Events like storms, floods, wildfires, earthquakes, power outages and disease outbreaks can leave you without shelter, supplies, electricity, or safe water, making it harder to safely feed your baby. Babies are at a higher risk of getting sick from unsafe food or water because their immune systems are still developing.

There are steps you can take to safely feed your baby human milk (breast milk) or formula during emergencies.

Preparing for emergencies

Families with babies have special considerations when preparing for emergencies. The information below can help you prepare for emergency situations, such as evacuations and power outages.

Include infant feeding supplies in your emergency kit

Have these items ready in case of an emergency.

If you breastfeed or chestfeed your baby:

• Disposable nursing pads

If you express your milk:

• Clean bottles and nipples
• Milk storage bags or containers
• Cooler with frozen gel packs for milk storage
• Electric pump and pump kit parts
• Power cords
• Extra batteries
• Manual hand pump (in case there’s a power outage)

If you provide formula to your baby:

• Infant formula, preferably ready-to-feed (RTF) formula in single serving cans or bottles
• Bottled water, a liquid measuring cup, clean bottles and nipples
• Disposable cups (for use when unable to clean and disinfect bottles and nipples)

Consider having a single burner camping stove and a pot to boil water for preparing liquid concentrate or powdered formula and for disinfecting feeding equipment.

Learn to hand express your milk

Hand expressing milk is a safe and effective way to feed your baby during emergencies. It can be especially helpful when you do not have electricity to use electric pumps, safe water to wash pumps, or when you will be away from your baby.

Hand expressing takes time and becomes easier with practice. Steps for expressing milk by hand:

• Wash your hands well or use hand sanitizer with at least 60% alcohol
• Gently massage your breast or chest tissue to help start the flow of milk
• Hold your breast or chest tissue with one hand, with your fingers on the bottom and your thumb on top. Your hand will make a C shape, with your fingers placed behind the areola. Your fingers and thumb will be about 2.5 to 4 cm (1 to 1.5 inches) back from the nipple
• Place a clean container with a wide opening in front of you or hold it under your breast or chest tissue to catch the milk
• Gently press your fingers and thumb back towards your chest wall, then squeeze them together while you move them towards the nipple. Do not squeeze the base of your nipple, as this will stop the flow of milk
• Relax your fingers, then repeat the same motion
• Move your hand around to express milk from different areas of the breast or chest tissue
• Switch your hands and breast or chest side as often as you like
• Stop when no more milk comes out

Talk to your health care provider, a public health nurse or a lactation consultant if you need help expressing your milk.

Breastfeeding or chestfeeding during emergencies

Breastfeeding or chestfeeding are the safest ways to feed your baby during emergencies. Human milk can help protect your baby from infections, diarrhea and vomiting.

Breastfeed or chestfeed often to offer nutrition and comfort to your baby.

Will emergencies affect my milk supply?

Emergencies can cause stress. But even if you’re stressed, your body will keep making milk. If you think you have less milk than usual, breastfeed or chestfeed more often to increase your milk supply.

It’s possible that stress can also affect the release of your milk. Breastfeeding or chestfeeding can help by releasing hormones that relax your body.

Can I still breastfeed or chestfeed if I feel sick?

You can still breastfeed or chestfeed your baby when you have a common illness like a cold, the flu or a stomach bug. Your milk can help protect your baby from illness.

If you’re feeling very unwell or need medications, discuss the safety of breastfeeding or chestfeeding with your health care provider.

Formula feeding during emergencies

What type of formula should I offer my baby?

Ready-to-feed (RTF) infant formula is the safest option when you do not have electricity or safe water. If available, use single-serve RTF formula. Liquid concentrate or powdered infant formula can be used if you have access to safe water.

Powdered infant formula is not sterile. Some babies are at higher risk of getting sick from powdered formula and should be fed RTF or liquid concentrate formula. This includes babies who:

• Were born premature, before 37 weeks of pregnancy, and are under 2 months of age (corrected age)
• Weighed less than 2500 grams at birth and are under 2 months of age
• Have a weakened immune system

How do I prepare infant formula?

For detailed steps on making and storing infant formula, see HealthLinkBC File #69b Feeding your baby formula: Safely making and storing formula.

Take extra caution to use safe water when you prepare formula, including when you clean and disinfect feeding equipment.

When preparing formula:

• Mix powdered or liquid concentrate formula with safe tap water or bottled water that has been boiled and cooled
• If you’re not able to boil water, the next safest option is bottled water with an unopened seal

When you clean and disinfect feeding equipment:

• First wash equipment with soap and safe water
• Then disinfect items by boiling them in a pot of safe water for 2 minutes
• If you’re not able to boil water, you can soak items for 2 minutes in a bleach and water solution that contains 5 mL unscented 5.25% household bleach and 2 L of water. Air dry items before using

If you cannot clean feeding equipment safely, infants can drink milk from a disposable cup.

How do I know if my tap water is safe?

Check current water notices and advisories to see if your water is safe. Follow any guidance provided by local authorities. If you’re not sure if your water is safe, check with your health authority contact: https://www2.gov.bc.ca/gov/content/environment/air-land-water/water/water-quality/drinking-water-quality/health-authority-contacts.

If your drinking water comes from your own private well, you’re in charge of testing your water to see if it is safe. It’s recommended you re-test after events like a flood or wildfire to see if water quality has become a problem. Learn more about well water testing here: HealthLinkBC File #05b Well water testing.

Storing human milk and formula

How do I safely store human milk?

Freshly expressed human milk can be stored in a clean container, marked with the date, for up to:

• 4 to 6 hours at room temperature (25°C or below)
• 24 hours in an insulated cooler with frozen gel packs (15°C or below)
• 5 days in a fridge (4°C or below)
• 6 months in a freezer (-18°C, separate door freezer on fridge)
• 12 months in a deep freezer (-20°C)

These recommendations are for healthy, full-term babies. Storage times may be shorter if your baby was born premature or has a medical condition.

How do I safely thaw human milk?

Thaw frozen milk overnight in a fridge if possible. You can also run the container under, or place it in warm, safe water if you need the milk right away. Keep the lid of the container out of the water. Do not defrost milk in a microwave. Microwaves heat unevenly and create hotspots that can burn your baby’s mouth.

Once thawed, human milk:

• Can keep in a fridge for up to 24 hours
• Can be kept at room temperature for up to 4 hours if it has not been warmed
• Should never be refrozen

After your baby has finished feeding, throw away any leftover milk.

How do I safely store prepared infant formula?

If you make more than one bottle of formula, store unused bottles in the fridge. If making powdered formula with boiled water that was cooled to 70 degrees, quickly cool bottles before storing them in the fridge. To do this, put them under cold, safe running water. Do not get water on the nipple or ring of the bottle.

Use stored bottles within 24 hours or follow label instructions. Once you start feeding, use the bottle within 2 hours. Throw out any leftover formula. Do not reheat formula during a feed. Do not refrigerate a partly used bottle.

What do I do if there’s a power outage?

Keep refrigerator or freezer doors shut whenever possible. When doors are kept shut:

• A refrigerator will keep food cold for 4 hours
• A full freezer will keep food frozen for 48 hours
• A half-full freezer will keep food frozen for 24 hours

Formula supply disruptions

Events like floods, wildfires or supply chain disruptions can impact access to infant formula. If you cannot find your usual infant formula, speak with your community pharmacist. They may be able to find a local source or place a special order.

You can also consider:

• Looking for different sizes, types or brands of formula
• Maintaining or increasing your milk supply if you breastfeed, chestfeed or express milk. To maintain or increase your milk supply, feed your baby or express milk more often. Feed your baby on one side until your baby’s sucking slows down or stops, then switch to the other side. Keep switching sides until your baby seems satisfied
• Introducing pasteurized whole cow milk (3.25% milk fat) if your child is between 9 to 12 months old and eating a variety of iron-rich foods

If switching formula, remember:

• You do not need to consult your baby’s health care provider before switching formula unless your baby has a medical condition, such as a food allergy
• Your baby may be gassy or fussy at the start. This should get better in a few days as they adjust to the new formula
• All infant formulas sold in Canadian stores and pharmacies are reviewed by Health Canada to make sure they are safe

For more tips on what to do if you cannot find your usual formula, see Health Canada: Information for families on the limited supply of infant formula.

Other considerations

Can I use a cup to feed my baby?

Cup feeding can be used for babies of all ages. Clean, disposable cups are a safe option when feeding equipment like bottles and nipples cannot be cleaned properly.

To feed your baby with a cup:

• Wash your hands well or use hand sanitizer with at least 60% alcohol
• Fill a small cup about half full with human milk or formula
• Make sure your baby is awake and alert
• If needed, keep their hands tucked in a loose blanket so they do not bump the cup
• Hold your baby upright, close to your body. Support their head, neck and body
• Hold the rim of the cup at your baby’s lower lip
• Gently and slowly tilt the cup so the milk or formula just touches your baby’s lip. Do not pour the liquid into their mouth. They will use their tongue to sip or lap from the cup
• Let your baby control the pace. Keep the cup tilted enough so that they can continue sipping
• Ensure your baby swallows. Take pauses to burp your baby
• Stop when your baby shows you they are full

Can I restart breastfeeding or chestfeeding after stopping?

In some cases, it’s possible to restart milk production (relactation) after stopping for weeks or months. If you wish to try relactation, get help from a lactation consultant or discuss with your health care provider.

Get help if you’re worried that your baby is not getting enough human milk or formula

Your baby is getting enough to eat if they’re growing well and have enough wet diapers and bowel movements.

After the first week, your baby will have around 6 or more wet diapers each day. The number of bowel movements can vary a lot between babies, especially after the first week of birth.

If your baby is breastfed or chestfed:

• They may have around 3 or more small bowel movements or 1 large movement each day
• After the first month, your baby may have fewer bowel movements. Some babies will only have one every few days or one every week

If your baby is fed formula:

• They may have around 1 or 2 bowel movements each day
• After the first month, they may have fewer bowel movements. For example, 1 every other day

If you’re worried about how your baby is growing, contact your health care provider, a public health nurse or lactation consultant.

You can also call 8-1-1 to speak to a registered nurse or registered dietitian.

If you’re in a shelter setting, ask the shelter staff or emergency relief workers for support.

For more information

For more information, see the following:

• HealthLinkBC File #70 Breastfeeding or chestfeeding
• HealthLinkBC File #69a Feeding your baby formula: Before you start
• HealthLinkBC File #69b Feeding your baby formula: Safely making and storing formula
• HealthLinkBC File #49b Disinfecting drinking water