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Protect breastfeeding – A shared responsibility

05 August 2021 | Story Dr Chantell Witten | Photo Supplied

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

The state of HIV/AIDS at the UFS

2010-05-11

“The University of the Free State (UFS) remains concerned about the threat of HIV/AIDS and will not become complacent in its efforts to combat HIV/AIDS by preventing new infections”, states Ms Estelle Heideman, Manager of the Kovsies HIV/AIDS Centre at the UFS.

She was responding to the results of a study that was done at Higher Education Institutions (HEIs) in 2008. The survey was initiated by Higher Education AIDS (HEAIDS) to establish the knowledge, attitudes, behaviours and practices (KABP) related to HIV and AIDS and to measure the HIV prevalence levels among staff and students. The primary aim of this research was to develop estimates for the sector.

The study populations consisted of students and employees from 21 HEIs in South Africa where contact teaching occurs. For the purpose of the cross-sectional study an ‘anonymous HIV survey with informed consent’ was used. The study comprised an HIV prevalence study, KABP survey, a qualitative study, and a risk assessment.

Each HEI was stratified by campus and faculty, whereupon clusters of students and staff were randomly selected. Self-administered questionnaires were used to obtain demographic, socio-economic and behavioural data. The HIV status of participants was determined by laboratory testing of dry blood spots obtained by finger pricks. The qualitative study consisted of focus group discussions and key informant interviews at each HEI.

Ethical approval was provided by the UFS Ethics Committee. Participation in all research was voluntary and written informed consent was obtained from all participants. Fieldwork for the study was conducted between September 2008 and February 2009.

A total of 1 004 people participated at the UFS, including the Main and the Qwaqwa campuses, comprising 659 students, 85 academic staff and 256 administration/service staff. The overall response rate was 75,6%.

The main findings of the study were:

HIV prevalence among students was 3,5%, 0% among academics, 1,3% among administrative staff, and 12,4% among service staff. “This might not be a true reflection of the actual prevalence of HIV at the UFS, as the sample was relatively small,” said Heideman. However, she went on to say that if we really want to show our commitment towards fighting this disease at our institution a number of problem areas should be addressed:

Around half of all students under the age of 20 have had sex before and this increased to almost three-quarters of students older than 20.
The majority of staff and a third of students had ever been tested for HIV.
More than 50% of students drink more than once per week and 44% of students reported being drunk in the past month. Qualitative data suggests that binge drinking over weekends and at campus ‘bashes’ is an area of concern.

Recommendations of the study:

Emphasis should be on increased knowledge of sexual risk behaviours, in particular those involving a high turnover of sexual partners and multiple sexual partnerships. Among students, emphasis should further be placed on staying HIV negative throughout university study.
The distribution of condoms on all campuses should be expanded, systematised and monitored. If resistance is encountered, attempts should be made to engage and educate dissenting institutional members about the importance of condom use in HIV prevention.
The relationship between alcohol misuse and pregnancy, sexually transmitted infections (STIs), HIV and AIDS needs to be made known, and there should be a drive to curb high levels of student drinking, promote non-alcohol oriented forms of recreation, and improve regulation of alcohol consumption at university-sponsored “bashes”.
There is need to reach out to students and staff who have undergone HIV testing and who know their HIV status, but do not access or benefit from support services. Because many HIV-positive students and staff are not receiving any kind of support, resources should be directed towards the development of HIV care services, including support groups.

Says Heideman, “If we really want to prove that we are serious about an HIV/AIDS-free campus, these results are a good starting point. It definitely provides us with a strong basis from which to work.” Since the study was done in 2008 the UFS has committed itself to a more comprehensive response to HIV/AIDS. The current proposed ‘HIV/AIDS Institutional response and strategic plan’, builds and expands on work that has been done before, the lessons learned from previous interventions, and a thorough study of good practices at other universities.

Media Release
Issued by: Mangaliso Radebe
Assistant Director: Media Liaison
Tel: 051 401 2828
Cell: 078 460 3320
E-mail: radebemt@ufs.ac.za
10 May 2010

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