In emergencies, infants and young children are at risk of morbidity and mortality, which is increased by malnutrition. Environmental factors, food insecurity, household needs, misconceptions regarding breastfeeding, uncontrolled distribution of breast-milk substitutes, and psychological trauma make it difficult to implement proper feeding practices during disasters. Breastfeeding reduces the risk of infectious diseases and mortality in emergencies and is the safest way of feeding. Therefore, breastfeeding should be supported and promoted under all circumstances. When breastfeeding is not possible, relactation, wet nursing, or donor human milk should be considered as alternatives. If these options are not feasible, infant formula should be used. Formula should be provided only for infants in need, based on individual assessment. Donations of breast-milk substitutes should not be accepted; when needed, the procurement and distribution should be conducted by a single center under strict control, adhering to the requirements of the Code and Codex Alimentarius. Education and support should be provided to the family for the safe use of formulas. For infants older than 6 months, appropriate complementary feeding should be started. Complementary foods should contain nutrients that support the growth and development of infants, and they should be stored, prepared, and served safely. In conclusion, nutrition of infants and young children should be given priority in disasters as part of all emergency interventions. Determining the infants needs and ensuring proper nutrition, overcoming environmental challenges, and supporting parents will reduce nutrition-related risks and protect the health and well-being of infants and young children in emergencies. Cite this article as: Bilgin DD, Karabayır N. Infant and young child feeding in emergencies: A narrative review. Turk Arch Pediatr. 2024;59(2):135-143.

The effects of inactivated SARS-CoV-2 vaccine (CoronaVac) on previously naturally infected individuals are unknown. This study compared immunogenicity and reactogenicity of CoronaVac in once naturally infected health-care workers (HCWs) and uninfected HCWs. All HCWs were immunized with two doses of CoronaVac (600 U/0.5 ml) intramuscularly at a 28-day interval. Adverse reactions were obtained by web-based questionnaires or telephone calls seven days after each vaccine dose. Detection of antibody levels against the receptor-binding domain (RBD) of SARS-CoV-2 spike protein was done four weeks after the second dose of the vaccine. We enrolled 103 previously naturally infected and 627 uninfected HCWs. The mean time for vaccination after the first nasopharyngeal SARS-CoV-2 positivity was 64 days (range: 15–136 days) in previously naturally infected HCWs. Among the previously naturally infected HCWs, 41 (40%) were asymptomatic, 52 (50%) had mild upper respiratory tract infections, 10 (105) had pneumonia, and only 6 (5%) were hospitalized. Any reported adverse reactions, either from the first dose or the second dose of vaccine administration, did not differ between previously infected and uninfected HCWs. Anti-RBD antibody titers were obtained in 50 (51%) of 103 previously infected HCWs and 142 (23%) of 627 uninfected HCWs. Anti-RBD antibody titers were significantly higher in HCWs with a previous natural infection (median 1220 AU/ml, range: 202–10328 AU/mL) than in uninfected HCWs (median: 913 AU/ml, range: 2.8–15547 AU/mL, p = .032). CoronaVac administration was safe and may elicit higher antibody responses in previously naturally infected individuals.

Vitamin B12 (vit B12) or cobalamin is a water-soluble vitamin that acts as a coenzyme and is effective in the formation of a healthy nervous system and erythrocytes. In its deficiency, except fatigue and weakness, may cause serious signs and symptoms such as macrocytic anemia, cognitive-developmental delay, irreversible neurological damage. In this study, hemoglobin, leukocyte, thrombocyte, iron, iron-binding, ferritin, and vit B12 levels were evaluated retrospectively during the routine controls of 689 children 5 to 18 years old without any complaints. In addition, the relationship between serum 25-Hydroxyvitamin D (vit D) levels and vit B12 levels, which were evaluated in 487 of the cases, was investigated. Vit B12 deficiency was diagnosed in a total of 160 (23.2%) cases, 99 (24.4%) girls and 61 (21.4%) boys. Vit B12 level was significantly lower in children over 12 years old. Vitamin D deficiency was found to be 49.3% in 487 cases and was significantly higher in the group under 12 years and girls. The frequency of anemia was 7.2% in this group. There was a significant relationship between vit D deficiency and vit B12 deficiency. In conclusion, vit B12 deficiency is common in school-age children, especially in the adolescent age group. It should be known that vit D deficiency may also be present in vit B12 deficiency cases. More comprehensive studies are needed to reveal the relationship between B12 and vit D deficiency.

Background: Breastfeeding is one of the most important factors ensuring the healthy growth and development of babies. Preterm babies, babies with metabolic, neurological, or developmental delays, babies separated from their mothers for any reason, and adopted babies need alternative feeding methods. This study was carried out to investigate the effect of the finger feeding (FF) method on relactation. Method: In this retrospective study, infants who were admitted to the Istanbul Medipol University breastfeeding counseling clinic between January 2020 and June 2021 and were recommended to be fed with finger feeding were evaluated. Gender, gestation, mode of delivery, birth weight, age, cause for admission, feeding type, breastfeeding starting time, finger feeding time, and breastfeeding duration of the cases were recorded from the counseling forms. Results: Of 41 babies, 29.3% were girls and 70.7% were boys, and 82.9% were term. Seventeen (41.5%) were born with spontaneous vaginal delivery and 24 (58.5%) with a cesarean section. The most common reason for admission was found to be the inability to latch. While 30 (73.2%) of the babies fed with finger feeding were able to suck, nine babies continued to be fed with a bottle, one baby with a spoon, and one baby with a supplemental nursing system (SNS). The breastfeeding starting time was 23.1 ± 27.5 (1-100) days. Conclusion: The finger feeding method is an effective alternative feeding method for successful breastfeeding. There is a need for studies to be conducted with more babies, both preterm and term, in this regard.

Objective: Postpartum mental health, significantly influences breastfeeding. Dysphoric milk ejection reflex (D-MER) is defined as negative emotional reaction to milk ejection, such as unpleasant feelings, anger-irritability or a strange feeling in the stomach. This study investigates the impacts of D-MER on mothers experiencing negative emotions during breastfeeding. Method: This cross-sectional, descriptive study was conducted between July 1 and September 30, 2023 among surveyed mothers with babies of ages 0–2 experiencing discomfort while breastfeeding. Mothers reached out through Instagram and Facebook and completed a semi-structured 45-question survey using a Google form. Results: Out of 141 mothers, 27.7% ( n : 39) had D-MER findings. Common emotions included tension (48%), exhaustion (43%), intolerance (41%), hypersensitivity (35%), and restlessness (33%). Symptoms reported to begin within the first month of breastfeeding in 59% of D-MER cases. Nausea was reported in 30% of mothers. The most common conditions that increased the severity of D-MER symptoms were insomnia, stress and breast fullness. Sleeping or resting, being alone, doing something else, drinking cold water, listening to music and talking to mothers who had similar experiences helped the mothers relax. In cases with D-MER findings, about 17.9% considered stopping breastfeeding, with 7.7% stopping. The postpartum depression score was ≥13 in 59% of D-MER cases. Conclusion: D-MER, which can cause early cessation of breastfeeding, may also be associated with the mother’s mental health problems. Raising awareness about D-MER and equipping health professionals on this subject are important in the continuity of breastfeeding.

Breastfeeding offers critical benefits in disasters but faces significant barriers. In this study, we aimed to determine the association between experiencing the 2023 Türkiye earthquake and breastfeeding problems. This cross-sectional descriptive study was conducted in pediatric clinics in eight different provinces of Türkiye, three earthquake-affected provinces and five earthquake-unaffected provinces, between April and July 2023. Breastfeeding mothers and their 0–23 month infants were included in the study. A structured questionnaire was applied to mothers face-to-face. Multivariate logistic regression analysis was performed to determine independent parameters associated with breastfeeding problems. A total of 761 mother-child pairs participated in the study. Among these mothers, 49% (n = 373) were living in the earthquake-affected region, and 51% (n = 388) were not. Breastfeeding problems were more common in the earthquake-affected mother-child pairs (48.8%) compared to unaffected pairs (28.6%). Perceived insufficient milk supply was the most common breastfeeding problem, reported by 33.0% in earthquake-affected regions and 11.1% in unaffected region. Breastfeeding problems were 2.01 times more common in mothers from earthquake-affected region (95% CI: 1.45, 2.77) and 1.66 times more common in those who bottle-fed their infants (95% CI: 1.45, 2.37). Perceived insufficient milk supply was 4.12 times more prevalent in earthquake-affected regions (95% CI: 2.73, 6.22) and 1.78 times higher in bottle-feeding mothers (95% CI: 1.23, 2.57). The likelihood of perceived insufficient milk supply was lower in mothers receiving mental health support (AOR: 0.53, 95% CI: 0.33, 0.84) and nutritional support (AOR: 0.49, 95% CI: 0.27, 0.89). Perceived insufficient milk supply is the most common breastfeeding challenge reported by mothers affected by earthquakes, occurring more frequently than among mothers who were not affected. This issue is associated with increased bottle feeding, limited mental health support, and inadequate nutritional support. Addressing this issue through adherence to the International Code of Marketing of Breast-milk Substitutes, controlling donation and distribution of commercial milk formula to discourage bottle feeding, alongside ensuring nutritional and mental health support for mothers, could significantly mitigate breastfeeding difficulties during disasters.