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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

Emotional health of vulnerable children needs urgent intervention

2014-02-04

In South Africa, thousands of children under the age of 18 are orphaned as a result of HIV/Aids. Experts are worried that these orphans and vulnerable children will experience serious socio-emotional problems and behaviour disorders, should urgent intervention programmes not be implemented urgently.

A study was undertaken by the Centre for Development Support at the UFS, in conjunction with Stellenbosch University and the Houston University in America. The research found that in the Free State province alone, about 15% of orphans and vulnerable children showed signs of psychiatric disorders. Almost half of the children in the study showed signs of abnormal or maladjusted behavioural functioning.

The research team believes that the South African government and the numerous non-governmental organisations put too much emphasis on the physical needs of orphaned and vulnerable children and that their socio-emotional or mental wellbeing receives very little attention.

The nominal financial grant is a welcome relief for some of the needs of this risk group. Researchers are worried, though, that the lack of reliable and culturally-sensitive diagnostic methods for the early detection of psychiatric disorders may pose a challenge when the children reach puberty.

The current study is focusing on the detection of emotional behavioural problems even before adolescence. Questionnaires were distributed across the Free State at clinics, schools and non-governmental organisations dealing with these children. The questionnaires enabled researchers to establish the children's socio-emotional needs.

"Overcrowding in houses where orphans and vulnerable children often live is directly linked to poor socio-emotional health in children," says Prof Lochner Marais from the Centre for Development Support. "The state institutions offering programmes for orphans and vulnerable children overemphasise the physical and/or financial needs of these children. The programme provides, for example, food for the children, grants for the [foster] parents, assistance with school clothes and ensures clinic visits for the children. Of these, only the supply of food has a direct impact on the improved mental health of children."

The study provides, for the first time, a profile of the state of mind of this group, as well as the emotional impact of HIV/Aids – an "urgent matter" according to Dr Carla Sharp from the University of Houston's Department of Psychology. According to Dr Sharp, much more could be done to assist foster parents in addressing the emotional needs of these children. The early detection of behavioural disorders should be the key in intervention programmes.

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