Dec. 5, 2006 — -- Trapped miles from civilization in a snowbound car in subfreezing temperatures, Kati Kim had to ensure that her children survived until search parties rescued them.
Nine days later, the helicopters came.
Remarkably, Kim's daughters, 4-year-old Penelope and 7-month-old Sabine, were reported to be in good condition after the ordeal.
The key to this fortunate ending may have been the fact that Kim breast-fed both of them to keep them alive amid the harsh conditions once no other food was available.
Experts say the episode suggests how mother's milk, in a disastrous pinch, can make the difference in whether a child survives.
"The fact that Kati Kim was able to breast-feed both of her children for the amount of time that they were stranded most likely was lifesaving for them," says Dr. Sheela Geraghty, assistant professor of pediatrics and medical director at the Center for Breastfeeding Medicine at Cincinnati Children's Hospital Medical Center in Cincinnati.
"Breast milk not only provides the calories needed to sustain life, it also helps prevents dehydration," Geraghty says.
"I'm really, really grateful that the mother had breast milk available for the baby, as well as for her other child," says Judy Hopkinson, assistant professor at the USDA/ARS Children's Nutrition Research Center at the Baylor College of Medicine in Houston.
"This is a remarkable fluid in many ways. There is nothing better you can give a child in a disaster than breast milk."
"Lucky for these children that mom was breast-feeding," says Kathy McCoy, a lactation consultant at Clarian Health Partners Methodist Hospital in Indianapolis. "No one ever expects disaster to happen, but when it does, breast milk is truly a lifesaver."
Breast milk is often reputed for its nutritional benefits for children, but Hopkinson says human milk confers more than just sustenance.
"These kids weren't getting, I'm sure, all the calories they needed," she says. "So the breast milk was also giving them protection against serious illness, in addition to nutrition."
The idea that babies get an immune boost from breast milk is not a new one.
According to the American Academy of Pediatrics, breast-fed babies suffer fewer illnesses such as diarrhea, earache and respiratory infections.
"Breast milk is really primarily an immune booster," Hopkinson says. "We think of it as nutrition, but it is really integral to the immune system."
Breast-feeding, in this case, may have also given Kim and her children another way to survive in the harsh conditions -- body heat.
"Breast-feeding her 7-month-old and 4-year-old child was undoubtedly what kept Kati Kim's children alive during their horrific snowbound ordeal," says Michelle Collins at the Vanderbilt University School of Nursing.
"The very act of holding her children against her body to nurse them would have preserved their body heat, allowing them to maintain their core body temperatures despite the freezing temperatures outside their vehicle."
The Kims' situation was nothing if not traumatic.
After the car ran out of fuel, and Kim and her husband, James, burned tires for warmth, James left her and their two young children and set off into the wilderness to seek help.
He still has not been found.
That Kim was able to continue to breast-feed her children while fearing for the survival of her family is a notable feat, Hopkinson says.
"People always talk about how stress can undermine breast-milk production. In this situation, it's very important to see that it's not about external stress, but it's about internal management of stress."
"You hear stories of mothers breast-feeding during disastrous situations, such as in the blitz on London in World War II. This was obviously a very stressful situation, but she wasn't internalizing it to the point that she could not do anything."
"A huge advantage to breast-feeding is that it is available in any emergency situation," says one expert from the Breastfeeding Center of Boston Medical Center in Boston. "In the Superdome in New Orleans, there was no formula, and women who were not breast-feeding had nothing to feed their infants."
"In times of natural disasters, when water and food sources become contaminated or scarce, breast-feeding is a lifesaving measure for our smallest survivors," says Ann Peery, a registered nurse and lactation consultant at the Women's Center at the University of Virginia Health System in Charlottesville.
It is also possible that the very act of breast-feeding could have kept Kim's fear -- and that of her children -- in check.
"Breast milk contains naturally occurring substances to calm the nursing child and help them to sleep, which would have been imperative to help keep, especially the older child, from panic," Collins says. "It would have benefited Mrs. Kim as well, because when a woman nurses, a hormone is released that we know as the 'mothering hormone' -- prolactin -- which would have helped Mrs. Kim stay calmer."
Experts say it is also remarkable that Kim was able to continue to breast-feed her children with little or no food for herself.
"Although the mother herself probably had a very limited food intake during this time, a lactating woman is able to produce an adequate milk supply based on the demand for the milk for a considerable amount of time even under the most extreme circumstances," Geraghty says.
"Think about running a marathon -- it takes a lot out of you, but you can do it," Hopkinson says.
"Mothers can, and often do, operate of a calorie deficit. There is no evidence that a 24-hour fast reduces milk production."
Kim's body was apparently also able to adjust to providing enough milk for both of her children to remain healthy.
"In the vast majority of cases, the baby determines how much milk it needs from the mother," Hopkinson says. "It's really quite amazing how some mothers breast-feed triplets without any help."
"Who knows what the human body is capable of."