Archive for March 25th, 2008

Food Storage With Pregnant Women, Infants and Young Children

Sharon March 25th, 2008

This week I’m going to spend a lot of time on specific needs, and how to adapt your food storage to meet those needs.  Among the most common special circumstances is a childbearing woman, infant or young children.  Even if you personally are male or past childbearing, you may end up being the place of respite for family who have these issues in a crisis, and it is, IMHO, important to think about them.  I have encountered many people over the years who never expected to see their children suddenly arrive back home, to end up raising their nephews or grandchildren, or never expected to get pregnant (or pregnant again) and did.  Do not think that this information could never be relevant to most of us.  Remember, plans are good - but plans go awry regularly.

The first, and probably most essential component here is water.  I know a lot of people respond to my discussions of storing water as “ok, we’ve moved into total whack-job territory.”  And yet, I’m going to say that this is particularly important if your household includes or might include pregnant women, infants or very young children who are especially vulnerable to disease, parasites and chemical contaminations.  They also all have very little toleration for dehydration or water stress.

 So if you have or might have young children, pregnant women or infants, store water, and have a way of filtering water in the long term.  If you have a limited supply of filtered or known safe water, and are worried about contamination, the last people to touch potentially contaminated water should be children or pregnant women - lifelong consequences are possible. 

Pregnant women need more water and more of some nutrients.  Storing a pregnancy multivitamin if you could potentially become pregnant is not a bad idea.  Regular multivitamins will mostly suffice, though, if a varied diet is possible.  Folate (found in eggs and greens) and protein are particularly important - make sure pregnant women get more of these foods.

One issue for pregnant women may be nausea - on a food storage diet it is particularly difficult to deal with food issues.  To the extent you can, women in early pregnancy suffering from nausea should be accomodated in any way possible - the reality is that hunger makes the nausea worse and can result in a “death spiral” of being unable to eat or keep anything down long enough to deal with hunger induced increases in nausea.  This can cause dehydration, occasionally even death.  So if you are relying on food storage and have a sick pregnant woman, do the best you can to find something she can eat, if you know you plan to be pregnant and have specific triggers you might consider storing them, also if you plan to be pregnant, sea bands or ginger might work (nothing worked for me ;-) but I mention it). 

Otherwise, pregnancy doesn’t require special foods.  But infants do.  Infants under 4 months (6 months is considered ideal) should be exclusively breast-fed whenever possible.  Breastfeeding is essential - and in a crisis, it can actually save lives.  Formula often becomes unavailable in a crisis, and a nursing mother can not only keep her own infant hydrated (even if she is suffering from dehydration she will continue to make some milk) but potentially other infants as well who can drink expressed milk in a bottle or cup or be taught to nurse (sometimes).  While not every woman can nurse, far more can than do, and for longer than most American women do. There’s more on the value of this here:

But what about women who can’t nurse, or those who adopt? And, for that matter, I’m going to say something that most mothers don’t like to hear.  We aren’t immortal or invulnerable - trust me, I know how it feels to believe that you have to be ok, because your children depend so much on you.  But things happen sometimes to mothers.  And the survival of our babies and children shouldn’t depend on the ability of any one adult to be present and to feed them.  So having some kind of backup situation makes sense. 

That backup situation could be another lactating woman in close proximity, it could be a goat (not a cow), or it could be a store of infant formula.  I know that we should whenever possible, store what we use and vote with our dollars.  But every time I had a baby, before I gave birth, my husband and I bought a six month supply of generic, cheap infant formula.  It lasts about 2 years in storage (and unopened can be safely used for another year or two, but will lose nutritional value and may not adequate, so do this only in a dire emergency to keep a baby alive - a wet nurse or goat would be better) and before it expired, we would give it to our local food pantry that always desperately needed formula. 

I am a passionate advocate of breastfeeding - but I care much more that babies live even if their Moms aren’t around, or can’t nurse them, and someone be able to take care of the babies around them. Only you know if your circumstance merits doing this, but it is something to think seriously about - I think of it as a charitable donation, one I hope never to need myself.

Once an infant is 4 months old (again, six is considered optimal, but by 5 months my kids were always grabbing food out of my mouth at the table, so thought they were ready), you can gradually begin transitioning them to mashed up solids.  (Actually, when I was an infant, solids were begun as early as 6 weeks - this is not recommended now, but if formula or breastmilk were in short supply, it could be considered - again, do it only if you have to.)  Waiting longer is considered better, particularly if you have a family history of food allergies.

Babies don’t need “baby food” per se, although it is good to start them on mashed up very simple, low allergen foods like white rice, greens, potatoes or orange vegetables.   But again, they should be primarily getting their food from mother’s milk, goat’s milk or formula until nearly a year - babies need a high fat, high protein, high quality diet.  If you think they may come into your orbit, store for them.

Young children, under 2, need more fat than most people, so storing some extra high fat food is a good idea.  Fish oil is a particularly useful thing if you can keep it cool, because it enhances brain development. Otherwise, they simply need a balanced, healthy diet.  But this can be tough with young children, since toddlers often are extremely picky eaters.  This means that storing familiar foods and getting kids familiar with whole foods used in storage is especially important. 

Toddler pickiness has some evolutionary advantages - as they get more mobile, they get more choosy about what they eat, which is protective.  It is helpful to recognize that this is a passing stage, and just concentrate on finding foods they like.  Remember also that toddlers often have to encounter an unfamiliar food over and over again before they will try it - keep trying.   Generally speaking, if they aren’t making a radical dietary transition - that is a complete break from familiar foods - which they shouldn’t be, since we’re all trying to eat what we store - kids won’t generally do themselves any harm.

For healthy older children, I think a low-tolerance policy towards picky eating is important - I’ve written more about getting over picky eating here.  And again, kids make it extra-urgent that you begin eating out of your food storage regularly.

I’ll post some kid friendly food storage recipes in one of my next posts - more coming soon!


Storing Medicines - And Other Options

Sharon March 25th, 2008

A while back a reader who depends for her life on daily medication emailed me asking what her options were in the case of a major disruption of supplies.  I’ve had occasion to think about these things before - for example, as I was writing the chapter on health care in _Depletion and Abundance_ and when thinking about family members, some of whom are equally dependent.  But it was helpful to sort out and organize things.

To start with, everyone who depends on a medication should keep a 2 week supply, plus duplicate copies of their prescriptions.  This is an absolute minimum, again, the FEMA/Red Cross minimum, and it reflects the reality that in a bad crisis, it is not unlikely that you may be unable to get a refill for several weeks.

 This does mean that you have to pay close attention to rotation - some medications (insulin for example) have a comparatively short lifespan.  Most have a mid-range one, and gradually lose potency, but there are a few that actually become toxic if they’ve been stored too long.  If you don’t know what the storage life and issues are with your medication, you should call the drug company that makes it and find out.  Ask them how they figure out storage lives and what the potential consequences of taking out of date drugs are.  Write the information down for all prescriptions you depend on.  And if you do take a short lifespan drug, you’ll need to be super-careful about using up the oldest first and keeping your supply updated.

Most over the counter medications can be safely used past their expiration date, but again, this is something you’ll want to research.  There are simply too many such drugs, and their compositions vary from brand to brand and country to country for me to provide a reliable list of OTC and Herbal preparations their storage lives.

I would also recommend that you keep up-to-date copies of your prescriptions (including, if you use them your glasses prescription) and your medical records somewhere easily accessible along with important papers so you can grab it if you are forced to evacuate.  It can be very difficult to find someone to write you a prescription in a crisis, and you don’t want to be without them.  The medical records are absolutely *imperative* if any of the medications you depend on are controlled narcotics (which odds are you won’t be able to get an extra prescription for) - because convincing a strange doctor in a strange place to give you a controlled substance is likely to be difficult.

Most medications are best stored in a cool, dark, dry place.  You might want to double zip-lock them or otherwise store them in as airtight way as possible to slow degradation if you are holding them for a longer period.  It should go without saying that all medications must be stored away from where children can get them, in childproof containers.   

What about drugs that require refrigeration?  What do you do if the power goes out?  In most parts of the country, water comes up from the ground fairly cool, and storing drugs in buckets of water, or dug holes in the ground will keep them cool enough for a short time.  If you have a creek or other water source that is cool, you often can seal the drugs in a container and submerge the container (don’t let it get washed away, obviously) in the creek.  In a short term emergency, with no way to keep needed medications cool, having a functional person go for help is probably the best solution.

What about longer term social disruptions, or major supply problems?  What if two weeks is not enough?  Well, it certainly would not be unwise to store larger quantities of most medications if you can - 3 months would probably be prudent, and if you can afford to buy it up front, it protects you as well from price fluctuations.  The difficulty is that many people cannot afford 3 months advance medication, and their insurance will not pay for it.  And those taking scheduled narcotics usually cannot get any more than an immediate supply.  Add to that the fact that eventually, in a serious crisis, stores will run out and what do you do?

My own feeling is that you should take a “belt and braces” approach - that is the more ways you have to hold up your pants or ensure your supply of medication, the better.  After all, your life is worth it.  So you do what you can, with what you’ve got.  You might want to make use of several of these strategies.

I should add that I personally think that the most likely scenarios are less about total disruption in supply than about increasing numbers of people unable to afford their drugs.  That, of course, is the reality in many places in the world where a diagnosis of an expensive disease simply means death.  But there are good and compelling reasons to avoid becoming one of those places - this is the subject for another post, but in _Depletion and Abundance_ I outline how we might create a low cost, localized “shadow” health care system that could meet a lot of needs both during a crisis and right now, for the millions of uninsured.  I believe passionately that Peak Oil and Climate Change advocates need to focus in on sustainable health care and add it to their agendas - because we have evidence that it is possible to have long lifespans and reasonably good health along with very low expenditures on health care.  But that, of course, is a discussion for another day.

But anyway, while it is technically possible imagine drug manufacturing simply stopping, it seems more likely to imagine sketchy supplies, not being able to get preferred drugs, and not being able to afford needed medication.  And I do want to caution people not to panic here - yes, plan.  But don’t assume that any crisis is inevitable.

Ok, so the first solution would be to store a larger supply.  If you are taking a narcotic, or using a short lived drug this is particularly difficult, but a friend of mine says that sometimes she is able to skip a dose, and when she does, she puts it aside - by refilling immediately and occasionally enduring quite a bit of pain, she has managed to put a small reserve aside.  Only you know if that is possible for you - but it might be worth trying.

If your current drugs are short-lived, it might be worth researching whether there are alternatives you could shift over to.  In fact, this is probably worth looking into for everyone - that is, if your drug is available in multiple forms, know what they are - one may be in short supply when another is available.  There are risks, of course, in any such substitutions, but being able to get ahold of a functional substitute is probably less risky than going entirely without.

What happens if there is a long term crisis and no way of getting your drugs at all?  Well, there are a couple of options.

1. First, is there a non-pharmaceutical company alternative.  In many cases, there will not be - but sometimes there are.  For example, those on heavy pain medication may be able to rely on homegrown opiates, marajuana (legal for medical purposes in some states and legal for anything in some countries), or alcohol for pain relief (note, this blog might get in trouble if I suggested you do illegal things, so FYI only). 

Some prescription medications can be substituted with herbal preparations - some quite successfully, some not very.  But it is worth noting that many drugs are herbs - or were in origin.  It is not worth dismissing herbal medication out of hand.  Talk in advance to a naturopath or other practitioner and to your doctor. 

Sometimes you can reduce your need for a medication partly or entirely by lifestyle changes.  Many of those with high blood pressure, for example, could manage it with diet and exercise alone if they really had to.  Giving up a western diet and eating very low on the food chain, and exercising a *lot* will suck badly if you are already unhealthy - but it might be better than the alternative.  A friend of mine with type 1 diabetes tells me he can halve his insulin requirements by careful dietary control and extensive exercise.

2. Have a plan for ensuring supplies.  If you can imagine a crisis in which drugs continue to be manufactured in some places, but just aren’t getting to you (what most crises have looked like in most of the world recently), it might be worth getting a group of concerned citizens together and contacting pharmaceutical companies about ensuring supplies during periods of disruption (you might mention climate change, Katrina, avian flu - just in case peak oil doesn’t cut it ;-) ).  That is, while one person is not a very powerful entity with a company, a city or state or regional group made up of people with medical dependencies might be able to work out supply delivery plans and direct purchasing for an extended emergency.  They might not - I have not tried this.  But advocacy groups are powerful.

 My own suggestion would be to start at the municipal or county level, and consider organizing from there, perhaps linking community groups together to contact major pharmaceutical companies directly.

3. Go Local.  Now this is not going to be possible for a majority of drugs, but some very simple chemical combinations can be made in college or even a good high school chemistry lab. I am not a chemist and I am not an expert here - but several chemistry professors and high school chemistry teachers did tell me that they could manufacture a number of drugs that had comparatively simply formulae.  Antibiotics, thyroid medications and heart medications were among those mentioned as particular accessible - if they had the relevant materials. 

Some of those chemical materials are cheap and fairly shelf stable.  It is not impossible that some drugs could be synthesized locally - and make a rather good business for a chemist.  My own recommendation would be to do some research into your drug (generally, it will be possible to find the formula if it is no longer proprietary information of a single company, so if you have a choice of medications, you want the oldest form in many cases)  and to talk to graduate students or professors at your local university or even a high school chem professor about your fears about the future and your desire to find a local solution.  It will not be possible in every case - maybe even most cases, but it is better than just accepting death.

This is not an easy issue once you get outside the short term.  But it is worth thinking about - and thinking hard.