When my Nurture Project International colleagues and I first arrived at the Eko camp near Idomeni in Greece, it looked like Glastonbury – just a bunch of pup tents. The mothers had no privacy, there was no support for infant feeding, and independent volunteers were going tent to tent handing out bottles of formula. While they thought they were helping, it was dangerous. Women in a situation of poor security will take anything that is offered to them, so even breastfeeding women will take formula milk. Many women think formula is healthier than their own milk and will start feeding it to their babies.

Formula use in refugee camps is dangerous because when the supply is unstable women will dilute the milk – they add water to it and the babies don’t get enough nutrients. Often the powdered milk, which is not sterile, can’t be heated properly. Just as you don’t eat raw chicken, you can’t drink formula without using boiling water. The formula is often out of date – I have seen some that is two years past its “use by” date, or volunteers put it in bags to hand out so there is no clue of how old it is.

We found that in the camps we visited, 40 to 60% of mothers were formula feeding. These women often had just one bottle each, which they boiled between feeds on a makeshift stove with no brush or soap. We met babies who were sick or failing to thrive and our midwives began to work with women to resume breastfeeding where possible, building up breastfeeding supply or giving appropriate formula where necessary.

We encourage cup use, handing out tiny medicine cups the women can use. We explain to them that even using a bottle without the teat is safer than using a teat that hasn’t been cleaned properly.

For a woman to relactate or start breastfeeding a newborn she has to have a lot of intention. It’s time consuming and frustrating and we set her up for that. We work with her, we check in with her more than a few times a day. If a woman is using formula we help her reduce it by small amounts each day.

We set up a space so the women can have a private place to go and breastfeed with support from our team. A lot of breastfeeding is psychological – you have to have confidence, you have to have support.

Our igloo dome tents come from More than Shelters in Germany and we make them look like a living room inside, with beanbags, cushions, and a private space curtained off for midwifery appointments. Then the women can start to come in and relax. They can come if they are tired, or if they need a break; they can even come without their babies. In fact we love that – this is what the space is intended for.

A lot of the women gave birth in transit, in Turkey or somewhere in Greece, and in both these countries it is common to give mothers formula as they are leaving hospital. These babies had never been breastfed and were now around eight or nine months old so they needed formula, which we can provide.

At our peer support groups the women can share their feelings about their baby crying, or the fact that their baby feeds all the time. I have done lactation consulting in Africa, the UK, the Middle East and now here in Greece, and mothers around the world have the same worries.

It’s important to us to support the women as well, through free formula and food for those who are breastfeeding. But we also bring them things to do while feeding such as knitting. We bring yarn, crochet materials or painting supplies. We are looking for ways to bring Arabic language books as well.

Now that we have been in the camps longer and are able to support women from birth, all the new babies are being exclusively breastfed. We have two formula-free camps and in our third camp we have four babies who are having their formula intake reduced slowly. There is one baby who has a medical need for formula and we will support that mother with milk supplies.

Volunteers bring formula because they feel that nobody else is providing it, but in reality mothers don’t need it. If you donate milk and are hoping for it to reach a refugee mother you have no way of knowing who it will reach and whether they are the person who needs it. We want to let people know to support groups in the field financially and we will ensure that every mother gets exactly the support she needs.

Brooke Bauer is founder and CEO of Nurture Project International.

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