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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

Cardiology Unit involved in evaluation of drug for rare genetic disease

2013-01-04

Front from the left, are: Marinda Karsten (study coordinator and registered nurse),
Laumarie de Wet (clinical technologist), Charmaine Krahenbuhl (study coordinator and radiographer),
Lorinda de Meyer (administrator), Andonia Page (study coordinator and enrolled nurse);
back Dr Gideon Visagie (sub investigator), Dr Derick Aucamp (sub investigagtor),
Prof. Hennie Theron, (principal investigator) and Dr Wilhelm Herbst (sub investigator).
Photo: Supplied
09 January 2013

The Cardiology Research Unit at the University of the Free State (UFS) contributed largely to the evaluation of the drug Juxtapid (lomitapide), which was developed by the Aegerion pharmaceutical company and approved by the FDA (Federal Drug Administration). Together with countries such as die USA, Canada and Italy, the UFS’ Unit recruited and evaluated the most patients (5 of 29) for the study since 2008.

The drug was evaluated in persons with so-called familial homozygous hypercholesterolemia (HoFH).

Following its approval by the FDA, Juxtapid is now a new treatment option for patients suffering from HoFH. The drug operates in a unique way which brings about dramatic improvements in cholesterol counts.

According to Prof. Hennie Theron, Associate Professor in the Department of Cardiology at the UFS and Head of the Cardiology Contract Research Unit, HoFH is a serious, rare genetic disease which affects the function of the receptor responsible for the removal of low-density lipoprotein cholesterol (LDL-C) (“bad” cholesterol) from the body. Damage to the LDL receptor function leads to extremely high levels of blood cholesterol. HoFH patients often develop premature and progressive atherosclerosis, which is a narrowing or blockage of the arteries.

“HoFH is a genetically transmitted disease and the most severe form of hypercholesterolemia. Patients often need a coronary artery bypass or/and aortic valve replacement before the age of 20. Mortality is extremely high and death often occurs before the third decade of life. Existing conventional cholesterol-lowering medication is unsuccessful in achieving normal target cholesterol values in this group of patients.

“The only modality for treatment is plasmapheresis (similar to dialysis in patients with renal failure). Even with this type of therapy the results are relatively unsatisfactory because it is very expensive and the plasmapheresis has to be performed on a regular basis.

“The drug Juxtapid, as currently evaluated, has led to a dramatic reduction in cholesterol values and normal values were achieved in several people. No existing drug is nearly as effective.

“The drug represents a breakthrough in the treatment of familial homozygous hypercholesterolemia. The fact that it has been approved by the FDA, gives further impetus to the findings,” says Prof. Theron.

In future further evaluation will be performed in other forms of hypocholesterolemia.

According to Prof. Theron, the findings of the study, as well as the recent successful FDA evaluation, once again confirms the fact that the UFS’ Cardiology Contract Research Unit is doing outstanding work.

Since its inception in 1992, the Unit has already been involved in more than 60 multi-centre, international phase 2 and 3 drug studies. Several of these studies, including the abovementioned study, really affected the way in which cardiology functions.

The UFS’ Cardiology Contract Research Unit is being recognised nationally and internationally for its high quality of work and is constantly approached for their involvement in new studies.

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