SA moms slowly prove breast is best
THE LATEST South African Demographic Health Survey (SADHS 2016) revealed that childhood stunting in South Africa remained unchanged from the previous SADHS (2003) – at 27% among children under the age of five years.
Stunting is caused by undernutrition. Its consequences extend into adulthood, increasing the risk of poor pregnancy outcomes, impaired cognition that results in poor school performance, reduced economic productivity and earnings, and future risk for overweight and non-communicable diseases such as diabetes.
The causes of undernutrition are inadequate dietary intake, including poor infant-feeding practices and infections. Both are consequences of underlying causes such as poverty, food insecurity and lack of knowledge about optimal infant feeding.
When it comes to optimal infant and young feeding, the first 1 000 days of life, from conception to a child’s second birthday, are a critical window of opportunity to improve child nutrition and prevent malnutrition.
The World Health Organisation and Unicef define optimal infant and young child feeding as initiation of breastfeeding within the first hour after birth, exclusive breastfeeding for the first six months and continued breastfeeding for two years or more – this combined with safe, nutritionally adequate, age appropriate, responsive complementary feeding starting in the sixth month.
The good news is that SADHS 2016 shows a marked improvement in the exclusive breastfeeding rate (EBF) under six months, which is 32%, up from 8% in 2003.
This is a notable achievement and coincides with the phasing out of free breastmilk substitutes/formulae after 2011, in accordance with the Tshwane declaration of support for breastfeeding in South Africa.
This trend is a significant step towards reaching the World Health Assembly target of 50% EBF rate by 2025.
It has often been asked why breastfeeding rates in South Africa are slow to increase?
Reasons include lack of knowledge about the benefits of breast milk and its superiority to formula and limited breastfeeding support.
There is the misconception that a crying baby must be a hungry baby, which tends to reinforce the notion that milk yield is not sufficient and ties in with the false belief that breast-milk substitutes aand formula are superior to breast milk, further undermining a woman’s confidence in her ability to produce enough milk to nourish her baby.
Mothers also struggle to sustain breastfeeding when they return to work before a baby is six months of age.
The only way we can hope to produce sustainable improvements is for all stakeholders to work together for the common good: The protection, promotion and support of breastfeeding. Mothers, fathers, families, communities, government departments (national, provincial and local), health facilities (public and private), workplaces, NGOs, researchers – every single one of us, whether or not you are breastfeeding yourself, and even if you do not have children – has a role to play in supporting mothers to be able to breastfeed.
One important area of intervention required is support for working mothers to continue breastfeeding.
Think twice next time you see a mother struggling to feed her baby in a public space, or at home when your partner is trying to manage breastfeeding, work and household chores, or when your friend just needs an ear to listen to her struggles as she adjusts to life as a working, breastfeeding mom.
Let’s work together to improve the protection, promotion and support of breastfeeding. Nutrition specialist, Unicef Department of dietetics and nutrition, faculty of community and health sciences, University of the Western Cape.
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GETTING BETTER: Last year’s SA Demographic Health Survey showed a marked improvement in the exclusive breastfeeding rate under six months, which was 32%, up from 8% in 2003.