GUIDELINES FOR USE OF BREAST-MILK SUBSTITUTES
IN EMERGENCY SITUATIONS
General Statement
These guidelines are intended for use by qualified staff and not for wide
distribution. It is suggested to provide the flyers to mothers/caregivers that
will be using the substitute
Recommendations for the use of breast-milk substitutes
• Mothers/caregivers should be taught about safe preparation of the breast-milk
substitute
• Possible breast-milk substitutes include: commercial infant formula, liquid
animal milk (cow or goat), powdered animal milk, evaporated milk
• All other milks are unsuitable for small infants
• The instructions for mixing the commercial formula need to be followed
exactly according to the supplier recommendations
• The recommendations when using liquid cow or goat milk in infants less than
6 months old and for each feed are the following:
o For the one-month old mix 40 ml of milk with 20 ml of boiled water
and add 4 g of sugar
o For a two-months old mix 60 ml of milk with 30 ml of boiled water
and add 6 g of sugar
o For infants 3-4 months old mix 80 ml of milk with 40 ml of boiled
water and add 8 g of sugar
o For infants 5-6 months old mix 100 ml of milk with 50 ml of boiled
water and add 10 g of sugar
• If the substitute is going to be prepared using powdered full-cream cow's milk
the following is recommended for each feed:
o For the one-month old infant mix 5 g of milk with 60 ml of boiled
water and add 4 g of sugar
o For the two month-old mix 7.5 g of milk with 90 ml of boiled water
and add 6 g of sugar
o For infants 3-4 months old mix 10 g of milk with 120 ml of boiled
water and add 8 g of sugar
o For infants 5-6 months old mix 12.5 g of milk with 150 ml of boiled
water and add 10 g of sugar
, • The following is recommended for preparing a substitute using evaporated
milk and for each feed:
o For the one-month old mix 16 ml of milk with 44 ml of boiled water
and add 4 g of sugar
o For the two-month old mix 24 ml of milk with 66 ml of boiled water
and add 6 g of sugar
o For infants 3-4 months old mix 32 ml of milk with 88 ml of boiled
water and add 8 g of sugar
o For infants 5-6 months old mix 40 ml of water with 110 ml of bolied
water and add 10 g of sugar
• For all breast-milk substitutes it is recommended to follow basic hygienic
measures for preventing infections:
o Wash hands with soap and clean water
o Clean all utensils, containers and cups with soap and clean water
• Mothers/caregivers should give the infant a micronutrient supplement every
day
• The breast-milk substitute should be fed by cup
Illustrated demonstrations to prepare the different breast-milk substitutes
are attached
For further information, contact:
Randa Jarudi Saadeh
Scientist
World Health Organization
Nutrition for Health and Development
Tel: +41 22 791 3315/3878
Fax: + 41 22 791 4156
E-mail:
Zita Weise Prinzo
Technical Officer
World Health organization
Nutrition for Health and Development
Tel: +41 22 791 4440
Fax: +41 22 791 4156
E-mail:
Or
Chantal Gegout
Nutritionist
Nutrition for Health and Development
Tel: +41 22 791 4233
E-mail:
Kunal Bagchi
Regional Adviser, Nutrition
Eastern Mediterranean Region
Tel: 202 670 25 35
Fax: 202 670 24 92/94
E-mail:
IN EMERGENCY SITUATIONS
General Statement
These guidelines are intended for use by qualified staff and not for wide
distribution. It is suggested to provide the flyers to mothers/caregivers that
will be using the substitute
Recommendations for the use of breast-milk substitutes
• Mothers/caregivers should be taught about safe preparation of the breast-milk
substitute
• Possible breast-milk substitutes include: commercial infant formula, liquid
animal milk (cow or goat), powdered animal milk, evaporated milk
• All other milks are unsuitable for small infants
• The instructions for mixing the commercial formula need to be followed
exactly according to the supplier recommendations
• The recommendations when using liquid cow or goat milk in infants less than
6 months old and for each feed are the following:
o For the one-month old mix 40 ml of milk with 20 ml of boiled water
and add 4 g of sugar
o For a two-months old mix 60 ml of milk with 30 ml of boiled water
and add 6 g of sugar
o For infants 3-4 months old mix 80 ml of milk with 40 ml of boiled
water and add 8 g of sugar
o For infants 5-6 months old mix 100 ml of milk with 50 ml of boiled
water and add 10 g of sugar
• If the substitute is going to be prepared using powdered full-cream cow's milk
the following is recommended for each feed:
o For the one-month old infant mix 5 g of milk with 60 ml of boiled
water and add 4 g of sugar
o For the two month-old mix 7.5 g of milk with 90 ml of boiled water
and add 6 g of sugar
o For infants 3-4 months old mix 10 g of milk with 120 ml of boiled
water and add 8 g of sugar
o For infants 5-6 months old mix 12.5 g of milk with 150 ml of boiled
water and add 10 g of sugar
, • The following is recommended for preparing a substitute using evaporated
milk and for each feed:
o For the one-month old mix 16 ml of milk with 44 ml of boiled water
and add 4 g of sugar
o For the two-month old mix 24 ml of milk with 66 ml of boiled water
and add 6 g of sugar
o For infants 3-4 months old mix 32 ml of milk with 88 ml of boiled
water and add 8 g of sugar
o For infants 5-6 months old mix 40 ml of water with 110 ml of bolied
water and add 10 g of sugar
• For all breast-milk substitutes it is recommended to follow basic hygienic
measures for preventing infections:
o Wash hands with soap and clean water
o Clean all utensils, containers and cups with soap and clean water
• Mothers/caregivers should give the infant a micronutrient supplement every
day
• The breast-milk substitute should be fed by cup
Illustrated demonstrations to prepare the different breast-milk substitutes
are attached
For further information, contact:
Randa Jarudi Saadeh
Scientist
World Health Organization
Nutrition for Health and Development
Tel: +41 22 791 3315/3878
Fax: + 41 22 791 4156
E-mail:
Zita Weise Prinzo
Technical Officer
World Health organization
Nutrition for Health and Development
Tel: +41 22 791 4440
Fax: +41 22 791 4156
E-mail:
Or
Chantal Gegout
Nutritionist
Nutrition for Health and Development
Tel: +41 22 791 4233
E-mail:
Kunal Bagchi
Regional Adviser, Nutrition
Eastern Mediterranean Region
Tel: 202 670 25 35
Fax: 202 670 24 92/94
E-mail:
