm of eat, activity, sleep (repeat), and how to read their cues to transition from one to the next; and “begin as you wish to go on”, meaning that if you want your baby to learn to sleep in their crib, you stop holding them while they sleep and begin now to do what you wish to do in the future.

References:

(1) http://www.healthsystem.virginia.edu/pub/peds-nutrition/targets-for-initiation/reqstable1.html

(2)http://abm.me.uk/restarting-breastfeeding-after-a-gap/

(3)http://newborns.stanford.edu/Breastfeeding/PMGs.html