Breastfeeding Support and Protection During Natural Disaster and Climate-Related Emergencies in Indonesia: Policy Audit.

Background: Indonesia is a middle-income country in Southeast Asia in which 2,394 disasters were recorded in 2022 alone, with a total loss of 178,367 lives. In 2018 governments at the World Health Assembly resolved to improve emergency planning using Operational Guidance on Infant and Young Child Feeding in Emergencies (OG IFE). Little is known about whether Indonesian policies protect the health and lives of women, infants, and young children in line with OG IFE through planning for breastfeeding support and protection during emergencies.

Research aim: To identify and audit Indonesian policy regulations regarding infant and young child feeding support and protection during emergencies.

Method: A search of the grey literature was conducted in 2023 through Google Basic and Advanced Search, official websites, and consultation with the Indonesian Breastfeeding Mothers Association (Asosiasi Ibu Menyusui Indonesia/AIMI) network. Keywords used included the Indonesian words for "regulation," "disaster," and the name of a province, city, or region, or the name of appropriate government organizations. Data was analyzed using a qualitative content analysis approach, and based on the Infant and Young Child Feeding in Emergencies: Operational Guidance for Emergency Relief Staff and Program Managers (OG-IFE) framework.

Results: A total of 513 regulations were found online; however, only four were included for audit. The 509 excluded regulations did not specifically mention infant and young child feeding in emergencies. Those Indonesian policies that did mention infant and young child feeding in emergencies lacked attention to, and comprehensive planning for, breastfeeding protection and support during emergencies.

Conclusion: Mothers and infants may be exposed to unnecessary risk and avoidable morbidity and mortality during emergencies. Indonesia could enhance its disaster relief policies to align with international standards supporting breastfeeding in emergencies. This could involve more comprehensive and integrated regional planning and preparation before disasters, including regular assessment of local infant and young child feeding practices, communication measures to raise emergency workers' awareness of breastfeeding, and resourcing of training so as to translate policies into practice.