South Africa has made encouraging progress in recognising the importance of a child's early years. The government has committed to universal access to quality early learning by 2030 and Basic Education Minister Siviwe Gwarube has set an ambitious target of getting seven million children into structured early learning programmes over the next four years. This is essential work. But if we are serious about giving every child the best possible start in life, we also need to look earlier, to the relationships that shape their development long before they ever enter a classroom.
From the moment they are born, babies begin learning through thousands of everyday interactions with the people who care for them. Every time a caregiver responds to a cry, makes eye contact, comforts distress or offers reassurance, a child's developing brain learns about trust, communication and emotional security. One of the earliest and most powerful of these interactions is breastfeeding. The warmth of a mother cradling her child at the breast offers physical contact, safety and the release of happy hormones for both mother and baby.
For decades, South Africa has rightly promoted breastfeeding because of its nutritional benefits, including protecting babies from illness, supporting healthy growth and giving them the best possible start in life. It is one of the country's most universal early caregiving practices, deeply rooted across communities and cultures. According to the 2023 National Food Security and Nutrition Survey, 95% of South African mothers say they breastfed their children at some point during their first two years of life.
But nutrition is only part of the story. Breastfeeding is also one of a child's earliest developmental experiences. It is one of the first opportunities for what child development specialists call responsive caregiving, expressed through “serve and return” interactions: the continuous back-and-forth relationship that emerges when babies signal a need and a caregiver notices, understands and responds. A baby’s hunger cues are met with warmth, touch and nourishment, teaching them their communication has meaning and loving support is available when they need it.
These moments may seem ordinary but they are far from insignificant. Scientists have long understood that the first 1,000 days of life represent one of the most important periods of human development. During this time, babies' brains develop at an extraordinary pace, shaped as much by relationships as by nutrition. Skin-to-skin contact and breastfeeding stimulate the release of oxytocin, often called the “love hormone”, in both mother and baby, helping babies feel safe and secure while laying the foundations for later learning, emotional regulation and social development.
Every feed creates an opportunity for communication. A baby signals hunger, discomfort or the need for comfort. A caregiver responds. Through hundreds, even thousands, of these interactions, children begin learning that their needs matter, that communication brings a response and that the world is a place where they can feel safe. These are some of the very first lessons a child ever learns.
In South Africa, millions of mothers are raising children in communities shaped by poverty, unemployment, food insecurity and violence. Many families have limited access to quality early learning programmes and overstretched public services. In these circumstances, the everyday interactions between a caregiver and child become even more important, because they are among the few developmental resources available to every family, regardless of income.
This should also change how we think about mothers. For generations, particularly under colonialism and apartheid, Black women were routinely separated from their own children, sent to raise other people's families as domestic workers or migrant labourers while their own children were cared for by grandmothers, aunts and neighbours. That caregiving sustained households, communities and the economy, yet received almost no recognition in return.
Today, many mothers continue to shoulder extraordinary responsibilities under extraordinarily difficult circumstances. Yet public conversations about breastfeeding often reduce it to a health behaviour or a personal choice, overlooking the emotional labour, knowledge and responsiveness involved in caring for a young child. Breastfeeding is more than a feeding practice. It is one of the first expressions of a mother's love, where her response to her baby's needs reflects not only knowledge and skill but the deeply human desire to comfort, protect and nourish her child. Seeing breastfeeding in this light means seeing the women who make children's healthy development possible and valuing the knowledge, skill and care their role requires.
This is not to suggest that breastfeeding can compensate for poverty or replace the need for quality services. It cannot. But it does remind us that some of a child’s most important foundations are built from day one through everyday relationships. Breastfeeding promotion should therefore sit within a broader nurturing care agenda. Health workers, nutrition programmes and early childhood development (ECD) practitioners should talk to mothers not only about milk and growth, but about the relationship they are building with their baby every time they breastfeed.
The government has already shown its willingness to invest in this generation of children, most recently through an additional R12.8 billion allocation for ECD over the next three years in the 2026 Budget. The establishment of the Inter-Ministerial Committee on Early Childhood Development in 2024, bringing together the departments of Health, Basic Education, Social Development and Labour, reflects a growing recognition that supporting young children requires coordinated action across sectors. That means looking beyond early learning programmes to maternity protection, accessible healthcare, community support and social protection that enables mothers to provide responsive care. Ongoing work to strengthen South Africa's Infant and Young Child Feeding policy provides another opportunity to embed responsive caregiving more firmly within that broader agenda. If breastfeeding is one of the earliest building blocks of learning and development, then supporting mothers is not simply a health intervention. It is an investment in children's cognitive, emotional and social development, and in the mothers whose care lays the foundation for that development.
Dr Chantell Witten is the director of Health Systems Strengthening at ilifa Labantwana. Her nutrition technical expertise spans nutrition and HIV/AIDS, infant and young child feeding and behaviour change communication. Her broader professional skills include proposal development, programme design, health systems research, advocacy, and report writing.