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Breast-feeding – no substitutes
We explain why nothing beats breast milk
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Only about eight percent of South African mothers choose to exclusively breast-feed their babies, despite the health benefits. To change this “unacceptable situation”, the government will stop providing formula, or breast milk substitutes, to mothers at state hospitals and clinics, unless a doctor prescribes it. There will also be formal changes to the way in which formula is marketed. National regulations on the marketing of breast milk substitutes are expected to be finalised and adopted as legislation within the next 12 months.
The strong stance, which calls for the active promotion, protection and support of exclusive breast-feeding, has been mostly welcomed by the health care sector. Health Minister Aaron Motsoaledi says South Africa is one of 12 countries worldwide where infant mortality is on the increase. “It is undeniable that breast-feeding is the very best way to nourish babies – there is, literally, no substitute for it.”
Motsoaledi is unequivocal about its merits. “Breast-fed babies are better protected against infections like diarrhoea, respiratory illnesses, allergies and ear infections; they are at much lower risk of malnutrition and as adults, are at a lower risk of chronic lifestyle diseases such as obesity, coronary heart disease and type 2 diabetes. Mother-child bonding is also accelerated through breast-feeding. This means that breast-feeding is not just about nutrition.”
He says mothers benefit from breast-feeding, as it lowers their risk of developing breast and ovarian cancer. The World Health Organisation also confirms that the benefits for HIV-positive mothers far outweigh the risks. The chance of the baby being infected, once put on antiretrovirals, is greatly reduced with exclusive breast-feeding.
State hospitals in KwaZulu-Natal have already stopped subsidising formula milk and the other eight provinces are expected to follow suit this year. If a mother does decide to bottle-feed, she will now have to pay for her own breast milk substitute. The state will, however, prescribe formula for the babies of mothers who cannot breast-feed for medical reasons.
So what does that mean for you?
Although patients at private hospitals and clinics will still have access to formula, and are able to buy formula if they choose to bottle-feed, proposed changes to labour legislation will enable all mothers to make a more informed choice when it comes to the feeding of their babies. Motsoaledi says the workplace is one of the many barriers to exclusive breast-feeding. “Most working environments are not supportive of breast-feeding.”
There are proposals to extend maternity leave to encourage mothers to breast-feed exclusively for longer than three months. A minimum of six months is considered healthy practice. The workplace needs to be an enabling environment for breast-feeding, and there should be a clean environment where a working mother can express, as well as facilities to store breast milk. Breast-feeding rooms and crèche facilities would help create workplaces more conducive to breast-feeding, says Motsoaledi. Furthermore, the “aggressive” promotion of formula by manufacturers will be restricted by the formal adoption of international marketing guidelines. These will extend to bottles and other products too. Labels should include, for example, information about the importance of breast-feeding and promote cup feeding as the preferred alternative.
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