Cup-feeding slashes mortality rate
SENZI Nxakanti watched attentively as her four-dayold son, Likhanya, stuck out his tongue and sucked hungrily from a cup containing her breast milk.
Seated at the baby clinic at KwaDabeka Community Health Centre in Durban, mother and child appeared comfortable feeding by cup, a method increasingly being promoted by the Department of Health to reduce infant mortality rates.
“I cup-fed my eldest son for two years and had no problem. I never use a bottle as I find cup-feeding easy, when I am not breastfeeding,” said Nxakanti.
There was also no fussing from newborn Simphiwe, when her mom, Chwayta Madikizela, held the miniature cup to her mouth just hours after her birth.
Although the department has been promoting cupfeeding since the launch in 1994 of the Baby-Friendly Hospital Initiative — a global strategy of Unicef and the World Health Organisation to discourage the use of artificial teats and pacifiers in favour of cup-feeding — it is placing renewed emphasis on the programme.
According to a report by the Medical Research Council’s Burden of Disease Unit in December last year, South Africa’s under-five mortality rate declined from 56 to 39 per 1 000 live births between 2009 and 2014. The infant mortality rate dropped from 39 to 28.
“Mothers are introduced to cup-feeding in health facilities to practise and understand that it is a better feeding option for infants who cannot be breast-fed,” said Dr Yogan Pillay, the department’s deputy director-general responsible for HIV, TB and women and child health.
“Gastroenteritis is a major cause of death in young children in South Africa. The cleaning of feeding utensils in poor communities with limited fuel for boiling water and no access to sodium hypochlorite solutions is a very important issue,” he said.
“Formula-fed infants are exposed to the risks of contaminated water, inadequately prepared powdered infant formula and inadequately cleaned bottles BABY-FRIENDLY: Chwayta Madikizela cup-feeds her newborn daughter, Simphiwe
The use of a wide-rimmed cup which can be easily cleaned cuts the risk of gastroenteritis
and teats. These expose them to an increased risk of morbidity and mortality due to gastroenteritis.
“The use of a wide-rimmed cup which can be easily cleaned with a finger using soap and water — unlike a bottle or teat — thus reduces the risk of gastroenteritis,” said Pillay.
The department’s goal is to reduce the under-five mortality rate to fewer than 30 deaths per 1 000 live births by 2020. The UN Sustainable Development Goal target is to reduce under-five mortality to below 25 per 1 000 live births by 2025.
Professor Dave Woods, a retired paediatrician who was involved in the implementation of cupfeeding at Groote Schuur Hospital about 20 years ago, said the use of bottles was one of the main causes of diarrhoea, a major killer of children in South Africa.
“It makes a significant difference to mortality rates in rural areas because of diarrhoea. Tiny premature babies who aren’t mature enough to feed on the breast will cup-feed from about two months premature. They cup-feed quicker than bottle-feed,” said Woods.
“The main advantage is that it doesn’t interfere with breast-feeding.”
Almost all hospitals in the Western Cape have replaced bottles with feeding cups.