South Africa Has The Lowest Rate Of Exclusive Breastfeeding In The World

Dr Scott Drimie is Director of the Southern Africa Food Lab.

Though touted in social media as something of a women’s lib issue; the importance of support for breastfeeding mothers goes far beyond that.

At under 8%, South Africa has the lowest rate of exclusive breastfeeding (EBF) for the first six months in the world. Given that we’re a food insecure nation where stunting is seen in 20-30% of children under the age of five, this 8% stat is at the same time a shocking fact and a glaringly obvious opportunity to improve the lives of millions.

The benefits of breastfeeding are well-documented. From improved immunity, to nutrition, to lowered risk of allergies through to higher IQ scores later in life according to some studies, breastfeeding also improves the mother-child bond, and lowers the risks of diabetes and obesity in infants and certain cancers in both mother and child. In informal settlements, where access to running water is limited, breastfeeding is especially useful in that it negates the need for sterilization of bottles and the costs associated with baby formula.

So why is our incidence of EBF so low? The answer is not simple. In part the challenge lies in social norms which seem to dictate that breastfeeding, and indeed the general care of infants, is the sole responsibility of the mother. But given that the benefits of breastfeeding impact the immediate family (no cost, improved health) and broader society (lower burden on healthcare, better education outcomes, happier employees in the case of breastfeeding mothers who are supported, etc), it stands to reason that broader societal support for breastfeeding should be developed.

One key area where support would be a game changer is the workplace. A leading reason for the early cessation of breastfeeding is the return to work of the mother. For the vast majority, work remains an unsupportive environment for breastfeeding moms.

In 2011 the Health Minister signed the Tshwane Declaration of Support for Breastfeeding in SA. This Declaration indicated a high level of political support for the promotion, protection and support of breastfeeding. The Declaration promised to review legislation regarding maternity leave and a subsequent enabling workplace.

While there has been some progress, to date little attention has been paid to the issue of workplace support for breastfeeding mothers. There are exceptions of course; the Western Cape Government being one of them whereby public health facilities are encouraged to establish comfort rooms for staff members to express milk.

The Western Cape Household Food Security and Nutrition Strategy 2016 states that the WCG will advocate for safer and more appropriate facilities for breastfeeding mothers including “the establishment of breastfeeding-friendly workplaces, including day centres; the establishment of an infant and young child feeding workshop; and the finalization of a policy on milk banking”.

Given that the WCG is a major employer, the implementation of the above is an opportunity to model what tangible and effective support for breastfeeding mothers could look like for other employers. Two examples of employees who could make a significant impact by including a policy on breastfeeding in their codes of good conduct are WIETA (The Wine and Agricultural Ethical Trading Association) and the Women on Farms Project.

The solution goes broader than that, however. As stated above, given that the benefits of breastfeeding are societal, so too should support for breastfeeding be societal. While government institutions should create conducive environments for breastfeeding mothers, so too should both formal and informal workplaces, this includes farms and domestic work situations.