Nutrition in emergencies programming tools, guidance and standards

The first eight years of a child’s life, especially the critical first 1,000 days, are marked by rapid brain development and the acquisition of skills essential for lifelong well-being. During emergencies, children face numerous stressors and deprivations, making early childhood development (ECD) a vital component of nutrition programming in crises. Adequate nutritional care for children and mothers must be paired with efforts to promote health, safety, security, responsive caregiving, and early learning opportunities. 

Evidence highlights the synergistic benefits of integrating responsive caregiving and early stimulation into nutrition in emergencies programs. These interventions not only improve young children’s nutritional status but also enhance their overall development, benefiting both the child and caregiver. Proper nutrition during early childhood fuels brain development and lays the foundation for healthy growth, while also fostering affection, protection, learning, and social interactions. 

Beyond individual outcomes, ECD interventions yield broader societal benefits. They contribute to poverty reduction, enhanced gender equity, resilience to climate shocks, and stronger social cohesion. By addressing the holistic needs of young children and their families, ECD-focused nutrition interventions build a healthier, more equitable, and resilient society. 

Key tools and resources 

In emergencies, child deaths can be two to seventy times higher than the average rate. For pregnant and lactating women and children from birth to twenty-three months, nutrition is key to reducing the death and illness that accompany emergencies of all kinds. During emergencies, ensuring that infants are exclusively breastfed for the first six months, and that breastfeeding is continued for two years or more, is crucial in safeguarding the health of infants and young children. The risks of feeding infants something other than breastmilk, particularly for the first six months, are increased because of unclean water, crowded and unhygienic living conditions, and inconsistent supplies in the markets. This can significantly endanger infants' health and can lead to increased illness, malnutrition and mortality. 

Infant and Young Child Feeding in Emergencies (IYCF-E) concerns the protection and support of safe and appropriate feeding for infants and young children in all types of emergencies, with the goal of safeguarding their survival, health and growth. It includes supporting the nutritional needs of infants and young children from birth to the age of two and concerns both breastfed and non-breastfed children as well as the well-being of mothers. IYCF-E protects breastfeeding alongside safe, diverse and locally available complementary foods. It is a cross-cutting field, requiring coordination of multiple areas of expertise, and must be integrated into the emergency preparedness and response plans. 

Key tools and resources 

MAMI stands for the management of small and nutritionally at-risk infants under six months and their mothers. Nearly half of all child deaths are due to undernutrition and infants under six months are the most vulnerable. ‘Small and nutritionally at-risk include infants' under 6 months (u6m) who have a low birth weight (preterm infants, small for gestational age) and/or infants u6m who are wasted, stunted and/or underweight. These infants are often described as malnourished. Effective management of small and nutritionally at-risk infants under six months and their mothers is essential. 

MAMI is an integrated approach to supporting the identification, assessment and management of small and nutritionally at-risk infants u6m and their mothers together. 

The approach involves early treatment to prevent immediate and future poor outcomes, such as more severe or recurrent malnutrition, illness, poor development and death. This means it encompasses both prevention and treatment. MAMI bridges maternal and child nutrition, health and social interventions, using and building on existing systems and services wherever possible. It promotes the integration of care into existing health and nutrition systems and services to increase chances of sustainable, scalable care for mothers and infants. 

Find complete list of resources on MAMI Global Network Webpage

Stay tuned for more MAMI tools and resources on the GNC MAMI Webpage! 

Child wasting is the life-threatening result of poor nutrient intake, recurrent illnesses, maternal malnutrition, low birthweight, poor feeding and care practices, or infection exacerbated by food insecurity, limited access to drinking water and poverty. Children suffering from wasting have weakened immunity, are susceptible to long-term developmental delays and face an increased risk of death, particularly when wasting is severe.  

The number of children who suffer from wasting globally keeps increasing dramatically because of multiple conflicts, epidemics and food insecurity, including that caused by climate-induced droughts and flooding. Yet, wasting is not only a characteristic of the crisis. In fact, two thirds of all children with wasting live in places that are not facing emergencies.  

Children living in vulnerable contexts and at risk of malnutrition require early detection and timely treatment and care to survive. Prevention, detection, and management of wasting are essential to preventing excessive child mortality and are at the core of a coordinated nutrition in emergency response.  

Everything about Community Management of Acute Malnutrition (CMAM) is in the GNC signposting document. 

Would you like to learn more about Wasting and the global policies aimed at addressing it? If so, be sure to add the UNICEF Wasting resource page to your favourites! 

Stay tuned for more Wasting tools and resources on the GNC Management of Wasting Webpage! 

More than 1 billion adolescent girls and women suffer from undernutrition, the majority of which stems from deficiencies in essential micronutrients and anaemia but also includes underweight and short height. Pregnant and breastfeeding women and adolescent girls are at heightened nutritional risk, compared to their non-pregnant and non-breastfeeding peers. 

Anaemia during pregnancy may lead to greater blood loss during delivery, increased risk of postpartum haemorrhage, and maternal mortality. In humanitarian or emergency settings, this situation may deteriorate further. Women’s existing nutritional vulnerabilities often reduce their resilience to shocks. Existing undernutrition can be further exacerbated by the contextual factors that drive – or result from – humanitarian crises, including exposure to violence, disruption of services, livelihoods and support, and increasing inequalities.  

Appropriate nutrition and healthcare during emergencies are likely to disrupt the vicious cycle of maternal, adolescent, and child undernutrition over the long term throughout the lifecycle. This highlights the substantial impact that such interventions can have on women and adolescent girls. 

Key tools and resources 

Micronutrient deficiencies can easily develop or worsen during emergencies, posing significant health risks, particularly for vulnerable groups such as children and women. Limited access to a diverse range of foods and poor dietary diversity are major contributing factors. Children and mothers who are deficient in micronutrients face an increased susceptibility to infections, illnesses, and even mortality. Addressing these deficiencies is crucial for their survival, as well as for their overall growth and development. 

In 2007, the World Health Organization (WHO), the World Food Programme (WFP), and the United Nations Children’s Fund (UNICEF) issued a joint statement on preventing and controlling micronutrient deficiencies in populations affected by emergencies. This statement included recommendations for the daily use of Multiple Micronutrient Supplementation (MMS) for pregnant and breastfeeding women. Since the release of the 2007 joint statement, these recommendations have been implemented to varying degrees across the globe.  

Key tools and resources 

A wide range of human behaviours have an impact on the causes and effects of undernutrition. Addressing the range of behaviours that have a direct or indirect impact on nutrition as well as the social and environmental factors that influence the adoption and maintenance of these behaviours is critical. Nutrition is also influenced, by the behaviours of many actors. These actors range from healthcare providers and schoolteachers to farmers and other agricultural agents, from religious and community leaders to private sector companies and policymakers, who collectively directly or indirectly influence care and feeding practices, household food security, the household environment, and healthcare services (USAID 2017). 

Nutrition social and behaviour change is a set of interventions that combines elements of interpersonal communication, program activities, social change and community engagement activities, mass media, and advocacy to support individuals, families, communities and service providers to adopt and maintain recommended behaviours for improved nutrition outcomes. 

To learn more, complete the eLearning course on GNC Learn: Community Engagement in Emergency Preparedness and Response 

To learn more, complete the eLearning course on GNC Learn:  Nutrition of Older People in Emergencies 

Food aid encompasses diverse interventions aimed at ensuring access to sufficient, safe, and nutritious food during emergencies to prevent excessive mortality, acute malnutrition, or harmful coping mechanisms. This includes making food available, improving access to quality and quantity of nutritious food, and promoting proper feeding practices. Food aid can involve direct food provision or other resources such as cash, vouchers, skills, or knowledge. Specialized products like small- and medium-quantity lipid-based nutrient supplements (LNS) are used to meet the nutritional needs of vulnerable groups, preventing malnutrition when integrated into essential nutrition actions. 

However, addressing malnutrition effectively requires more than standalone interventions. Evidence suggests that achieving 100% coverage of nutrition-specific actions reduces stunting by only 20%, underscoring the need for combined nutrition-specific and nutrition-sensitive strategies. Emergency responses must adopt preventive and curative approaches delivered through multisectoral efforts. 

Collaboration across clusters such as Food Security, Health, and WASH is crucial to tackling underlying causes of malnutrition. Depending on the context, coordination with Social Protection, Education, and Child Protection sectors can further enhance outcomes. By integrating these efforts, nutrition interventions can maximize their impact on affected populations, supporting recovery and resilience in crisis-affected communities. 

Key tools and resources