Every August we take time to celebrate women — yet despite women having equal rights, employers in South Africa still have a long way to go towards supporting women’s efforts to breast-feed and give their children the best start in life.
The Lancet’s 2016 breast-feeding series presents compelling evidence that investing in breast-feeding is the most effective single intervention in reducing child mortality.
Breast milk contains a potent mix of vitamins, minerals, nutrients and antibodies specifically tailored to meet an infant’s changing nutritional needs. It aids digestion, strengthens immunity and helps to protect the baby from infections such as diarrhoea and pneumonia.
These protective effects extend into adulthood, reducing the risk of chronic health conditions such as diabetes,being overweight and obesity.In addition,breast-feeding protects women’s health, promoting healing after birth, burning calories and reducing the risk of breast and ovarian cancer.
Exclusive breast-feeding is also an investment in children’s education because it is associated with a higher IQ, academic performance and economic productivity.And it provides a foundation for healthy relationships by promoting early attachment and responsive care giving, reducing stress and strengthening the bond between mother and child in the critical first 1000 days of life.
Last but not least, it makes good business sense — helping to promote gender equality, reduce absenteeism (because breast-fed babies are less likely to get sick than those receiving formula)and improve staff loyalty and retention. In other words, breast-feeding is good for mom, good for baby and good for business.
Yet very few mothers in South Africa exclusively breast-feed for the first sixmonths of life as
recommended by the World Health Organisation; only one in four babies are exclusively breast-fed by the time they are four to five months old.And these low rates contribute to the high prevalence of malnutrition, diarrhoea, pneumonia and under-five mortality.
So what can employers do to facilitate exclusive and extended breast-feeding and help mothers to give their children the best possible start in life? The two most precious ingredients are time and privacy.
There are a number of laws and policies in place designed to support breast-feeding women in the workplace but implementation and enforcement remain poor. For example, the Basic Conditions of Employment Act guarantees women four months unpaid maternity leave. Although this provides some measure of protection for working women, many mothers have to return to work even earlier to earn an income. And the stress of returning to work and trying to express milk during working hours can diminish the mother’s milk supply, placing additional strain on both mother and baby.
For this reason the South African Code of Good Practice on the Protection of Employees during Pregnancy and after the Birth of a Child stipulates that employers should make arrangements for employees to have two 30-minute breaks a day to breast-feed or express milk for the first six months of their child’s life.Yet most women — and their employers — are unaware of the code and their legal entitlements.Without breast-feeding breaks, women are forced to choose between keeping their job or breast-feeding their baby.
Employers can support breast-feeding women with these steps:
Time: Women are entitled to two 3-minute breaks to express milk or breast-feed their baby. Create a more flexible work schedule so that women can express milk when they need to. If possible, give mothers options to extend maternity leave, work from home or work part-time so that they can continue breast-feeding, or provide child care on-site or close to work.
Space: Women need privacy and a clean, safe environment in which to breastfeed. No woman should be expected to express milk or breast-feed in a toilet or store cupboard. If possible set aside a private room with a comfortable chair. Breast milk can be refrigerated or stored in a personal cooler bag.
Develop a clear policy and guidelines:Create a supportive work environment. Develop a clear policy and extend provision of breast-feeding/expressing breaks from six to 12 months to support mothers and infants as they make the transition to solid food.
Educate staff and management: Educate employees about the policy and the benefits of breast-feeding. Enlist the support of supervisors and co-workers. Inform pregnant women about their rights — to maternity leave and breast-feeding breaks — so that they can plan ahead and continue breast-feeding.
Lori Lake, Chris Scott and Max Kroon are members of the advocacy committee in the department of paediatrics and child health at the University of Cape Town