Telehealth and remote breastfeeding support in a war zone: a case series from Gaza

INTRODUCTION

In humanitarian emergencies, breastfeeding becomes a critical intervention and a pillar of the Infant and Young Children Feeding in Emergency (IYCF-E), leading to reduction in infant morbidity and mortality. In Gaza, where war has led to displacement, infrastructure collapse, and healthcare breakdown, traditional lactation support is severely limited. Exclusive breastfeeding rates were already low pre-conflict (36%, UNICEF 2020), and likely to have dropped further during the last 18 months. Since March 2024, the Gaza Infant Nutrition Alliance (GINA) has developed a hybrid model of remote training, mentorship, and mother-centered telehealth support to protect breastfeeding practices in this high-risk setting.

CASE DESCRIPTION

This series presents three integrated interventions:

Hospital-Based Support

Remote mentorship was delivered by international lactation consultants to neonatal nurses and doctors in Nasser and Al Aqsa Hospitals, and in a temporary breastfeeding tent in Al Mawasi. Real-time case discussions, Arabic-language workshops, and online simulations improved frontline staff ability to manage a wide spectrum of breastfeeding challenges.

Training Program

Over 30 health workers were enrolled in GINA’s lactation advisor training programme, with 120 more receiving structured IYCF-E training with special focus on breastfeeding and pragmatic maternal nutrition.

Direct Mother Support

Through GINA’s “Mother-Centered Bubble,” displaced mothers were paired with Arabic-speaking and non-Arabic lactation consultants via mobile platforms. Cases included premature infants, post-surgical feeding complications, and mothers separated from newborns. Breastfeeding was maintained or restored in most cases.

DISCUSSION

This model demonstrates that telehealth and remote mentorship can be adapted to fragile settings, strengthening both provider knowledge and maternal resilience. Key success factors included cultural relevance, language-appropriate tools, and collaboration with local actors such as MSF Spain and the Ministry of Health. Remote strategies filled urgent gaps when direct care was impossible.

CONCLUSIONS

In war-affected areas like Gaza, remote breastfeeding support is not just feasible, it is essential. This case series affirms the value of integrating telehealth into emergency paediatric and neonatal care.