First Responders

In emergencies, infant and young child feeding becomes a public health priority. First responders are on the front lines of keeping families safe and must be prepared to support both breastfeeding and non-breastfeeding families with compassion, knowledge, and resources. Ask your local first responders to  review and share the information below, so that your community can recognize Breastfeeding Friendly First Responders! 

Supporting Infant Feeding in Emergencies — A Guide for First Responders

Breastfeeding in Public

All fifty states, the District of Columbia, Puerto Rico and the Virgin Islands have laws that specifically allow women to breastfeed in any public or private location. Research the rules for your municipality. *North Carolina law states that “…a woman may breastfeed in any public or private location where she is otherwise authorized to be, irrespective of whether the nipple of the mother’s breast is uncovered during or incidental to the breastfeeding.” This means that a breastfeeding parent is not in violation of indecent exposure laws. Click here to read the N.C. Gen. Stat. § 14-190.9 (1993).

An older law signed in 1999, Public Law 106-58, refers specifically to breastfeeding on Federal Property: Section 647 states: “Notwithstanding any other provision of law, a woman may breastfeed her child at any location in a Federal building or on Federal property, if the woman and her child are otherwise authorized to be present at the location.”

Workplace Regulations

​The Affordable Care Act mandates that employers are required to provide reasonable break time for employees to express their milk for their nursing children. The employer must also provide a place, other than a bathroom, for the employee to express breast milk.  These requirements shall not preempt a state law that provides greater protections to employees. The United States Breastfeeding Committee (USBC) maintains a helpful information page on workplace support for breastfeeding in federal law.

Childcare Regulations

​Research the rules for your local municipality 

Disaster Relief Sites

Parents and caregivers have the right to breastfeed their infants in emergency shelters and evacuation centers. Staff and volunteers should create supportive, private spaces and help uphold these rights during crisis response.

Why Infant Feeding Support Matters During Emergencies

Any time a parent needs a first responder, it feels like an emergency for that family. Emergencies often occur when least expected, and sometimes when we are least prepared. They can include a wide range of unsettling events, including personal or family crises, public health emergencies (such as a flu pandemic), acts of terror and violence, and natural disasters or weather-related events (such as floods and blizzards). Emergencies can make it hard for parents and caregivers to feed their infants and young children safely. Know the law and follow these tips to keep our children safe when disaster strikes.

And during disasters or public health crises, we need you even more, infants are especially vulnerable. Unsafe water, lack of electricity, and interrupted healthcare access increase the risks of disease and malnutrition—especially for formula-fed babies. Breastfeeding provides clean, safe, and immediately available nutrition. First responders can protect infant health by supporting breastfeeding families and reducing risks for those who use formula. Every interaction matters.

We know that breastfeeding, and the lower breastfeeding rates, is a public health issue that has affected certain marginalized communities and certain racial groups more than others. And breastfeeding isn’t easy for everyone, particularly in emergencies. 

Video uploaded from Save the Children USA

Infants and children are the most vulnerable during emergencies

Breastfeeding offers a protective layer in these situations. It provides safe, accessible, and clean nutrition that doesn’t require sterilization, water, or refrigeration. Human milk contains antibodies that fight infection, lowers stress in both the parent and baby, and helps regulate infant body temperature.

For families who are formula feeding, emergencies can make safe preparation difficult or impossible. That’s why it’s critical to take a harm reduction approach—ensuring families have access to ready-to-feed formula, clean water, and sanitized feeding tools. Supporting infant feeding during emergencies isn’t just a health issue—it’s a matter of survival.

  • Nearly 95% of infant and child deaths in emergencies result from diarrhea due to contaminated water and an unsanitary environment.
  • Infant formula has been linked to an increase in infant disease and death: it can also be contaminated and requires clean water and fuel to sterilize formula, bottles, and nipples. Lack of electricity also can make it difficult to preserve formula.
  • Breastfeeding saves lives! Human milk is always clean, requires no fuel, water, or electricity, and is available, even in the direst circumstances.
  • Human milk contains antibodies that fight infection, including diarrhea and respiratory infections common among infants in emergency situations.
  • Human milk provides infants with perfect nutrition, including the proper amount of vitamins and minerals required for normal growth.
  • Breastfeeding releases hormones that lower stress and anxiety in both babies and parents.
  • Parents who breastfeed are able to keep their babies warm to prevent hypothermia.

Parents can breastfeed in an emergency!

  • The safest food in an emergency is the parents’s own milk. Donor human milk is the next best option. Parents who cannot directly feed their babies also can be supported to express their milk.
  • Parents who are stressed can continue to make milk. A quiet area to help parents relax can help their milk flow to the baby; however, parents can breastfeed even without the support of a quiet space.
  • Malnourished parents can make milk.
  • Even parents who have already discontinued breastfeeding may be able to restart breastfeeding (known as
    “relactation”).
  • If a baby (or parent) becomes ill, the best thing the parent can do is to continue breastfeeding to provide her baby with human antibodies that fight the illness.
  • Support makes the difference!

What First Responders Can Do: A Checklist”

If you are a first responder or an emergency relief worker, the Centers for Disease Control and Prevention (CDC) recommends keeping this Breastfeeding Support Checklist for Relief Workers on hand. Read more at “Facts about Breastfeeding in an Emergency – Especially for Health Workers“

  • ✅ Keep families with infants together during evacuation and sheltering. Emergency Preparedness Checklist for Breastfeeding
  • ✅ Create or designate safe, private areas for breastfeeding
  • ✅ Encourage continued breastfeeding whenever possible
  • ✅ Avoid distributing infant formula unless it is ready-to-feed and medically indicated
  • ✅ Refer families to lactation support (virtual or in-person)
  • ✅ Provide access to clean water, soap, wash basins, and drying racks. How to clean infant feeding items.
  • ✅ Avoid giving electric breast pumps unless power and sterilization are available
  • ✅ Know where to access Durham County’s emergency infant feeding materials

⚠️ Key Harm Reduction Tips

  • Use ready-to-feed formula only when possible—do not distribute powdered formula unless safe water, clean bottles, and sterilization supplies are available.
  • Do not provide electric breast pumps in shelters without guaranteed access to power and sterilization.
  • Avoid giving out formula unsolicited—follow WHO guidelines and distribute only when medically appropriate or requested by the parent.

🧼 Safe Cleaning Practices:

  • Never advise parents to wash bottles or nipples in bathroom sinks.
  • Provide access to clean water, soap, a basin, bottle brushes, and drying racks.
  • Use disposable cups or cups with handles when bottles are unavailable or can’t be properly cleaned.
  • Train families and volunteers in basic safe cleaning procedures using available supplies.

🧭 First responders and shelter staff are not expected to be lactation experts—but your support, compassion, and basic knowledge can save lives.

For Healthcare Providers

In addition to your basic emergency preparedness training, explore resources from The Carolina Global Breastfeeding Institute (CGBI).

Recovery Resources

First responders, volunteers, and shelter staff can all play a role in supporting safe infant feeding and family well-being during emergencies. The resources below provide tools for training, family communication, and cross-agency collaboration.