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      Infant and young child feeding in emergencies: Organisational policies and activities during the refugee crisis in Lebanon

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          Abstract

          Appropriate infant and young child feeding (IYCF) is key to reducing mortality amongst children aged under 2. Facilitating adherence to recommended IYCF practices during emergencies includes having relevant policies to support breastfeeding and complementary feeding as well as regulating the distribution of breast milk substitutes. In the current crisis, more than 1.2 million Syrian refugees are in Lebanon and it is timely to examine organisational IYCF policies and programmes. One hundred and thirty‐five non‐governmental organisations providing humanitarian aid in Lebanon were invited to participate in an online survey about organisational policies and programmatic activities on IYCF. Responses were obtained from 54 organisations: 29 International Non‐Governmental Organisations (INGOs) and 25 Local Non‐Governmental Organisations (LNGOs). In total, 8 (15%) reported having a written policy on IYCF, but only 1 policy (in draft format) was available for inspection. Twelve (8 INGOs and 4 LNGOs) indicated endorsing an external IYCF policy, but only 6 listed a valid policy. Four organisations (3 INGOs and 1 LNGO) had programme objectives that indicate protection, promotion, and support of IYCF. Three LNGOs reported receiving infant formula donations and 5 organisations (2 INGOs and 3 LNGOs) indicated distributing infant formula; 2 (1 INGO and 1 LNGO) did so in accordance with international and national policies. Few organisations violated IYCF guidance but organisational policies and activities on IYCF are not well established. In order to improve response in the current refugee crisis in Lebanon, there is a need to ensure policies are in place and implemented so that interventions support, promote, and protect IYCF.

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          Most cited references20

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          Maternal and child undernutrition and overweight in low-income and middle-income countries

          The Lancet, 382(9890), 427-451
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            Donated breast milk substitutes and incidence of diarrhoea among infants and young children after the May 2006 earthquake in Yogyakarta and Central Java.

            Distribution of breast milk substitutes (BMS) after the 2006 Yogyakarta earthquake was uncontrolled and widespread. We assessed the magnitude of BMS distribution after the earthquake, its impact on feeding practices and the association between consumption of infant formula and diarrhoea among infants and young children.
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              Barriers to breastfeeding in Lebanon: A policy analysis.

              Although the issue of breastfeeding in Lebanon has risen on the political agenda, the country does not meet international recommendations for early breastfeeding practices. This study analysed barriers to dissemination, implementation, and enforcement of key policies to improve early breastfeeding practices. We conducted interviews with stakeholders in breastfeeding policy in Lebanon and used a framework approach for analysing data. We found a disconnect between policy endorsement and translation on the ground, weak engagement of professional associations and governmental institutions, undue influence by the breast milk substitute industry, and competing priorities-most notably the current refugee crisis. This study highlights the potential policy opportunities to counter these barriers and points to the role of international organisations and grassroots advocacy in pushing, monitoring, and implementing policies that protect breastfeeding, where government capacity is limited, and the private sector is strong.
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                Author and article information

                Contributors
                l.shaker@dundee.ac.uk
                Journal
                Matern Child Nutr
                Matern Child Nutr
                10.1111/(ISSN)1740-8709
                MCN
                Maternal & Child Nutrition
                John Wiley and Sons Inc. (Hoboken )
                1740-8695
                1740-8709
                08 January 2018
                July 2018
                : 14
                : 3 ( doiID: 10.1111/mcn.2018.14.issue-3 )
                : e12576
                Affiliations
                [ 1 ] School of Nursing and Health Sciences University of Dundee Dundee Scotland UK
                [ 2 ] Faculty of Heath Sciences American University of Beirut Beirut Lebanon
                [ 3 ] Centre for Public Health Nutrition Research University of Dundee Dundee UK
                Author notes
                [*] [* ] Correspondence

                Linda Shaker‐Berbari, University of Dundee School of Nursing and Health Sciences, 11 Airlie Place Dundee DD1 4HJ, UK.

                Email: l.shaker@ 123456dundee.ac.uk

                Author information
                http://orcid.org/0000-0002-4703-5169
                http://orcid.org/0000-0001-8864-3374
                http://orcid.org/0000-0001-9269-940X
                http://orcid.org/0000-0002-0047-4500
                Article
                MCN12576 MCN-06-17-OA-2678.R2
                10.1111/mcn.12576
                6055656
                29316209
                9b17ac06-a8d5-40ee-9087-6d1f87eacfad
                © 2018 The Authors. Maternal and Child Nutrition Published by John Wiley & Sons, Ltd.

                This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

                History
                : 26 June 2017
                : 09 November 2017
                : 13 November 2017
                Page count
                Figures: 1, Tables: 3, Pages: 8, Words: 4481
                Categories
                Original Article
                Original Articles
                Custom metadata
                2.0
                mcn12576
                July 2018
                Converter:WILEY_ML3GV2_TO_NLMPMC version:version=5.4.3 mode:remove_FC converted:23.07.2018

                breastfeeding,emergencies,health policy,infant and young child feeding,infant feeding,refugees

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