SA moms slowly prove breast is best

The Star Early Edition - - LETTERS - Catherine Pereira

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.

WRITE TO US

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.

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