Optimal breastfeeding is of vital importance to infant and child health and has been adopted by countries as a standard recommendation. However, in the context of an infectious disease outbreak, especially when the disease is poorly understood, policy makers must balance the benefits of breastfeeding against the risk of disease transmission through breastfeeding. During the 2014-2015 Ebola Virus Disease (EVD) outbreak in Sierra Leone, the development of correct and consistent messaging about infant feeding and nutrition programming was considerably delayed by numerous challenges. These challenges included a lack of sufficient information about the risk of transmission through human milk, numerous stakeholders, limited communication between coordination pillars, inconsistent and evolving messages from various stakeholders, and the public's distrust of the health system and international actors. For improved response to future disease outbreaks, research on vertical transmission of EVD should be prioritized, infant and young child feeding experts should be integrated into outbreak response collaboration, and a digital repository of potential and appropriately tailored messages should be created.
