SUPERFOOD OFSUPERHEROES THE

TA L K I N G P O I N T Donor breastmilk is saving the lives of some of our very smallest prem babies. You too could be a Wonder Woman by donating your extra milk

Move over, kale smoothies. Take a number, quinoa. The only real superfood the world has ever known and needed is breastmilk. The magic formulation every mother produces is so perfectly formulated to nourish and protect her new baby, no formula milk in the world has ever been able to come close.

Here’s what breastmilk does: it transfers antibodies to your baby so that your tiny one won’t get sick if your twoyear-old has a cold – or if mom is sick. Your newborn has an immature immune system, but your breastmilk is full of healthy bacteria, white blood cells and cell wall protectors which help your baby while her immune system is developing. Your baby’s digestive system is immature, but if she’s breastfed, her stomach lining will become 15 times thicker than a formula-fed baby’s. Breastmilk has antiinflammatory properties and contains human growth factors to help your baby grow. It even contains endorphins to keep your baby happy and help her feel better when she’s stressed! Breastmilk contains fats and proteins

in the right proportions and breastfed babies experience the health benefits throughout their lives, being less at risk of obesity, tooth decay, SIDS, certain cancers and other diseases lifelong.

THOSE MOST AT RISK

Every baby deserves the healthiest start to life, but some babies aren’t so lucky. Premature babies are especially vulnerable: babies in NICU are at risk of necrotising enterocolitis, where parts of the intestine become damaged and sometimes actually die off. “Necrotising enterocolitis is associated with formula feeding and prematurity,” says Elizabeth Brierley of the human milk bank NGO Milk Matters in Cape Town. “Formula lacks antibodies and immunoglobin, so an immature gut plus an immature immune system can lead to necrotising.” It’s very dangerous. But – you guessed it – receiving breastmilk makes a baby seven times less likely to contract this horrid condition.

It is a sad fact that South Africa has a high rate of premature births (eight out of 100 births) and that between 15 to 19 out of every 1 000 live births end in neonatal death. “Of children who die under the age of five, 40 percent are newborns,” says Elizabeth. Most of those babies are in fact premmies.

We know that kangaroo care is a cheap and effective way of improving the outcomes of prem babies: they are kept skin to skin between their mother’s breasts and regularly breastfed. Many South African hospitals support this in principle. However, an added obstacle is that many mothers are young and poor. A mother may not be able to spend days at her baby’s side if she needs to work or go to school, or cannot afford the transport money, or she may be very ill and unable to breastfeed herself. Some – too many – mothers do not survive childbirth. Tragically, too, many prem babies are abandoned in hospital.

Enter the concept of donor milk – sharing the breastmilk of other lactating mothers to feed these most at-risk babies. It’s not a new concept. The first milk bank was established in Vienna in 1909, says the Human Milk Bank Association of SA (www.hmbasa.org.za). The concept spread and many babies’ lives were saved using donated breastmilk, until the latter part of the 19th century, when “the aggressive marketing of formula milk and the onset of HIV/AIDS” led to a drastic decline in milk banks.

Nowadays, we know more about how to manage and protect against HIV and Aids, and we also know how to safely pasteurise breastmilk.

SAFETY FIRST

Like all other milk banks in South Africa, Milk Matters, which supplies donor milk to infants under 1.5kg in more than 30 hospitals in the Western Cape, screens donor mothers for HIV and hepatitis B, smoking, alcohol consumption and lifestyle factors before accepting donated milk from them. They also wait for breastfeeding to be well established before using excess milk from donors so that the mothers’ own babies are not compromised. As the donated milk is going to the most vulnerable babies, mothers are also educated about how to date and store their milk safely in sterile containers and asked to donate milk to one of 22 depots around the province, most being pharmacies or baby clinics.

“We consistently struggle to keep up with the demand,” says Elizabeth. So while milk banks are enjoying a resurgence, and there are milk banks across the country (see sidebar for one in your area), you can help by donating any excess breastmilk in your freezer instead of tossing it out. “You can start donating once your own breastfeeding is established and you are confident with that,” says Elizabeth. “You won’t deplete your supply by donating, and it doesn’t matter how much or how little you give.

Think of it like this: just 50ml of milk can feed a prem baby for a whole 24 hours.” Elizabeth shares that Milk Matters has even had some mothers whose babies were stillborn or did not survive beyond infancy donate breastmilk, in an amazing act of charity.

“We think of donor milk as being a stopgap measure, an emergency supply,” says Elizabeth. “We promote breastfeeding, not the elective use of donor milk.” She says the concept is similar to a blood bank: a doctor needs to write out a prescription and the mother sign a consent form to allow the baby to receive donor milk, and the milk will only go to babies who have had abdominal surgery or who weigh under 1.5kg, or to babies in exceptional circumstances, such as the mother undergoing chemotherapy, for instance. YB

Guess what: we don’t actually experience the true form of hayfever in South Africa! We’ve actually got it far worse, explains allergist Dr Roz Rabie. “Hayfever is a condition that people suffer from in the Northern hemisphere where pollen counts surge over a period of two weeks in spring, causing sneezing, itching and a runny nose. We have pollen production almost the entire year round, so we really suffer here,” she says.

Your postal code can also dictate the type of environmental allergens you are exposed to. “Kwazulu-natal has high levels of house dust mite and cockroach allergies. Because it’s damp in the Western Cape there are lots of house dust mite allergies, but they also have some grassrelated allergies because of the interior of the Cape. And Gauteng is a grass biome (region) so there are lots of grass allergies and they suffer most of the year because the grasses release pollen for ten months of the year,” she explains.

WHAT DOES THIS MEAN?

An allergy is the response of the body’s immune system to normally harmless substances, such as pollens, foods, and house dust mite, explains Allergy UK. In allergic people, their immune system identifies the substances as a threat and releases histamine and other chemicals that cause those awful allergic symptoms. “Hayfever and sinusitis are a spectrum of the same disorder. Hayfever mainly affects your nose, but may extend into the sinuses as well,” explains allergist Dr Ahmed Manjra. When you get allergic inflammation into the nose and sinuses, we call it allergic rhinitis. But you also get a form of sinusitis that’s caused by an infection. “Acute sinusitis is usually caused by an infection, while chronic sinusitis is usually caused by an allergy,” he says. However, small children should not really suffer from sinusitis as their sinuses have not opened yet.

PREVENTION STARTS IN PREGNANCY

Anyone who has parents who are allergic will have a higher risk of developing allergies. But many factors of the environment that a growing baby is exposed to can also impact on their risk factors to experience allergies, explains Dr Rabie. “What the mother’s diet is like, if she smokes – these factors can modify the intrauterine environment for the baby and add to their risk profile of developing allergies,” she says.

So how can you give your baby the best fighting chance against allergies? The thinking has changed. A decade ago moms were advised to avoid peanut butter when pregnant and this is believed to have contributed to the spike in the food allergies that we’ve seen since. “The current recommendation is to eat everything that is culturally appropriate for your diet, with enough Vitamin D and fish oils for nervous system development for the baby,” says Dr Rabie. Get this

balance right and you could decrease the risk of your child developing allergies, she says.

You may be wondering how avoiding a potential food allergy can prevent your child from suffering from allergic rhinitis, but all allergies are related, explains Dr Rabie. “We talk about the progression of allergies, which is referred to as the allergic march,” she says. This means that children who have one allergy are more likely to develop others. They usually start off with eczema and then they develop food allergies, and then they have the nasal allergies, and anywhere along that spectrum they can then develop allergic asthma. Some children develop all four, while others may only develop one presentation of allergy,” she says. In babies, about 20 percent will develop eczema, and 30 percent of these cases are triggered by a food allergy. Thirty percent of children who have eczema go on to develop nasal allergies.

KNOW THE TRIGGER, FIND THE TREATMENT Kids under three seem to have a constant snotty nose, so it can be tricky knowing