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National Commission on Children and Disasters: 2010 Report to the President and Congress

Public Health Emergency Preparedness

This resource was part of AHRQ's Public Health Emergency Preparedness program, which was discontinued on June 30, 2011, in a realignment of Federal efforts.

Now this resource is supported by the Administration for Children and Families (ACF).

This information is for reference purposes only. It was current when produced and may now be outdated. Archive material is no longer maintained, and some links may not work. Persons with disabilities having difficulty accessing this information should contact us at: https://info.ahrq.gov. Let us know the nature of the problem, the Web address of what you want, and your contact information.

Please go to www.ahrq.gov for current information.

Appendix F: Supplies for Infants and Toddlers in Mass Care Shelters and Emergency Congregate Care Facilities

This document was facilitated by the National Commission on Children and Disasters with guidance from subject matter experts in emergency management and pediatric care. The document identifies basic supplies necessary to sustain and support 10 infants and children up to 3 years of age for a 24-hour period. The guidance is scalable to accommodate 10 or more children over a longer period of time.

The National Commission on Children and Disasters recommends State and local jurisdictions provide caches of supplies to support the care of children in mass care shelters and emergency congregate care facilities for a minimum of 72 hours. The amount of supplies cached in an area should be based upon the potential number of children up to 3 years of age that could be populating the local shelters and facilities for a minimum of 72 hours, as determined by an assessment of current demographic data for the jurisdiction.

Depending on the nature of the event, a 24-72 hour supply of essential child-specific supplies should be on site prior to the opening of a shelter or facility. In situations where this is not possible, supplies should still be available for immediate delivery to the shelter, when children are sheltered, within 3 hours (for example, through local vendor agreements, supply caches, interagency mutual aid, etc.).

Such a level of preparedness is critical due to the high vulnerability of this population.

Recommended Perishable Supplies for Immediate Delivery Within 3 Hours

Quantity Description Comment

40 Jars

Baby food—Stage 2 (jar size is 3.5-4 oz.).

Combination of vegetables, fruits, cereals, meats.

1 Box (16 oz)

Cerea—single grain cereal preferred (e.g., rice, barley, oatmeal).

Rice, barley, oatmeal, or a combination of these grains.

For additional information, go to "Supplemental Information."

Diaper wipes—fragrance free (hypoallergenic).

Minimum of 200 wipes.

40

Diapers—Size 1 (up to 14 lbs.).

Initial supply should include one package of each size diaper, with no less than 40 count of each size.

40

Diapers—Size 2 (12-18 lbs.).

40

Diapers—Size 3 (16-28 lbs.).

40

Diapers—Size 4 (22-37 lbs.).

40

Diapers—Size 5 (27 lbs. +).

40

Pull Ups 4T-5T (38 lbs. +).

320 oz.

Formula, milk-based, ready to feed (already mixed with water). For additional information, go to "Supplemental Information."

Breastfeeding is the best nutritional option for children and should be strongly encouraged.

64 oz.

Formula, hypoallergenic-hydrolyzed protein, ready to feed (already mixed with water). For additional information, go to "Supplemental Information."

64 oz.

Formula, soy-based, ready to feed (already mixed with water). For additional information, go to "Supplemental Information."

1 Quart

Oral electrolyte solution for children, ready-to-use, unflavored—Dispensed by medical/health authority in shelter. For additional information, go to "Supplemental Information."

Do not use sports drinks. The exact amount to be given, and for how long, should be determined by an appropriate medical authority (doctor or nurse) and based on the degree of dehydration. To be used in the event that an infant or child experiences vomiting or diarrhea.

For additional information, go to "Supplemental Information."

Nutritional supplement drinks for kids/children, ready-to-drink—Dispensed by medical/health authority in shelter.

Not for infants under 12 months of age.
Requirement is a total of 40-120 fl. oz. per day; in no larger than 8 oz. bottles.

Non-Perishable Supplies & Equipment

Quantity Description Comment

25

Infant feeding bottles (plastic only). For additional information, go to "Supplemental Information."

4-6 oz. size preferred (to address lack of refrigeration).

30

Infant feeding spoons. For additional information, go to "Supplemental Information."

Specifically designed for feeding infants with a soft tip and small width. Can be used for younger children as well.

50

Nipples for baby bottles (non-latex standard). For additional information, go to "Supplemental Information."

2 per bottle.

25

Diaper rash ointment (petroleum jelly, or zinc-oxide based).

Small bottles or tubes.

100 pads

Disposable changing pads.

At least 13 x 18 in size. Quantity is based on 8-10 diaper changes per infant per day.

10

Infant bathing basin.

Thick plastic non-foldable basin. Basin should be at least 12" x 10" x 4."

For additional information, go to "Supplemental Information."

Infant wash, hypoallergenic.

Either bottle(s) of baby wash (minimum 100 oz.), which can be "dosed out" in a disposable cup (1/8 cup per day per child) or 1 travel size (2 oz.) bottle to last ∼ 48 hrs per child.

10

Wash cloths.

Terry cloth/cotton—at least one per child to last the 72 hr period

10

Towels (for drying after bathing).

Terry cloth/cotton—at least one per child to last the 72 hr period

2 sets

Infant hat and booties. For additional information, go to "Supplemental Information."

Issued by medical/health authority in shelter.

10

Lightweight blankets (to avoid suffocation risk).

Should be hypoallergenic, (e.g., cotton, cotton flannel, or polyester fleece).

5

Folding, portable cribs or playpens.

To provide safe sleeping environments for infants up to 12 months of age.

2

Toddler potty seat.

That can be placed on the seat of an adult toilet, with handles for support. One each should be located in both a Men's and Women's restroom.

1 pack

Electrical receptacle covers.

Minimum 30 (Note: Prioritize covering outlets in areas where children and families congregate (family sleeping area, children's areas, etc.).

Other Recommended Perishable Supplies

Quantity Description Comment

40

Baby food—stage 1 (jar size ∼ 2.5 oz)

Combination of vegetables, fruits, cereals, meats

40

Baby food—stage 3 (jar size ∼ 6 oz)

Combination of vegetables, fruits, cereals, meats

40

Diapers—preemie size (up to 6 lbs.)

As needed for shelter population

 

Healthy snacks that are safe to eat and do not pose a choking hazard (intended for children 2 years and older)

Should be low sugar, low sodium: yogurt, applesauce, fruit dices (soft) (e.g., peaches, pears, bananas), veggie dices (soft) (e.g., carrots), 100% real fruit bite-sized snacks, real fruit bars (soft), low sugar/whole grain breakfast cereals and/or cereal bars, crackers (e.g., whole grain, "oyster"/mini)

Other Recommended Non-Perishable Supplies and Equipment

Quantity Description

10

Sip cups (support for toddlers). For additional information, go to "Supplemental Information."

Supplemental Information

Description Supplemental Notes

Formula.

Use of a powered formula is at the discretion of the jurisdiction or shelter operator. If using powdered formula, preparation of the formula should be conducted by appropriately trained food preparation workers. Water used should be from an identified potable water source (bottled water should be used if there is any concern about the quality of tap or well water).

Hypoallergenic hydrolyzed formula can be provided in powdered form—(1) 400 gram can—but only if potable water is accessible.

Infant feeding bottles and nipples.

Each time nutritional fluids, formula and/or other infant feeding measures (including breast milk in a bottle) are distributed by trained, designated shelter staff and/or medical professionals, clean, sterilized bottles and nipples must be used. Note: After use, bottles are to be returned to the designated location for appropriate sterilization (and/or disposal). Bottle feeding for infants and children is a 24/7 operation and considerations must be in place to provide bottle feeding as needed. (On average, infants eat at minimum 5-8 times daily.)

Note to staff: Sterilizing and cleaning

Sterilize bottles and nipples before you use them for the first time by putting them in boiling water for 5 minutes. Nipples and bottles should be cleaned and sterilized before each feeding. If disposable bottles and nipples are not available and more durable bottles and nipples will be re-used, they must be fully sterilized before each feeding. To the greatest extent possible bottles and nipples should be used by only one child.

In the event parents want to use their own bottles and nipples, shelter staff should provide support for cleaning these items between feedings. Such support includes access to appropriate facilities for cleaning (not public restrooms).

Note regarding all feeding implements for infants/children.

There is a specific concern with cleaning and sanitizing of all feeding implements associated with infants and children (infant feeding bottles/nipples, spoons, sip cups, etc). These items will require additional attention by food preparation staff to ensure they are sanitary as a means of reducing foodborne illness. Medical/health staff should be consulted on best means of raising awareness among shelter residents and enlisting their support for these extra sanitary measures.

Feeding implements such as spoons and sip cups should be cleaned using hot soapy water provided potable water is available. When the item is being cleaned to give to another child the item must be sterilized.

For the following items: infant bathing basin, lightweight blankets, diaper rash ointment, wash cloths, and towels.

Consider pre-packaging the listed items together and providing one package to each family with children. Note: additional blankets and towels will be necessary for families with more than one child.

 

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