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Infant formula donations and code violations during earthquake relief efforts in Türkiye in 2023: an observational
Jiayi Guan1, Alessandro Iellamo2, Jodine Chase3
1Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States of America. charlotteguanjy@gmail.com.
Insights
Commercial milk formula (CMF) donations and feeding practices during earthquake relief efforts violated international infant feeding guidelines. This highlights a critical need for improved emergency responses to protect vulnerable infants.
Area of Science:
- Public Health
- Nutrition
- Disaster Response
Background:
- The 2023 Türkiye-Syria earthquake critically impacted millions of children, increasing vulnerability for infants reliant on commercial milk formula (CMF).
- Safe preparation of CMF is challenging in disaster settings, risking infant health and nutrition.
- International guidelines, including the Operational Guidance on Infant and Young Child Feeding in Emergencies (OG-IFE) and the International Code of Marketing of Breastmilk Substitutes (the Code), aim to protect infant feeding.
Purpose of the Study:
- To document violations of the Code and OG-IFE during earthquake relief efforts.
- To inform future disaster relief policies and strengthen infant and young child feeding (IYCF) emergency responses.
Main Methods:
- Internet data collection from February 6 to March 10, 2023, including social media, news websites, and the Emergency Nutrition Network forum.
- Analysis focused on donation information and violations of infant feeding guidelines.
- Turkish content was translated into English for comprehensive analysis.
Main Results:
- Forty reports concerning donations of CMF, complementary foods, and feeding equipment were collected.
- Identified three primary types of violations of the OG-IFE and the Code, predominantly involving the solicitation or acceptance of donations.
- Infant formula companies repeatedly violated the Code by donating substantial amounts of CMF and equipment to relief organizations and government agencies.
Conclusions:
- Observed incidents reflect systematic violations of the Code and non-compliance with OG-IFE standards.
- Fragmented early responses led to inconsistent application of globally accepted IYCF standards.
- Urgent enhancement of efforts is required to ensure safe and appropriate IYCF practices for all infants during emergencies.
Background:
On 6 February 2023, an Mw 7.8 earthquake struck southern and central Türkiye and north-western Syria, affecting the lives of 4.6 and 2.5 million children, respectively. In such crises, infants who are dependent on commercial milk formula (CMF) face increased vulnerability to diseases and malnutrition as safe preparation of CMF becomes difficult and sometimes impossible. The Operational Guidance on Infant and Young Child Feeding in Emergencies (OG-IFE) provides guidance on protecting and supporting recommended infant and young child feeding and minimizing the risks that come with CMF feeding. In addition, the International Code of Marketing of Breastmilk Substitutes (the Code) ensures adequate nutrition for infants by protecting and promoting breastfeeding and ensuring the proper usage of CMF. This study aims to document violations of the Code and the OG-IFE during the earthquake relief efforts to help strengthen infant and young child feeding emergency responses and inform future disaster relief policies.
Methods:
Data was collected from 6 February to 10 March 2023 through Internet sources. Social media, news websites, and the Emergency Nutrition Network forum were used for data collection. Turkish content was translated into English for analysis, with a focus on donation-related information and Code violations related to baby food and infant feeding.
Results:
A total of 40 reports on CMF, complementary food, and feeding equipment donations were collected. Three main types of violations of the OG-IFE and the Code were identified, with the majority of them being incidences of individuals, humanitarian organizations, and government agencies seeking or accepting donations. Infant formula companies continued to violate the Code by donating large quantities of CMF and feeding equipment to the Turkish Red Crescent, government agencies, and disaster relief infant and young child feeding (IYCF) coordination authorities.
Conclusions:
These incidents reflected a systematic violation of the Code and non-compliance with the OG-IFE. Globally accepted IYCF standards and recommendations were not consistently followed due to fragmented early responses. There is a critical need to step up efforts to ensure appropriate and safe IYCF practice protecting and supporting breastfed and non-breastfed infants in emergencies.
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