Breastfeeding is vital for providing every child with the healthiest start to life. It is a baby’s first “vaccine” and is the best source of nutrition. It bolsters brain development and reduces mortality – globally, it is projected that breastfeeding can save up to 520,000 children’s lives in the next 10 years. In low- and middle-income countries, improved rates of exclusive breastfeeding will increase children’s chances of survival and their cognitive capability, thus enabling more children to be economically productive as adults.

This year’s theme for World Breastfeeding Week is Sustaining Breastfeeding Together, because all of us – governments, decision-makers, development partners, professional bodies, academia, media, advocates and other stakeholders — must work together to strengthen existing partnerships and forge new ways to invest in and support breastfeeding for a more sustainable future.

In a joint message for Breastfeeding Week, Unicef Executive Director Anthony Lake and the WHO Director-General Tedros Adhanom Ghebreyesus emphasised the benefits of breastfeeding for improving national economies, by helping lower health care costs, increase educational attainment and ultimately boost productivity. Breastfeeding is one of the most effective investments a country can make. Every dollar invested in supporting breastfeeding generates an estimated $35.00 in economic returns across lower and middle-income countries. By contrast, low breastfeeding rates translate into billions of dollars’ worth of lost productivity and health care costs to treat preventable illnesses and chronic diseases.

The good news is that the recently completed South African Demographic and Health Survey (2016) found a significant improvement in exclusive breastfeeding rates, from 8% in 2003 to the current 32%. This is a notable achievement for the country and is a significant step towards reaching the World Health Assembly (WHA) target of 50% by 2025.

As a country we need to continue with our efforts to ensure that more babies are exclusively breastfed for the first six months of life, with no other food, other liquids, or even water. Optimal breastfeeding practices also include initiation of breastfeeding within an hour after birth and continued breastfeeding until two years of age and beyond.

As part of the Global Breastfeeding Collective, Unicef has called for increased financing and better implementation of policies, programmes and interventions to provide mothers the support they need to breastfeed. To achieve these goals, Unicef and the Global Breastfeeding Collective recommend seven steps for the global community to consider:

• Increase funding for breastfeeding by at least $570-million a year in order to raise the rate of mothers who breastfeed their babies exclusively for six months to at least 50%.
• Fully implement the International Code of Marketing of Breast milk Substitutes and relevant World Health Assembly resolutions through strong legal measures that are enforced and independently monitored.
• Enact family leave and workplace breastfeeding policies that build on the International Labour Organisation’s maternity protection guidelines, which include the informal employment sector.
• Implement the Ten Steps to Successful Breastfeeding in maternity facilities, including providing breast milk for sick and vulnerable newborns.
• Improve access to skilled breastfeeding counselling as part of comprehensive breastfeeding policies and programmes in health facilities.
• Strengthen links between health facilities and communities, and encourage community networks that protect, promote, and support breastfeeding.
• Strengthen monitoring systems that track the progress towards achieving both national and global breastfeeding targets.

In South Africa progress on these seven recommendations have been made, which were part of the 2011 Tshwane declaration, to protect, promote and support breastfeeding. The South African government adopted the regulations to foodstuffs for infants and young children R991 in 2015; which means the marketing of breast milk substitutes has been highly regulated in South Africa. Yet mothers may still be exposed to marketing by breast milk substitute manufacturers’ direct or indirect promotion strategies. A mother should be allowed to objectively decide how she would like to feed her child and have available to her the benefits of human breast milk while also fully understanding the risks associated with giving her child breast milk substitutes.

Other initiatives adopted by South Africa, include the implementation of the Mother Baby Friendly Initiative with 70% of public health facilities participating. Human milk banks have been established in some hospitals to provide breast milk to high-risk infants. Use of local youth peer-educators to support teenage breastfeeding mothers is another initiative that is showing promising results. In Limpopo, initiatives have included training for community health workers and involving men and grandparents in breastfeeding promotion, acknowledging that women with support are more likely to breastfeed their children.

There is no doubt that breastfeeding provides the best start in life. Know your role in protecting, promoting and supporting breastfeeding and support a breastfeeding mother to exclusively breastfeed her baby for six months and beyond. DM

Dr Yogan Pillay is currently employed as Deputy Director General: HIV/AIDS, TB and Maternal, Child and Women’s Health in the National Department of Health