Your baby’s environment

• Keep your baby away from harmful chemicals and products.
• Don’t smoke and keep your baby away from secondhand smoke.
• Put together a plan for what to do in case of a disaster.

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The needs of families with newborns during a disaster are unique. You still need to follow any evacuation and preparation instructions given by your state, but here are some special things to consider.

This article is designed for anyone caring for a baby and affected by a disaster. If you are caring for an infant and have questions about the health effects of the disaster, please talk with a health care professional.

To support March of Dimes local efforts, you can donate directly to our chapters.

Before a disaster

Make sure to let your health care provider's office (doctor, midwife or nurse-practitioner) know where you and your baby will be.

If you have a case manager or participate in a program such as Healthy Start or Nurse- Family Partnership, let your case manager know where you are going. Give your case manager a phone number to use to contact you.
If your baby is in the neonatal intensive care unit (NICU), check with the hospital to find out its disaster plan and where your baby will be sent in the event of a disaster.
 
During a disaster

Keep a copy of your and your baby's medical and immunization records along with contact information for your health care providers. Infants should continue to receive their scheduled vaccines. Local health departments can provide information about how to obtain these vaccines.

Packing checklist

• Several pacifiers to help soothe your baby.
• Diapers (you will need about 70 a week for an infant).
• A blanket for your baby.
• A baby carrier because there may not be a crib or bassinet for your baby once you arrive at your destination.
• Extra clothes for your baby because these may be hard to find.
• It can be loud in shelters and hospitals. Bring anything that could help soothe you and your baby.
• Food for your baby.
• Hand sanitizer.
• Rectal thermometer and lubricant.
• Non-aspirin liquid pain reliever.

After a disaster

Food
Do your best to eat at regular intervals throughout the day. Do not eat spoiled food or any food you think may be spoiled.

The U.S. Centers for Disease Control and Prevention (CDC) provides information about food safety on its Web site.

Feeding your baby
In emergency situations, babies have an increased need for the disease-fighting factors and the comfort provided by breastfeeding. Breastfeeding is especially recommended during a disaster because it is naturally clean. Refrigeration, bottles, or water for preparing formula are not necessary.

Breast milk is the best food for a baby during the first year of life. In emergencies, it's usually best for the baby if the mother can continue to breastfeed. If pre-prepared formula is unavailable or water supplies are unsafe, breastfeeding is especially wise. Breast milk can be especially good for premature babies.

While stress may affect milk supply, breastfeeding itself can help to reduce stress. When you breastfeed, your body creates hormones that are calming. Do your best to make breastfeeding time as relaxed as you can under the circumstances.

If breastfeeding has been interrupted, the La Leche League provides information to help you start again.
 
Some women may find it impossible to continue to breastfeed. If this occurs, wean the baby as slowly as possible. This is important for both your health and the baby's. Hold and cuddle your baby as much as possible to reduce your baby's stress. In a disaster, pre-prepared formula is recommended because of concerns about water safety.

The La Leche League provides information about breastfeeding for women affected by disasters.

The International Lactation Consultant Association also provides help with breastfeeding. Call (919) 787-5181.

If you are staying in a shelter and need help with breastfeeding, ask the medical staff for assistance.

If breastfeeding is not possible, have a supply of single-serving, ready-to-feed formula. Ready-to-feed formula does not need mixing, and water should not be added to it. When using ready-to-feed formula, pour the needed amount into a bottle, and throw away the formula that the baby does not drink if you cannot refrigerate it. After it is opened, the formula must be refrigerated.

Water for drinking, cooking and bathing
Listen to and follow public announcements. Local authorities will tell you if tap water is safe to drink or to use for cooking or bathing. If the water is not safe to use, follow local instructions to use bottled water or to boil or disinfect tap water for cooking, cleaning or bathing.

If tap water is not safe, boiling is the preferred way to kill harmful bacteria and parasites. To kill most organisms, bring water to a rolling boil for 1 minute.

If you can't boil unsafe tap water, you can treat it with chlorine tablets or iodine tablets. Follow the directions that come with the tablets. Keep treated water out of reach of children and toddlers.

If you have a baby and are not breastfeeding, ready-to-feed formula is recommended because of concerns about water safety. Do not use water treated with iodine or chlorine tablets to prepare powdered formulas.

Drink at least six to eight glasses (eight-ounce servings) of water, juice or milk every day.

Immunizations
Infants and children affected by a disaster should continue to receive their scheduled vaccines. Local health departments can provide information about how to obtain these vaccines. For information on recommended immunizations for infants up to 18 months, read the March of Dimes article.

Stress: Physical Relief
No matter what your housing situation, take a little time (10 to 15 minutes) to lie down and put your feet up. Try to do this three times a day--such as after breakfast, lunch and dinner. You and your baby need to rest often and not get overheated. To have this time be most effective, try your best to:

• Go to a quiet spot.
• Clear your mind of worries for these few minutes.
• Take deep breaths from your belly, not your chest.

Stress: Mental/Emotional Relief
Find someone to talk to for a couple of minutes a few times a day. Invite the person to be your “buddy.” Share with him or her any concerns you may have in these difficult circumstances. The fact that you have someone to talk to is helpful all by itself.

Health care providers can help you cope with stress or refer you to other professionals. You can also get help from:

• A clergy member
• The department of psychology at a local college or university
• The local community mental health center

Many new mothers have "the blues" after the birth of their baby. They may feel irritable, cry easily, or feel sad. But if these feelings last longer than the first ten days after birth, they may be a sign of postpartum depression. If you think you may have postpartum depression, call a health professional. This is a serious illness. Do not be afraid to ask for help or discuss your feelings.

If you ever feel like harming yourself or your baby, talk to a health care provider right away.

An emergency situation causes stress for a family. If you are concerned about your relationship and your safety, call the National Domestic Violence Hotline at (800) 799-SAFE (7233). 
 
More tips

• Rest often and do not get overheated.
• Wash your hands often or use hand sanitizer.
• If you recently gave birth, follow any directions given by your health care provider.
• Read more health information on the Web site of the U.S. Centers for Disease Control and Prevention.

Potential dangers

Flood water in streets and buildings
Flood water may contain harmful substances. For instance, the water may contain bacteria that could cause serious disease. It’s best if children avoid touching or walking in flood water.

If you do touch the water, use soap and clean water to wash the parts of your body that came in contact with it. Whenever possible, people who must come in contact with the water should wear protective clothing, such as gloves and boots.

Be careful not to swallow any flood water. Try to keep it away from your mouth. If you feel sick in any way, talk to a doctor or nurse right away.

Toxic exposures
If you are worried that you and your baby may have been exposed to dangerous chemicals or substances, talk to a health care professional.

The Organization of Teratology Information Specialists (OTIS) offers free telephone counseling to families worried about toxic exposures to their babies. The service is available 8 a.m. to 6 p.m., central time, at (866) 626-6847.

Returning to your home
Your state and local health or environmental departments can tell you about pollutants in your area.

Resources

American Red Cross
American Association of Poison Control Centers
American Mental Health Counselors Association
American Psychological Association
Center for Mental Health Services, Emergency Services and Disaster Relief Branch
Girls and Boys Town National Hotline 
National Mental Health Association 
Salvation Army
United Way

October 2006