Breast is best, says Motsoaledi

Infant formula will no longer be supplied free of charge at government health facilities to mothers who are able to breastfeed, the Health Minister Aaron Motsoaled said on Tuesday.

Motsoaledi expressed grave concern that South Africa is one of only 12 countries in the world where infant mortality rates are increasing.

Reducing child mortality is one of the most important priorities in our country and “breastfeeding is a central to this as a child survival strategy”, he said.

The choice to stop supplying formula at government hospitals and clinics was in line with the government’s move to promote exclusive breastfeeding, according to the minister.

Motsoaledi said that babies aged of nil to six months should only drink breast milk but the Demographic and Health Survey in 2003 showed that only 1.56% of babies in South Africa aged four to six months were exclusively breastfed.

However, he made it clear that mothers who could not breastfeed for medical reasons would be supplied formula at government clinics and hospitals.

He said the low levels of breastfeeding in the country could be blamed on “aggressive promotion of formula by manufacturers, challenges working mothers faced breastfeeding in the workplace” and the use of formula feeding by relatives looking after babies left at home by teenage mothers.

Motsoaledi also said there was “sub-optimal involvement of men in supporting breastfeeding”.

He explained that there was confusion around the risks of passing on HIV through breastfeeding. Mothers who breastfed exclusively for six months have only a 1% chance of passing on HIV to babies.
But when HIV-positive mothers mix-feed their babies using a combination of breast milk and infant formula, the likelihood of passing on HIV increased.

Motsoaledi blamed the “limited understanding of breastfeeding’s benefits for the lack of large-scale efforts to promote exclusive breastfeeding”.

Better protection
Breastfed babies were better protected against infections such as diarrhoea, respiratory illnesses, allergies and ear infections, and had a much lower at risk of malnutrition. Adults who had been breastfed as infants had a lower risk of developing chronic lifestyle diseases such as obesity, coronary heart disease and type-two diabetes he said.

The South African Medical Association’s chairperson Dr Norman Mabaso told the Mail & Guardian that Sama welcomed the minister’s initiative to promote breastfeeding.

But he added that they were cautious about the policy to stop supplying infant formula at government health facilities. He said health workers must be allowed to make the final decision about whether to prescribe formula to women who are medically unable to breastfeed. Mabaso also said he was concerned that government decision meant that formula could “run in short supply” and not be accessible to women who need it for medical reasons.

Health Department spokesperson Fidel Hadebe told the M&G that the government policy would be implemented gradually. He said there were still tenders between health departments and formula suppliers that needed to be addressed.

Asked what relatives would feed a baby if they couldn’t afford to buy formula and the mother was away, Hadebe said the policy had to be implemented as it was in line with the government’s stance to promote exclusive breastfeeding.

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