Breastfeeding: South Africa's key to nutritional equality
South Africa is known for its stark social and economic divides and this inequality is evident in the nutritional status of many of our children.
Despite the significant benefits of breastfeeding, South Africa’s exclusive breastfeeding rates remain worryingly low. This disparity highlights the urgent need to address both the benefits of breastfeeding and the challenges that prevent many families from choosing this optimal path for their children.
Breastfeeding is often hailed as a game-changer for child health. According to the World Health Organization (WHO), breastfeeding exclusively for the first six months is crucial for a baby’s development and survival.
It’s the most effective single intervention to reduce child mortality and improve overall health.
However, in South Africa, only 32% of infants are exclusively breastfed for the recommended period, according to the University of Cape Town’s (UCT) Health Sciences Department.
This statistic is alarming when considering the rising cost of formula milk, which have doubled in volume over the past 20 years. For many families, formula milk - costing between R375 and R561 a month - is simply unaffordable.
With one in three infants living below the food poverty line of R531, this cost is a significant burden.
South Africa has progressive policies and legislation aimed at supporting breastfeeding, yet these are not consistently implemented or enforced.
Even though SA has solid policies in place, the real challenge lies in effective implementation and ensuring that support systems for breastfeeding mothers are robust and accessible.
The lack of widespread support for breastfeeding moms in homes, workplaces, and communities exacerbates the problem. There’s a critical need for a cultural shift to normalise and support breastfeeding across all levels of society.
The benefits are well-documented: improved health for mothers and children, reduced household and national healthcare costs, and better child development.
Why support matters
Breastfeeding isn’t just about feeding a baby; it’s a comprehensive approach to health and well-being.
By supporting breastfeeding, we can:
Improve maternal and child health: Breastfeeding lowers the risk of infections and chronic conditions for both mothers and infants.
Reduce household food costs: Breastfeeding is a cost-effective way to nourish babies, which is vital for families struggling with poverty.
Decrease national healthcare costs: Healthier children mean fewer medical expenses for the healthcare system.
Enhance child development: Breastfeeding supports optimal growth and development during the critical early years.
While some issues are medical and unavoidable, a large number are related to barriers that could be overcome with better support and education.
Tsholofelo Mohloane, a Registered Dietitian and Lactation Consultant with the Association for Dietetics in South Africa (ADSA), offers insight into these challenges.
Mothers often encounter obstacles that hinder their ability to breastfeed effectively. According to Mohloane, who works extensively in public hospitals, many issues are solvable but require proper support to address.
“I frequently see mothers struggling with problems like perceived low milk supply, sore nipples, engorged breasts, and improper breastfeeding positions,” Mohloane explains. “These issues, while challenging, can be managed with the right advice and resources.”
Low milk supply
For mothers who feel they have a low milk supply, increasing the frequency of breastfeeding or pumping can help boost production.
Additionally, staying hydrated and consuming a balanced diet rich in nutrients can support milk production. Consulting with a lactation consultant can provide personalized advice and reassurance.
Sore nipples
Sore nipples are another common issue that can cause significant discomfort for breastfeeding mothers. A proper latch is crucial for preventing and alleviating sore nipples.
The baby’s mouth should cover not only the nipple but also a portion of the areola.
To address sore nipples, mothers can ensure that the baby is latching on correctly and experiment with different breastfeeding positions. Applying lanolin cream or using nipple shields can also provide relief.
Engorged breasts
Engorged breasts occur when the breasts become overly full with milk, leading to discomfort and sometimes difficulty with breastfeeding. This condition is particularly common in the early days after childbirth when milk comes in.
Engorgement can be managed by breastfeeding frequently and ensuring that the baby empties the breasts as much as possible. Hand expression or pumping can also help relieve pressure.
Applying warm compresses before breastfeeding and cold packs afterwards can alleviate discomfort. Additionally, wearing a well-fitting, supportive bra can help manage engorgement.
Improper breastfeeding positions
Improper breastfeeding positions can lead to various issues, including sore nipples and ineffective milk transfer. Finding a comfortable and effective breastfeeding position is essential for both mother and baby.
Positions like the cradle hold, cross-cradle hold, and football hold can each offer different benefits.
Experimenting with different positions can help mothers find what works best for them and their baby. Using pillows for support can make breastfeeding more comfortable and help achieve a better latch.
Professor Lisanne du Plessis from Stellenbosch University, an expert in Public Health and Community Nutrition, underscores the importance of offering practical support rather than pushing for commercial milk formula as a quick fix.
She advises, “Before encouraging a mother to switch to formula, we should consider how we can help her overcome breastfeeding challenges. Providing the right support can help her continue to nourish her baby in the best possible way.”