Feeding the youngest in crises: infant and young child feeding preparedness in high-income setting

Infant and young child feeding (IYCF) is a critical public health priority during emergencies, yet remains poorly integrated into emergency preparedness planning in many high-income countries (HICs). Despite the availability of international guidance, such as the Operational Guidance on IYCF in Emergencies the implementation of these tools in national systems has been inconsistent within HICs. This review examines recent emergencies in HICs to identify policy and operational gaps affecting breastfeeding support, the management of commercial milk formula (CMF) and the distribution of commercially available complementary foods (CACFs). The present review focuses on the practical translation of Infant and young child feeding in Emergencies (IYCF-E) guidance into emergency responses across a range of contexts. This review highlights widespread failures to protect breastfeeding during crises, often due to a lack of trained personnel, inadequate shelter infrastructure and limited integration of IYCF into emergency protocols. CMF was frequently distributed without needs assessment or support, undermining breastfeeding and introducing risks related to hygiene and preparation. CACFs were often age-inappropriate, ultra-processed or culturally unsuitable, with potential long-term implications for child health. Even in countries with strong health systems, IYCF-E was often fragmented, under-resourced or absent from preparedness frameworks. To build nutritional resilience, IYCF-E must be embedded within public health and disaster planning, supported by legal protections, trained personnel, regulated product distribution and coordinated communication. This requires a shift in policy and perception, recognising that the right to safe and appropriate feeding in emergencies applies equally in all settings.