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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

Mathematical methods used to detect and classify breast cancer masses
2016-08-10

Description: Breast lesions Tags: Breast lesions

Examples of Acho’s breast mass
segmentation identification

Breast cancer is the leading cause of female mortality in developing countries. According to the World Health Organization (WHO), the low survival rates in developing countries are mainly due to the lack of early detection and adequate diagnosis programs.

Seeing the picture more clearly

Susan Acho from the University of the Free State’s Department of Medical Physics, breast cancer research focuses on using mathematical methods to delineate and classify breast masses. Advancements in medical research have led to remarkable progress in breast cancer detection, however, according to Acho, the methods of diagnosis currently available commercially, lack a detailed finesse in accurately identifying the boundaries of breast mass lesions.

Inspiration drawn from pioneer

Drawing inspiration from the Mammography Computer Aided Diagnosis Development and Implementation (CAADI) project, which was the brainchild Prof William Rae, Head of the department of Medical Physics, Acho’s MMedSc thesis titled ‘Segmentation and Quantitative Characterisation of Breast Masses Imaged using Digital Mammography’ investigates classical segmentation algorithms, texture features and classification of breast masses in mammography. It is a rare research topic in South Africa.

 Characterisation of breast masses, involves delineating and analysing the breast mass region on a mammogram in order to determine its shape, margin and texture composition. Computer-aided diagnosis (CAD) program detects the outline of the mass lesion, and uses this information together with its texture features to determine the clinical traits of the mass. CAD programs mark suspicious areas for second look or areas on a mammogram that the radiologist might have overlooked. It can act as an independent double reader of a mammogram in institutions where there is a shortage of trained mammogram readers. 

Light at the end of the tunnel

Breast cancer is one of the most common malignancies among females in South Africa. “The challenge is being able to apply these mathematical methods in the medical field to help find solutions to specific medical problems, and that’s what I hope my research will do,” she says.

By using mathematics, physics and digital imaging to understand breast masses on mammograms, her research bridges the gap between these fields to provide algorithms which are applicable in medical image interpretation.

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