In the days leading up to Hurricane Helene’s arrival in North Carolina, Ziska Maria tried to stock up on her five-month-old son’s formula in nearby stores, but none had it. “We were like, ‘okay, we’ll just get it after [the storm],’” says Maria, who lives in Black Mountain with her partner, three-year-old and infant.
But after the morning of 27 September, the family quickly realized they wouldn’t be making grocery runs anytime soon. “We didn’t have water, we didn’t have power, we didn’t have cell reception, we didn’t have internet, all the roads were blocked and we couldn’t leave,” says Maria.
Maria’s son was born with a cleft lip, which was repaired in surgery but caused feeding challenges. After months of trial and error, Maria finally landed on the right combination of bottle and formula, along with a supply of frozen breast milk donated by another mom, which she mixes with the formula.
But after Helene, Maria was stuck with a now-dwindling supply of formula, a small backup stash of formula that her son didn’t tolerate well and a freezer full of breast milk now in danger of thawing.
A few days later, the nearby highway was cleared. Desperate for more formula, Maria and her partner packed up the kids without a destination in mind. Three hours outside of Asheville, they finally found a store stocking the right formula. “They were telling us that everybody was coming there and getting all of it and bringing it to Asheville,” Maria says.
The family did eventually find formula for their son, as well as a place to stay temporarily. But in the wake of the storm, not all families have been able to evacuate. Instead, many are navigating infant feeding with no clean running water, in some cases with no electricity, and little access to the outside world.
For families like Maria’s, who rely on formula, Helene has created a crisis within a crisis; breast milk or formula are the primary sources of nutrition for the first six months of a baby’s life. Powdered formula, which isn’t sterile, must be prepared with clean, boiled water – but in some parts of western North Carolina, running water isn’t expected to return for weeks, if not months.
Other families have had to throw away hundreds or even thousands of ounces of stockpiled breastmilk that is no longer safe. Lane T, mother to a four-month-old living in Asheville, has been able to continue breastfeeding, but lost about a month’s worth of frozen breast milk, which she had saved to prepare for her return to work. She’s now trying to figure out how she’ll be able to sanitize her breast pump parts when she goes back to her job next week. ”It’s just a lot of added logistics,” she says.
Without clean running water, bottles and breast pump parts are difficult to sanitize, raising the risk of infection. Jayne Carpenter, an international board-certified lactation consultant and infant feeding specialist, says that local pediatric practices have already observed an uptick in gastrointestinal and diarrheal admissions in the last week. “That is the first thing we see in infants when this is happening,” says Carpenter.
To reduce this risk, Carpenter and other lactation consultants are assembling and distributing safe cleaning kits so that parents can safely sanitize bottles and prepare powdered formula. The kits include instructions in both English and Spanish. “In times like this, if folks are formula feeding, we need to make sure they’re being educated,” Carpenter says.
In the days after the storm, Carpenter and her colleague, Brandi Harrison, a fellow lactation consultant who lives in Jackson county, set up four depots for collecting and distributing human milk donation. Carpenter has also personally delivered supplies and support to families, including two families who had given birth at home unassisted, either during the storm or immediately after. “It took two days for folks to cut their way up” to their homes in Weaverville, she says.
The North Carolina Breastfeeding Coalition is now supporting these efforts, with 30 to 40 volunteers a day assembling sanitation kits, processing milk donations and conducting needs assessments.
It was formula, not diapers, that the Diaper Bank of North Carolina rushed to distribute in the immediate aftermath of the storm. Michelle Schaefer-Old, the organization’s CEO, describes the need as “dire”, especially for low-income families who couldn’t afford to stock up ahead of time. “Right off the bat, we started getting requests for formula, and hearing stories of families not being able to feed their baby for 14 or 24 hours,” she says.
Donations helped the organization buy pallets of formula directly from manufacturers; over about a week, the bank distributed more than 5,000 containers of formula across the 28 North Carolina counties impacted by Helene.
Still, she adds: “I would say we’re only about 50% meeting the need of [the demand] we’re seeing in western North Carolina.”
At this point, meeting that need isn’t necessarily about collecting more supplies, but distributing them to the most far-flung and isolated communities. “What’s happening right now in Asheville is that we have a lot of stuff,” says Roxy Robbins, an Asheville doula who co-founded The Flow of Life Yoga and the maternal health non-profit Perinatal Health Connect. “The pivot we’re looking at is how to get out beyond the city center and support the rural communities that can’t get into town.”
Similar coalitions were bracing for the impact of Hurricane Milton. Melissa Butler, a birth and postpartum doula in St Petersburg, says birth workers had started to spread the word about relief efforts. “What a lot of us are doing is sharing resources so they reach more people,” she says; one birth center is offering to be a hurricane shelter, and a pelvic floor therapist is collecting and distributing infant supplies.
Organizations like the Mothers’ Milk Bank of Florida, which collects and distributes 8,000 ounces of pasteurized human donor milk to 78 hospital and community partners each week, are bracing for a surge in need. Earlier this week, they asked people in unaffected areas of the state to consider donating surplus milk, to meet demand after the storm. These donations will help make sure “babies receiving care in Florida NICUs have the nourishment they need to thrive if their own mom’s milk is unavailable”, says Laene Keith, director of community engagement.
After Helene, Robbins, her business partner Sue Ann Fisher and other birth workers quickly established a maternal health mutual aid hub in Asheville. They’re now helping families evacuate, coordinating them with care providers in other states and raising funds to subsidize travel, for those who can’t afford to leave.
“People want to stay and protect their home, they want the community to hold them up – this is what they know and love,” says Melissa Poole, a nurse-midwife working with the collective. “But a lot of them are having to make the hard decision that this is better for their kids.”
Maria and her family, who are now staying in a family member’s vacation cabin a few hours from their home, haven’t decided what their long-term plans will be. Most of the families with little kids she knows have left, she says. Some have attempted to return, only to leave again. She thinks it will be months before her area has running water again.
“It’s super unclear how and when we could possibly go back to anything close to normal, and what would be safe for our kids, and when we could get formula for him,” she says. “How do we even imagine what the future looks like?”
