Last update Aug. 19, 2021


Very Low Risk

Safe. Compatible. Minimal risk for breastfeeding and infant.

Endemic disease of humanity. Catastrophe caused by adults, generally middle-aged and male, in which young people are sent to kill, rape and steal and which generates destruction of the social fabric, the health system, poverty, displacement of people, refugees and great mortality among children, women, the elderly and among the young combatants themselves (Ben Taleb 2014).

War is associated with a decrease in the prevalence and duration of breastfeeding and an increase in the use of infant formula, which implies even more serious risks to children’s health. Formula-fed infants in disaster situations have high mortality (Rabbani 2020, Sumbele 2020, Diwakar 2019, MirMohamadaliIe 2019, Wagner 2019 and 2018, Habek 2016, Andersson 2010, Guerrero 2009, O’Connor 2001, Robertson 1995, Sapir 1993).

The consequences of a war are especially serious for children and women, with mortality, decreased life expectancy, anemia, nutritional and growth disorders, psychological disorders, sexual violence and greater suffering of women compared to men (Sumbele 2020, Diwakar 2019, MirMohamadaliIe 2019, Wagner 2019, Guerrero 2009, Sapir 1993).

Although the lack of access to artificial formula could lead to an increase in breastfeeding as the only option (Diwakar 2019), it has been observed that displacement, poor diet and stress suffered by mothers (Summers 2018), separation, death or serious trauma to the mother (O’Connor 2001), lack of promotion and support of breastfeeding by aid agencies (Andersson 2010), poor training of health workers (Robertson 1995) and systematic free distribution of breastmilk substitutes by international and local humanitarian agencies (Zakanj 2000) in war-affected areas are the causes of the decline in the prevalence and duration of breastfeeding (Rabbani 2020).

To mitigate the effects of conflict and improve child health, a humanitarian action is needed which focuses on helping mothers cope with conflict-related stress and displacement through support for maternal mental health and psychosocial support programs (Summers 2018).

Protecting a woman’s right to breastfeeding in emergencies is associated with better maternal and neonatal outcomes (MirMohamadaliIe 2019).
Breastfeeding has enabled babies to survive even under the direst circumstances (Eidelman 2013).

Specialized breastfeeding support for conflict-affected mothers is a matter of utmost urgency, both during and after periods of conflict, as it can provide more sustainable benefits and with fewer unintended consequences than the distribution of infant formula (Sumbele 2020, Diwakar 2019).

Breastfeeding is the most effective way to provide perfect and adequate nutrients, even in emergency situations where the nutritional status of mothers is affected (Nidzvetska 2017).
Promoting and supporting breastfeeding and limiting the distribution of substitutes by international aid agencies prevents the increase in malnutrition that occurs during armed conflicts (Andersson 2010, Robertson 1995, Moro 1995).

In war and natural disasters, the WHO “Guiding Principles for Feeding Infants and Young Children in Emergencies” (WHO 2004) should be followed:
- Principles 1 and 2:
Infants born to emergency-affected populations should be exclusively breastfed from birth to 6 months of age. Every effort should be made to identify alternative ways of breastfeeding babies whose biological mothers are not available. Create and maintain an environment that encourages frequent breastfeeding for children up to two years of age or older.
- Principle 3:
The quantity, distribution and use of breast milk substitutes should be strictly controlled in emergency settings.

Suggestions made at e-lactancia are done by APILAM team of health professionals, and are based on updated scientific publications. It is not intended to replace the relationship you have with your doctor but to compound it. The pharmaceutical industry contraindicates breastfeeding, mistakenly and without scientific reasons, in most of the drug data sheets.

Jose Maria Paricio, Founder & President of APILAM/e-Lactancia

Your contribution is essential for this service to continue to exist. We need the generosity of people like you who believe in the benefits of breastfeeding.

Thank you for helping to protect and promote breastfeeding.

José María Paricio, founder of e-lactancia.


War belongs to this group or family:


  1. Akseer N, Wright J, Tasic H, Everett K, Scudder E, Amsalu R, Boerma T, Bendavid E, Kamali M, Barros AJD, da Silva ICM, Bhutta ZA. Women, children and adolescents in conflict countries: an assessment of inequalities in intervention coverage and survival. BMJ Glob Health. 2020 Jan 26;5(1):e002214. Abstract
  2. Rabbani A, Padhani ZA, A Siddiqui F, Das JK, Bhutta Z. Systematic review of infant and young child feeding practices in conflict areas: what the evidence advocates. BMJ Open. 2020 Sep 13;10(9):e036757. Abstract
  3. Sumbele IUN, Asoba GN, Teh RN, Metuge S, Anchang-Kimbi JK, Nkuo-Akenji T. Burden of moderate to severe anaemia and severe stunting in children < 3 years in conflict-hit Mount Cameroon: a community based descriptive cross-sectional study. BMC Pediatr. 2020 Aug 24;20(1):396. Abstract
  4. MirMohamadaliIe M, Khani Jazani R, Sohrabizadeh S, Nikbakht Nasrabadi A. Barriers to Breastfeeding in Disasters in the Context of Iran. Prehosp Disaster Med. 2019 Feb;34(1):20-24. Abstract
  5. Diwakar V, Malcolm M, Naufal G. Violent conflict and breastfeeding: the case of Iraq. Confl Health. 2019 Dec 30;13:61. Abstract
  6. Wagner Z, Heft-Neal S, Wise PH, Black RE, Burke M, Boerma T, Bhutta ZA, Bendavid E. Women and children living in areas of armed conflict in Africa: a geospatial analysis of mortality and orphanhood. Lancet Glob Health. 2019 Dec;7(12):e1622-e1631. Abstract
  7. Wagner Z, Heft-Neal S, Bhutta ZA, Black RE, Burke M, Bendavid E. Armed conflict and child mortality in Africa: a geospatial analysis. Lancet. 2018 Sep 8;392(10150):857-865. Abstract
  8. Summers A, Bilukha OO. Suboptimal infant and young child feeding practices among internally displaced persons during conflict in eastern Ukraine. Public Health Nutr. 2018 Apr;21(5):917-926. Abstract
  9. IFE-CG. Emergency Nutrition Network Infant and Young Child Feeding in Emergencies. Operational Guidance for Emergency Relief Staff and Programme Managers. Operational Guidance for Emergency Relief Staff and Programme Managers. 2017 Full text (link to original source) Full text (in our servers)
  10. Nidzvetska S, Rodriguez-Llanes JM, Aujoulat I, Gil Cuesta J, Tappis H, van Loenhout JA, Guha-Sapir D. Maternal and Child Health of Internally Displaced Persons in Ukraine: A Qualitative Study. Int J Environ Res Public Health. 2017 Jan 9;14(1). pii: E54. Abstract
  11. IFE-CG. Red de Nutrición en Emergencias. Alimentación de lactantes y niños/ as pequeños/as en emergencias. Guía operativa para Personal de Mitigación de Emergencias y Administradores/as del Programa. 2017 Full text (link to original source) Full text (in our servers)
  12. Habek D, Dujaković T, Habek JC, Jurković I. TWENTY-THREE-YEAR LONG-TERM HEALTH OUTCOME AFTER THE WAR IN VUKOVAR. Acta Clin Croat. 2016 Mar;55(1):58-62. Abstract
  13. Ben Taleb Z, Bahelah R, Fouad FM, Coutts A, Wilcox M, Maziak W. Syria: health in a country undergoing tragic transition. Int J Public Health. 2015 Jan;60 Suppl 1:S63-72. Abstract
  14. Eidelman AI. Breastfeeding mitigates a disaster. Breastfeed Med. 2013 Jun;8(3):344-5. Abstract Full text (link to original source)
  15. Andersson N, Paredes-Solís S, Legorreta-Soberanis J, Cockcroft A, Sherr L. Breast-feeding in a complex emergency: four linked cross-sectional studies during the Bosnian conflict. Public Health Nutr. 2010 Dec;13(12):2097-104. Abstract Full text (link to original source)
  16. Guerrero Serdan, Gabriela. The Effects of the War in Iraq on Nutrition and Health: An Analysis Using Anthropometric Outcomes of Children. MPRA Paper No. 14056. 2009 Full text (link to original source) Full text (in our servers)
  17. WHO. World Health Organization. Guiding principles for feeding infants and young children during emergencies. WHO Library Cataloguing-in-Publication Data. 2004 Abstract Full text (link to original source) Full text (in our servers)
  18. O'Connor ME, Burkle FM Jr, Olness K. Infant feeding practices in complex emergencies: a case study approach. Prehosp Disaster Med. 2001 Oct-Dec;16(4):231-8. Abstract
  19. Zakanj Z, Armano G, Grgurić J, Herceg-Cavrak V. Influence of 1991-1995 war on breast-feeding in Croatia: questionnaire study. Croat Med J. 2000 Jun;41(2):186-90. Abstract
  20. Robertson A, Fronczak N, Jaganjac N, Hailey P, Copeland P, Duprat M. Nutrition and infant feeding survey of women and children in Sarajevo during July 1993. Eur J Clin Nutr. 1995 Oct;49 Suppl 2:S11-6. Abstract
  21. Moro D. Birthweight and breast feeding of babies born during the war in one municipal area of Sarajevo. Eur J Clin Nutr. 1995 Oct;49 Suppl 2:S37-9. Abstract
  22. Sapir DG. Natural and man-made disasters: the vulnerability of women-headed households and children without families. World Health Stat Q. 1993;46(4):227-33. Abstract

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