The Minister of Health has announced that South Africa will, in an endeavour to reduce infant mortality rates and improve child well-being, adopt an exclusive breastfeeding strategy. This means it will discontinue providing milk formula through hospitals and clinics, except when this is recommended by an authorised health practitioner.

The evidence is indisputable: breastfeeding is the best infant feeding option. It protects them against infections like diarrhoea, respiratory illnesses, allergies and ear infections; they are at a lower risk of malnutrition; and as adults, they are at a lower risk of chronic lifestyle diseases such as obesity, heart disease, and type 2 diabetes.

It has been conclusively proven that exclusive breastfeeding is a safe feeding option for HIV-positive mothers and that the benefits outweigh the risks. If a baby is exclusively breastfed, the chances of it being infected with the virus are greatly reduced. However, the risk is greatly increased if mothers practice mixed feeding.

The policy position is thus that South Africa will adopt the WHO recommendation to adopt a single breastfeeding strategy; all babies should be breastfed for the first six months of their lives, and the babies of HIV-positive mothers should be exclusively breastfed for the first six months. Complementary foods should only be introduced after six months. In addition, mother and baby should undergo ARV therapy throughout the breastfeeding period.

Challenges to breastfeeding include:

• Challenges for working mothers to breastfeed in the workplace;
• Teenage mothers leaving their infants at home with relatives who rely on formula;
• Lack of family and community support for breastfeeding;
• Insufficient support in healthcare facilities;
• Confusion around HIV transmission and breastfeeding.

Regulations will be made to enforce the international code of marketing of breast milk substitutes. The policy will be supported by three systemic changes to the health system, namely: ward-based primary health-care outreach teams; strengthened school health programme; district-based clinical specialist teams.

Civil society, NGOs and CBOs have a critical role to play in supporting the realisation of this policy through home and community-based support. To succeed, there is a need, as the Minister points out, for information and support. Such information and support should ideally be embedded in all integrated early childhood development programmes, facilities and sites, alongside the clinics, where there is regular and early contact with mothers of small babies as well as pregnant mothers. It is therefore important that the ECD sector mobilise behind this policy and promote the development, distribution and capacitation of ECD role-players with regards to accurate and locally relevant knowledge of exclusive breastfeeding, especially in the context of HIV-positive mothers. Given the designated role of local government in relation to early childhood care, there is a need for local government to become an active and leading partner at local government level to support and promote exclusive breastfeeding through ECD sites and through local level communication and support programmes.

WEB LINKS FOR THIS ARTICLE

Click here to view the Minister of Health’s statement on the proposed policy.