As we commemorate another annual breast-feeding week we are faced with statistics that are refusing to shift. (Photo by STR / AFP) / China OUT / TO GO WITH Health-family-China-healthcare by Helen Roxburgh and Poornima Weerasekara (Photo by STR/AFP via Getty Images)
This week is World Breast-feeding Week and, like many similar such events on the health calendar, it is quickly forgotten until it is time to dust off the posters and put them up again for the following year’s celebrations. Despite our year-on-year awareness raising campaign, South Africa’s exclusive breast-feeding rates remain worryingly low. National surveys estimate that only 32% of our babies are exclusively breast-fed for the recommended six months, despite high initiation rates at birth.
What’s puzzling is that research suggests that new mothers understand that “breast is best”, but this does not seem to translate into practice. So why are mothers not breast-feeding? Perhaps it’s because we’ve placed the burden of responsibility on them alone, when we should be asking, why is it so hard to exclusively breast-feed in South Africa?
A 2018 study found that only 34% of companies interviewed were implementing the Code of Good Practice on the Protection of Employees during Pregnancy and after the Birth of a Child. This code exists in our labour law to enable new mothers returning to work to continue breast-feeding their child by allowing them to take two 30-minute breaks a day to express breast milk or breast-feed their baby. Unfortunately, few employers in South Africa are even aware of this code.
A 2016 paper in the South African Health Review reports that although most women initiate breast-feeding shortly after birth, there is little community-based support once they are discharged from hospital to assist new mothers when they encounter difficulties such as cracked nipples or the baby securing a good latch to adequately drink. These conditions make it difficult for women to sustain breast-feeding, even if they had initially hoped to.
And then there is public stigma. Media reports of women being shamed and pressured to cover up when breast-feeding in public spaces such as malls and restaurants, are not uncommon. Too many women are reduced to having to breast-feed their babies in toilets when frequenting public spaces.
Considering that breast milk is nature’s superfood when it comes to brain development, good health and nutrition — it contains a variety of nutrients and proteins as well as growth factors and hormones that are vital to healthy growth and general wellbeing — and considering that research has shown that babies who are exclusively breast-fed perform better in intelligence tests as children and teens and have higher IQs in adulthood compared to babies who were not exclusively breast-fed, we as a country should be doing more to enable exclusive breast-feeding in our homes, neighbourhoods and workplaces.
This year’s World Breast-feeding Week theme is Protect Breast-feeding: A Shared Responsibility. If we wish to be a breast-feeding nation, that sets children on a path to future health and wealth, then we all need to play our part in ensuring that our partners, sisters, nieces, neighbours, employees are supported to exclusively breast-feed. There is a role for each of us. As a father, you can feed baby expressed breast-milk from time to time to give the mother a rest. As a family member you can create an enabling environment in your home for those who are breast-feeding, ensure they are well fed and hydrated and reduce their share of household chores. As an employer you can ensure your workplace environment is supportive and enabling by creating a safe and private space for staff members returning to work after maternity leave to breast-feed or express milk. As a religious leader, you can ensure that your place of gathering is where breast-feeding mothers are welcomed and celebrated and free to breast-feed in a manner that is most comfortable for them.
This breast-feeding week, let’s not ask why mothers do not breast-feed, but how we can do more to make it possible.