{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T11:41:09Z","timestamp":1791891669415,"version":"4.3.4"},"reference-count":49,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,5,17]],"date-time":"2024-05-17T00:00:00Z","timestamp":1715904000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Nutr."],"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>During emergencies, breastfeeding protects infants by providing essential nutrients, food security, comfort, and protection and is a priority lifesaving intervention. On February 24, 2022, the war in Ukraine escalated, creating a humanitarian catastrophe. The war has resulted in death, injuries, and mass internal displacement of over 5 million people. A further 8.2 million people have taken refuge in neighboring countries, including Poland. Among those impacted are infants and young children and their mothers. We conducted a study to explore the infant feeding challenges and needs of Ukrainian women affected by the war.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We conducted a qualitative descriptive study involving in-depth interviews (IDIs) with 75 war-affected Ukrainian mothers who had at least one infant aged less than 12 months at the time of the interview. Eligible mothers were either (1) living as Ukrainian refugees in Poland, having crossed the border from Ukraine on or after February 24, 2022, when the war started (<jats:italic>n<\/jats:italic> = 30) or (2) living in Ukraine as internally displaced persons or as residents in the community (<jats:italic>n<\/jats:italic> = 45). All interviews were audio-recorded (either transcribed or had responses summarized as expanded notes) and analyzed using qualitative thematic analysis using a two-step rapid analysis process.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Participants in Ukraine who wanted to initiate breastfeeding right after birth faced opposition from healthcare workers at maternity hospitals. Ukrainian refugees who gave birth in Poland faced language barriers when seeking breastfeeding support. Half of the participants in Ukraine received commercial milk formula (CMF) donations even if they said they did not need them. Most respondents stated that breastfeeding information and support were urgently needed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Our data suggests that healthcare workers in Ukrainian maternity hospitals require additional training and motivation on delivering breastfeeding support. In addition, lactation consultants in maternity ward are needed in Ukraine, and interpretation support is needed for refugees to overcome language barriers. There is a need to control the indiscriminate donations of commercial milk formula and to ensure that complementary foods and commercial milk formula are available to those that need it. This study confirms the need for actions to ensure infant and young child feeding (IYCF) support is provided during emergencies.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fnut.2024.1225940","type":"journal-article","created":{"date-parts":[[2024,5,17]],"date-time":"2024-05-17T04:35:35Z","timestamp":1715920535000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":17,"title":["\u201cI could not find the strength to resist the pressure of the medical staff, to refuse to give commercial milk formula\u201d: a qualitative study on effects of the war on Ukrainian women\u2019s infant feeding"],"prefix":"10.3389","volume":"11","author":[{"given":"Alessandro","family":"Iellamo","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christina Misa","family":"Wong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oleg","family":"Bilukha","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie P.","family":"Smith","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mija","family":"Ververs","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karleen","family":"Gribble","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bart\u0142omiej","family":"Walczak","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aleksandra","family":"Wesolowska","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sura","family":"Al Samman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"O\u2019Brien","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annette N.","family":"Brown","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tobias","family":"Stillman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Blythe","family":"Thomas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2024,5,17]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"475","DOI":"10.1016\/S0140-6736(15)01024-7","article-title":"Breastfeeding in the 21st century: Epidemiology, mechanisms, and lifelong effect.","volume":"387","author":"Victora","year":"2016","journal-title":"Lancet."},{"key":"B2","doi-asserted-by":"publisher","first-page":"30","DOI":"10.1111\/apa.13133","article-title":"Long-term consequences of breastfeeding on cholesterol, obesity, systolic blood pressure and type 2 diabetes: A systematic review and meta-analysis.","volume":"104","author":"Horta","year":"2015","journal-title":"Acta Paediatr."},{"key":"B3","doi-asserted-by":"publisher","first-page":"65","DOI":"10.1016\/S0140-6736(03)13811-1","article-title":"How many child deaths can we prevent this year?","volume":"362","author":"Jones","year":"2003","journal-title":"Lancet."},{"key":"B4","doi-asserted-by":"publisher","first-page":"491","DOI":"10.1016\/S0140-6736(15)01044-2","article-title":"Why invest, and what it will take to improve breastfeeding practices?","volume":"387","author":"Rollins","year":"2016","journal-title":"Lancet."},{"key":"B5","author":"Horta","year":"2007","journal-title":"Evidence on the long-term effects of breastfeeding: Systematic reviews and meta-analyses."},{"key":"B6","year":"2018","journal-title":"Global nutrition policy review 2016-2017: Country progress in creating enabling policy environments for promoting healthy diets and nutrition."},{"key":"B7","year":"2017","journal-title":"Operational guidance on infant feeding in emergencies (OG-IFE) version 3.0."},{"key":"B8","year":"2014","journal-title":"Guiding principles for feeding infants and young children during emergencies."},{"key":"B9","article-title":"World health assembly resolution 63.23.","year":"2010","journal-title":"Proceedings of the sixty-third world health assembly."},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1097\/01.HJ.0000530642.01935.6f","article-title":"World health assembly resolution 71.9.","year":"2018","journal-title":"Proceedings of the sventy-first world health assembly."},{"key":"B11","year":"2018","journal-title":"The sphere handbook: Humanitarian charter and minimum standards in humanitarian response."},{"key":"B12","doi-asserted-by":"publisher","first-page":"612","DOI":"10.2471\/BLT.12.113936","article-title":"Protecting and improving breastfeeding practices during a major emergency: Lessons learnt from the baby tents in Haiti.","volume":"91","author":"Ayoya","year":"2013","journal-title":"Bull World Health Organ."},{"key":"B13","first-page":"7","article-title":"Shaken but not broken: Supporting breastfeeding women after the 2011 Christchurch New Zealand earthquake. Breastfeeding review: Professional publication of the nursing mothers\u2019.","volume":"23","author":"Hargest-Slade","year":"2015","journal-title":"Assoc Aust."},{"key":"B14","doi-asserted-by":"publisher","first-page":"625","DOI":"10.6133\/apjcn.092015.08","article-title":"Infant feeding concerns in times of natural disaster: Lessons learned from the 2014 flood in Kelantan, Malaysia.","volume":"25","author":"Sulaiman","year":"2016","journal-title":"Asia Pac J Clin Nutr."},{"key":"B15","doi-asserted-by":"publisher","first-page":"917","DOI":"10.1017\/S1368980017003421","article-title":"Suboptimal infant and young child feeding practices among internally displaced persons during conflict in eastern Ukraine.","volume":"21","author":"Summers","year":"2018","journal-title":"Public Health Nutr."},{"key":"B16","article-title":"The emergency in Ukraine, the war: Focus on breastfeeding.","year":"2022","journal-title":"Proceedings of the IYCF-E international conference; 2022 October 22."},{"key":"B17","year":"2023","journal-title":"Ukraine humanitarian situation report No. 26."},{"key":"B18","year":"2022","journal-title":"Global gendered impacts of the Ukraine crisis on energy access and food security and nutrition."},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyg.2023.1152478","article-title":"The impact of the war in Ukraine on the perinatal period: Perinatal mental health for refugee women (pmh-rw) protocol.","volume":"14","author":"Rodr\u00edguez-Mu\u00f1oz","year":"2023","journal-title":"Front Psychol."},{"key":"B20","doi-asserted-by":"publisher","first-page":"59","DOI":"10.1177\/1525822X05279903","article-title":"How many interviews are enough?: An experiment with data saturation and variability.","volume":"18","author":"Guest","year":"2006","journal-title":"Field Methods."},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.1186\/s13012-019-0853-y","article-title":"Comparison of rapid vs in-depth qualitative analytic methods from a process evaluation of academic detailing in the veterans health administration.","volume":"14","author":"Gale","year":"2019","journal-title":"Implement Sci."},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2017-019993","article-title":"Can rapid approaches to qualitative analysis deliver timely, valid findings to clinical leaders? A mixed methods study comparing rapid and thematic analysis.","volume":"8","author":"Taylor","year":"2018","journal-title":"BMJ Open."},{"key":"B23","doi-asserted-by":"publisher","first-page":"349","DOI":"10.1093\/intqhc\/mzm042","article-title":"Consolidated criteria for reporting qualitative research (COREQ): A 32-item checklist for interviews and focus groups.","volume":"19","author":"Tong","year":"2007","journal-title":"Int J Quality Health Care."},{"key":"B24","doi-asserted-by":"publisher","DOI":"10.1111\/mcn.13255","article-title":"The rates and factors of perceived insufficient milk supply: A systematic review.","volume":"18","author":"Huang","year":"2022","journal-title":"Matern Child Nutr."},{"key":"B25","doi-asserted-by":"publisher","first-page":"355","DOI":"10.1111\/j.1547-5069.2008.00234.x","article-title":"Maternal perceptions of insufficient milk supply in breastfeeding.","volume":"40","author":"Gatti","year":"2008","journal-title":"J Nurs Scholarsh."},{"key":"B26","first-page":"259","article-title":"Influence of psychological stress on suckling-induced pulsatile oxytocin release.","volume":"84","author":"Ueda","year":"1994","journal-title":"Obstetr Gynecol."},{"key":"B27","author":"Gribble","year":"2023","journal-title":"Want to help the children? Help the parents\u2019: Challenges and solutions from the babies and young children in the black summer (BiBS) study."},{"key":"B28","doi-asserted-by":"publisher","DOI":"10.1136\/bmjpo-2023-001907","article-title":"Breastfeeding initiation and duration through the COVID-19 pandemic, a linked population-level routine data study: The born in wales cohort 2018-2021.","volume":"7","author":"Jones","year":"2023","journal-title":"BMJ Paediatr Open."},{"key":"B29","doi-asserted-by":"publisher","first-page":"e523","DOI":"10.1016\/j.wombi.2022.06.006","article-title":"Impact of COVID-19 on breastfeeding intention and behaviour among postpartum women in five countries.","volume":"35","author":"Chien","year":"2022","journal-title":"Women Birth."},{"key":"B30","doi-asserted-by":"publisher","first-page":"2097","DOI":"10.1017\/S1368980010001667","article-title":"Breast-feeding in a complex emergency: Four linked cross-sectional studies during the Bosnian conflict.","volume":"13","author":"Andersson","year":"2010","journal-title":"Public Health Nutr."},{"key":"B31","doi-asserted-by":"publisher","DOI":"10.1111\/mcn.12576","article-title":"Infant and young child feeding in emergencies: Organisational policies and activities during the refugee crisis in Lebanon.","volume":"14","author":"Shaker-Berbari","year":"2018","journal-title":"Matern Child Nutr."},{"key":"B32","article-title":"Save the children\u2019s IYCF-E rapid response in croatia.","volume":"102","author":"Modigell","year":"2016","journal-title":"Field Exchange."},{"key":"B33","author":"Dimitrievska","year":"2016","journal-title":"Anthrolactology."},{"key":"B34","doi-asserted-by":"publisher","first-page":"242","DOI":"10.1177\/0890334417750144","article-title":"Maternal perceptions of infant feeding and health in the context of the 2015 Nepal Earthquake.","volume":"34","author":"DeYoung","year":"2018","journal-title":"J Hum Lact."},{"key":"B35","doi-asserted-by":"publisher","first-page":"307","DOI":"10.1017\/S1368980010003423","article-title":"Donated breast milk substitutes and incidence of diarrhoea among infants and young children after the May 2006 earthquake in Yogyakarta and Central Java.","volume":"15","author":"Hipgrave","year":"2012","journal-title":"Public Health Nutr."},{"key":"B36","doi-asserted-by":"publisher","first-page":"573","DOI":"10.1177\/0890334417707717","article-title":"Are commercial complementary food distributions to refugees and migrants in Europe conforming to international policies and guidelines on infant and young child feeding in emergencies?","volume":"33","author":"Theurich","year":"2017","journal-title":"J Hum Lact."},{"key":"B37","author":"De Brabandere","year":"2014","journal-title":"Baby friendly spaces: Holistic approach for pregnant, lactating women and their very young children in emergency."},{"key":"B38","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0231899","article-title":"Noncommunicable disease burden among conflict-affected adults in Ukraine: A cross-sectional study of prevalence, risk factors, and effect of conflict on severity of disease and access to care.","volume":"15","author":"Greene-Cramer","year":"2020","journal-title":"PLoS One."},{"key":"B39","author":"Kuznetsova","year":"2019","journal-title":"The mental health of internally displaced people and the general population in Ukraine."},{"key":"B40","doi-asserted-by":"publisher","DOI":"10.1186\/s13006-021-00398-w","article-title":"Barriers and challenges of infant feeding in disasters in middle- and high-income countries.","volume":"16","author":"Hwang","year":"2021","journal-title":"Int Breastfeed J."},{"key":"B41","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-019-7528-0","article-title":"Emergency preparedness for infant and young child feeding in emergencies (IYCF-E): An Australian audit of emergency plans and guidance.","volume":"19","author":"Gribble","year":"2019","journal-title":"BMC Public Health."},{"key":"B42","doi-asserted-by":"publisher","first-page":"215","DOI":"10.1016\/j.clinthera.2021.11.007","article-title":"Maternal psychological distress and lactation and breastfeeding outcomes: A narrative review.","volume":"44","author":"Nagel","year":"2022","journal-title":"Clin Ther."},{"key":"B43","doi-asserted-by":"publisher","first-page":"506","DOI":"10.1016\/j.midw.2012.04.009","article-title":"Psychosocial correlates of exclusive breastfeeding: A systematic review.","volume":"29","author":"de Jager","year":"2013","journal-title":"Midwifery."},{"key":"B44","doi-asserted-by":"publisher","first-page":"475","DOI":"10.1089\/bfm.2019.0058","article-title":"Association between stressful life events and exclusive breastfeeding among mothers in the United States.","volume":"14","author":"Dugat","year":"2019","journal-title":"Breastfeed Med."},{"key":"B45","doi-asserted-by":"publisher","first-page":"451","DOI":"10.1111\/scs.12489","article-title":"Sociodemographic, physical, mental and social factors in the cessation of breastfeeding before 6 months: A systematic review.","volume":"32","author":"Mangrio","year":"2018","journal-title":"Scand J Car Sci."},{"key":"B46","doi-asserted-by":"publisher","DOI":"10.1111\/mcn.13440","article-title":"Interventions to support the re-establishment of breastfeeding and their application in humanitarian settings: A systematic review.","volume":"19","author":"Amat Camacho","year":"2023","journal-title":"Matern Child Nutr."},{"key":"B47","doi-asserted-by":"publisher","first-page":"391","DOI":"10.1002\/nur.20259","article-title":"Is there a bias against telephone interviews in qualitative research?","volume":"31","author":"Novick","year":"2008","journal-title":"Res Nurs Health."},{"key":"B48","doi-asserted-by":"publisher","first-page":"112516","DOI":"10.1016\/j.psychres.2019.112516","article-title":"Qualitative methods in implementation research: an introduction.","volume":"280","author":"Hamilton","year":"2019","journal-title":"Psychiatry Res"},{"key":"B49","doi-asserted-by":"publisher","DOI":"10.1186\/s12939-020-01357-3","article-title":"Maternal education and equity in breastfeeding: Trends and patterns in 81 low- and middle-income countries between 2000 and 2019.","volume":"20","author":"Neves","year":"2021","journal-title":"Int J Eq Health."}],"container-title":["Frontiers in Nutrition"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fnut.2024.1225940\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,17]],"date-time":"2024-05-17T04:35:41Z","timestamp":1715920541000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fnut.2024.1225940\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,5,17]]},"references-count":49,"alternative-id":["10.3389\/fnut.2024.1225940"],"URL":"https:\/\/doi.org\/10.3389\/fnut.2024.1225940","relation":{},"ISSN":["2296-861X"],"issn-type":[{"value":"2296-861X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,5,17]]},"article-number":"1225940"}}