Whether it’s a sudden accident at home, a local emergency, or something affecting the whole country, thinking ahead helps us protect the people we care about.
The effects of an emergency can include tap water being stopped or not being safe, a local or national power outage, or phone or internet networks going down. In an emergency, you might need to “shelter in place” – not being able to get out to the shops or to access other services such as health appointments, or you might need to evacuate to a safe place.
Being ready for emergencies is particularly important for families with young children: babies and toddlers are limited in what food they can eat and are more sensitive to extremes of heat and cold. They can also be harder to evacuate in an emergency. Babies under 6 months are especially vulnerable as their only nutrition is breast or infant formula milk and they are dependent on a trusted adult for all their needs.
If you need support around how to feed your baby in an emergency, including sterilising equipment, making up formula and breastfeeding, you could contact your midwife or health visitor, get in touch with local peer support services or contact the National Breastfeeding Helpline.
This section of our website provides information and support for feeding infants during emergency situations. When possible, you should follow the relevant NHS and government guidance on making up formula and sterilising feeding equipment.
The UK government provides general guidance on how to prepare for emergencies. Ready Scotland and Wales Civil Contingencies & Resilience – Wales Safer Communities also have guidance.
We have developed a simple checklist specifically to help families with babies or young children think about planning for emergencies – Emergency Checklist
If you are pregnant or have children under five, please consider signing up for the Priority Services Register. This is a free UK-wide service providing extra advice and support, including when there’s an interruption to your electricity, gas or water supply
If you are involved in supporting infant feeding families or in emergency preparedness, then please contact us about our online training course – courses@breastfeedingnetwork.org.uk.
Breastfeeding is the safest way to feed babies, particularly during an emergency, as it does not rely on supply chains or require clean water or energy for preparation and cleaning. If you are breastfeeding, you are likely to need more water and food than other adults – about 300—500 more calories per day, and up to a litre more water.
You can carry on breastfeeding, even if you have less food, or less nutritious food, than ideal, in the short term. Your body will keep making milk, and your supply shouldn’t drop unless you have a long period of eating too little. Keeping breastfeeding, even if hungry, will help maintain your milk supply.
People worry that stress will dry up their milk – stress can make it harder for your milk to letdown but shouldn’t reduce the quantity of milk you make. Breastfeeding releases hormones that can help you relax and reduce your stress. You may find it helpful to make yourself comfortable in a quiet place you feel safe, especially if your baby has reached the stage where they’re easily distracted while feeding. If you have been evacuated to a public rest centre, you might want to ask if there is a comfortable or private area where you can feed if needed.
If you are currently combining breast and formula feeding, you may be able to increase your supply and move to exclusive breastfeeding. If this is something you would like to do, start by feeding more frequently and perhaps expressing between feeds. You will need to continue giving some formula milk until your own supply can meet your baby’s needs. The National Breastfeeding Helpline, local peer support services or your local healthcare providers can provide you with support and guidance.
If you are currently not breastfeeding, but you have in the past, you could consider trying to restart breastfeeding. This is called relactation. If your baby will latch on, you can start by trying to feed them, being aware that they may not be getting any milk to begin with. You can also hand express or use a pump. The National Breastfeeding Helpline or your local healthcare providers can provide you with support and guidance. If you do this, you will still need to keep giving your baby formula while your supply returns.
In emergency situations where parents are unable to feed their baby with their own breastmilk and cannot safely prepare, or prefer not to use, formula, some parents choose to use breastmilk from someone else. This is sometimes called shared nursing or informal milk sharing.
First infant formula is suitable for infants up to 12 months; switching to follow-on milk is not necessary. NHS.uk states that switching to follow-on formula at 6 months has no benefits for your baby.
In emergencies, ready-to-feed liquid formula is the safest option. If you are using this, then your main concern will be ensuring the container you use to feed your baby is sterile. You can also buy ready-to-feed formula in small bottles. This is very expensive but could sometimes be useful.
Making up formula – To make up formula, you ideally need clean water, and the ability to boil it. Whenever possible, you should aim to make up formula milk using normal NHS guidance; this is especially important if your baby is premature, very young or unwell. Using water that is at least 70°C is important whenever possible, as powdered formula isn’t sterile.
You can use tap water with a boil notice for making up infant formula, unless your water company has advised you otherwise. If you are advised that your tap water is not safe to use or if your water is off, you can boil bottled water to make up formula. Bottled water needs to have less than 200mg per litre of sodium (Na), and less than 250mg per litre of sulphate (SO4), to be safe to use for formula. Check the label of bottled water before using.
In an emergency, you may not be able to find your usual brand of formula. Parents often worry that changing formula may cause issues, but there is no evidence of changing formula doing any good or harm. All infant formulas in the UK have the same basic composition. It is also safe to give a baby over six months first stage formula – it is suitable for up to 12 months, switching to follow-on milk is not necessary.
If you cannot boil water at home then you could:
- Use ready to feed liquid formula.
- Boil water at a friend or family members house nearby, if possible, and either make up bottles in advance or transport the water home in a flask that will keep the water above 70°C until you use it
- Make up formula using cooled previously boiled water or clean room temperature water. This should only be done if there is no other option and for the shortest time possible.
There is NHS guidance here if you cannot follow the normal guidance around making up bottles.
If you are currently exclusively expressing breastmilk to feed your baby, then in an emergency this may become more complex. If it is an option for you then you could try feeding your baby directly at the breast, as this may be easier. You could ask for support with transitioning from exclusive expressing to feeding at the breast from your midwife or Health Visitor, from a local peer support service or from the National Breastfeeding Helpline.
If your electricity is off, you may need to consider hand expressing, or using a hand pump (a breast pump that doesn’t need any power to work). Freshly expressed breastmilk is safe at room temperature for up to 6 hours, so you can express your milk and give it to your baby without needing a fridge. Once your baby has drunk from a bottle or cup, the milk can only be kept and used for another hour. See the section on sterilising pumps and bottles for information about how to sterilise pump and bottles.
If you cannot sterilise your pump or bottles then you could hand express and cup feed using single use disposable cups. These cups should ideally be brand new in a sealed packet and should only be used once.
If you are in a rest centre or temporary shelter, it can be useful to tell staff that you are expressing, and to ask if there is a private area in which to do it. You can also ask about fridge or freezer space that may be available for you to store your expressed milk in.
If there is a disruption to your water or electricity supply you may have to consider different ways to sterilise your infant feeding equipment or breast pump. The method that is most suitable will depend on the situation and what equipment you have at home. Different options include microwave or steam sterilisation (if you have power), cold water or boiling water sterilisation. There is NHS guidance on the different methods of sterilising bottles here.
Water with a boil notice can be used like normal tap water once boiled. If your tap water is unsafe or not available then you can use bottled water for cold water, boiling water or steam or microwave sterilising. You would also need enough water to wash the bottles before sterilisation (and to rinse them afterwards for cold water sterilising). Any bottled water you use for sterilising does not have to be safe for formula preparation, as your baby will not be drinking the water. This means the levels of sodium or sulphate in the bottled water do not matter.
If you are unable to wash and sterilise bottles, one option is to cup feed using disposable cups, for example new single use coffee cups. Follow the normal NHS guidance for making up formula if you can and use a heatproof measuring container to measure the hot water carefully before mixing with the formula powder in the disposable cup. Each cup should only be used once.
If you are evacuated because of an emergency situation, or even if you need to shelter in place and not leave your house for a few days it can be useful to think about other supplies you might need if you have a baby or young child. Spare clothes that can be layered to be warm or cool, bedding, books and toys, can all make a stressful situation a bit easier. You might need a pram or car seat, to transport your baby. You might also want a sling or baby carrier so you can keep your baby close. It can also be useful to think about where your baby may sleep during an emergency. It is important you continue to consider safe sleep guidance during emergency situations, both in your home and in evacuation settings such as rest centres or hotels. You can find general guidance about safe sleep from the NHS here, and from the Scottish government here.
You should also make sure you have a baby or general first aid kit including any prescribed medicines your baby needs and enough nappies, wipes, nappy bags and hand sanitiser to last for a few days. Antibacterial wipes might also be useful for cleaning surfaces before preparing infant formula or after nappy changes.
This checklist might help you think about what you need to prepare and think about if there is an emergency.