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05 August 2021 | Story Dr Chantell Witten | Photo Supplied
Dr Chantell Witten is from the Division of Health Professions Education at the University of the Free State (UFS) and she believes there can be no greater dividend than to invest in optimal nutrition for infants and children. They are the future

Opinion article by Dr Chantell Witten, Division of Health Professions Education, University of the Free State.


World Breastfeeding Week is celebrated every year from 1-7 August. In South Africa, it coincides with Women’s Month and gives us the opportunity to reflect on how far we have come and how far we still have to go to achieve gender equity in different spheres of life. Even more reason for us in the academic sphere to stop and think about the areas of support that may still need attention and effort to correct.

In the context of protecting breastfeeding this would speak to the Code of Good Conduct in the Labour Act which affords pregnant and breastfeeding women protection and support. In extreme cases it means protection from exposure to hazardous substances, but in the general setting of the work environment this relates to workplace support for a private and safe place to express breastmilk. One institution made headlines when a staff member was secretly videoed while she was expressing breastmilk. What is also needed is to put in place a policy that guides on how university property such as a fridge may or may not be used to store expressed breastmilk, or how to deal with a manager who insists on holding meetings in a woman’s scheduled milk-expressing time slots. The law may indicate that you are entitled to two 30-minute time slots to express but it is quite another issue to get your colleagues to accommodate or respect your biological needs.

Protecting breastfeeding 

Besides the protection of employees, the government in its commitment to improve child health and nutrition has committed to protect breastfeeding from the undue influence of the infant-formula industry by implementing the recommendations of the International Code for the Marketing of Breastmilk Substitutes. South Africa approved the Regulations Relating to Foodstuff for Infants and Young Children (R991) to control the marketing and promotion of infant formula by limiting how the product may be marketed and how the industry may engage with the public and child health and development professionals, in particular. 

While many are aware of the prohibition to advertise or to promote and distribute free or incentivised sales of infant formula, many may not be aware of the limitations placed on academics and researchers. The academic and research fraternity has had a long and conflicted relationship and history with the infant-formula industry. Many departments and individual researchers have received funding, conference sponsorship and gifts from the infant-formula industry. In the early 2000s at the height of the HIV epidemic, the Department of Health recommended that women living with HIV should not breastfeed and instead provided six months of free formula milk, inadvertently implying that health professionals approved of infant formula. While the national Department of Health has since stopped the distribution of free infant formula through the programme for the prevention of mother-to-child transmission of HIV (PMTCT) from 2011, many health professionals trained in the early years continue giving mixed messages to mothers and display limited skills to promote and support breastfeeding.

So how do we protect breastfeeding in the academic setting? 
As more women enter academia, managers and the institutional leadership need to be cognisant and purposeful in developing a breastfeeding culture by granting women the protections afforded them by the Labour Law. Furthermore, in all spheres of academia and research, and as an institution, we need to guard against conflict of interest and conflicted relationships with the infant-formula industry. We need to do due diligence by raising the awareness of R991. All child health and development professionals should be acquainted with R991 through their curricula, and we should individually and collectively be accountable in our conduct to protect, promote and support breastfeeding as a human right, an investment in health and development, and for a sustainable future. There can be no greater dividend than to invest in optimal nutrition for infants and our children. They are the future.  

News Archive

Early nutrition impacts on burden of disease
2017-11-15


 Description: Corinna Walsh read more Tags: Corinna Walsh read more

Prof Corinna Walsh during her inaugural lecture on ‘Nutrition in Transition’.
Photo: Stephen Collett 

“The first 1 000 days, from conception to two years, is a critical time to ensure that the early environment is optimal to guarantee the best outcomes,” Prof Corinna Walsh, Professor in the Department of Nutrition and Dietetics at the University of Free State (UFS), said. She delivered her inaugural lecture on Nutrition in Transition on 30 October 2017. 

During her lecture, Prof Walsh explained how an unfavourable early environment impacts on the health and well-being of both children and adults. She gave an overview of the prevalence of hunger and food insecurity in the Free State, and described the shift that has occurred from healthier traditional diets to more unhealthy Western diets accompanied by sedentary lifestyles. These patterns are closely linked to the triple burden of malnutrition, including undernutrition, micro-nutrient malnutrition, and obesity. Finally, Prof Walsh highlighted the double burden of disease, focusing on chronic lifestyle diseases on the one hand, and infectious diseases such as HIV/AIDS and TB on the other hand.

“Preparing for this lecture has given me the opportunity to reflect on the almost thirty years of my research journey, a process that I thoroughly enjoyed,” said Prof Walsh.

“It was a privilege to share the work of my research team with fellow colleagues as well as with family and friends,” she said. Prof Walsh is a National Research Foundation C-rated researcher and also served on the Board of the Medical Research Council from 2005 to 2010.

Foundations for health, growth established early
The first 1 000-day window focuses on the time between conception and the second birthday. “This is a critical period for growth and development,” Prof Walsh said. It is a unique period, as the foundations for health, growth, and neuro-development are established. It also focused on the implications of malnutrition, which is the biggest risk factor contributing to the global burden of disease.


Research identifies burden of disease
Her research has made a considerable contribution to identifying the burden of disease in the Free State. “It focuses on both malnutrition and infectious diseases such as HIV and TB on the one hand, and chronic lifestyle diseases such as obesity, diabetes, and hypertension on the other,” she said. The research team have also implemented a number of interventions to address these challenges, including programmes that have assessed the impact of nutrition-education programmes, household food gardens, and nutrition supplementation.

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