For emergency managers and planners
This is a procurement item, not a craft project. A kit runs roughly twelve to fifteen dollars in parts, the bill of materials is on this page, and it is among the cheapest things in a mass care budget that prevent an infant illness. Cold water sanitation matters because it works when there is no power and no way to boil.
Kits are consumable supplies. In a declared incident with Public Assistance Category B specified, consumable medical supplies are an eligible cost. Pre stage them the way you pre stage anything else, and put a quantity in the plan rather than sourcing them during the event. See Emergency Management and Preparedness Coordinators.
Sanitation kits let families clean and sanitize infant feeding items when the water is not safe, the power is out, or the only place to wash is a bathroom sink. This page walks through the decisions: whether you need kits at all, what belongs in them, what to call them, and what we actually put in ours after Hurricane Helene.
A kit solves half the problem. Cleaning the bottle matters, and so does the water the formula is mixed with, which has to be hot enough to kill bacteria the powder may already carry. See Preparing powdered formula safely in an emergency.
Are sanitation kits needed?
Start here, before you buy anything. If you are planning ahead for an emergency that has not happened yet, ask the same questions about what is likely.
- Is clean water easily accessible to everyone?
- Does everyone have power?
- Does everyone have access to a sink that is not in a bathroom?
- Can all families clean feeding items properly, and easily?
If the answer to all four is yes, you may not need kits at all. There is a second question worth asking even when the answer is no: would teaching families to put a kit together themselves be more useful than handing out assembled kits? Sometimes it is.
What should be in the kit?
Deciding what to include
- What kind of emergency is happening, or is likely to happen where you are?
- What do people actually need?
- Are people displaced, or sheltering in place?
- Are the items easy to use with very little instruction?
- Can the instructions be followed regardless of language, education or literacy level?
- Are there cultural considerations in your community you should account for?
- Where will the kits be stored? Do you have room for supplies and assembled kits before and during an emergency, and will the kit be practical for the family carrying it?
Deciding what to call it
- What do you want people to do with the kit? The name should tell them.
- What do people in your area understand those words to mean?
- Is there a risk that certain terminology will be misunderstood, or put people off?
What we did after Hurricane Helene
An example, not a template. The right kit depends on what your community is actually facing.
What we were working with
- Long term, widespread power and water outages.
- Many displaced families living in shelters, hotels, tents, or with family and friends in close quarters.
- Damaged transportation infrastructure, with many areas reachable only on foot or by ATV.
- Large Latin American and Eastern European immigrant populations, with Spanish and Russian the most commonly spoken minority languages.
- Roughly 10 to 20 percent of the population with a high school education or less, with significant racial and demographic disparities.
- Fewer than half of families earning a living wage, ranging from 38 to 50 percent across the counties we served.
What we put in the kit
- Plain bleach, to make water potable and to sanitize items after washing.
- A 5 mL syringe, so families could measure the bleach accurately.
- Dish soap, for washing items.
- A bottle brush with a nipple cleaner, for reusable bottles, nipples and cups.
- Disposable cups, bagged to keep them clean, for cup feeding.
- An instruction booklet with cleaning and sanitizing steps in English, in Spanish, and in a simple picture format.
- A plastic tub, to store everything and to double as a wash basin. Filled about halfway with water it needed exactly one syringe of bleach, which made the instructions easy to follow even for families with limited English. Turn the lid upside down and it becomes a clean surface for air drying.
What we left out, and why
- Sanitizing wipes. They cost more and clean less well than bleach and water.
- Breast pump sterilization bags. They need a microwave and electricity. We gave these out case by case, to families who received an electric pump, and only after confirming they had both.
- Mesh bags. Cost and availability.
- Five gallon buckets. They took up too much of our storage space and were hard to carry into the field.
- Wash cloths. They harbor bacteria and grow mold if they stay damp, and there was no reliable way to wash and dry them without water and power.
- Disposable gloves. They create a false sense of cleanliness and often lead to more cross contamination, not less.
Handouts and resources
SAFE Infant Feeding Sanitation Kit Decision-making Guide (PDF)
The questions to work through before you decide what goes in a sanitation kit, and how many you need.
DIY Infant Feeding Sanitation Kit (PDF)
How to build the sanitation kit the SAFE Team used in western North Carolina, for disinfecting infant and young child feeding items. Also available in Spanish.
Bleach Alternative Notes (PDF)
What to use for cold water purification when liquid bleach is not available, and what the evidence says about each option.
Water Filters Meeting WHO Standards (PDF)
Household water treatment products evaluated under the WHO international scheme. A three star rating is the best performance tier.
See also: CDC Safer Spaces recommendations.
Want to go deeper?
Session 6 of Nourishing Resilience covers sanitation kits in more detail, alongside cup feeding, hand expression, relactation and co-nursing. Watch session 6, or start at the beginning of the full series.