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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

Hearing loss a silent public health crisis in South Africa

2017-03-27

Dr Magteld Smith engages on the topic of hearing loss
and how it coincides with the commemoration of
World Hearing awareness during the month of March.
Photo: Oteng Mpete

Communication is a principal challenge for people with hearing loss. It can be difficult to negotiate everyday interactions, whether in the workplace, on the street, in classrooms, courts, during consultations with health professionals, or even when contacting the police. The World Health Organisation’s (WHO) World Hearing Day is an annual advocacy event held each year on 3 March to raise awareness and promote ear and hearing care across the world. In many countries this awareness campaign usually starts on 3 March but many continue to create awareness for the full month of March.

Hearing loss is a global reality
According to Dr Magteld Smith, a researcher at the University of the Free State (UFS) School of Medicine’s Department of Otorhinolaryngology, unaddressed hearing loss poses a high cost for the economy globally and has a significant impact on the lives of those affected. Interventions to address hearing loss are available in South Africa but are not accessible or affordable for most citizens. This is partly because not only persons with hearing loss but also people with disabilities experience barriers in accessing services that many of us take for granted, including health, education, employment, and transport as well as information. These difficulties are exacerbated in less-advantaged communities.

“WHO estimates that there are more than 360 million persons with hearing loss globally. The statistics in South Africa are unreliable due to the different definitions used by Statistics South Africa and the absence of training of the officials who conduct and collect statistics concerning hearing loss in South Africa,” says Dr Smith.

According to Dr Smith, analysis from retrospective studies reflects that about 17 out of 1 000 infants are born daily in South Africa with severe to profound hearing loss. However, Dr Smith states that the number could be higher because of late diagnosis, high levels of undiagnosed and untreated hearing loss. This excludes young adults, adults and the elderly as well as children with acquired (become deaf after birth) hearing loss.

Crisis that needs urgent intervention
Dr Smith says hearing loss is an emergency which the South African government fails to prioritise. She says that research published confirms that the risk compounding the projected increase in hearing loss that comes with an ageing population. This is a looming and silent public-health crisis.
She believes that the government should take urgent action to align research-spending with the current and projected size and impact of hearing loss. It should also collaborate across related conditions, such as vision, neurodegenerative diseases and neurological conditions. Furthermore, the government needs, and is obligated, to deliver more accessible and integrated services and develop quality standards that take account of the whole pathway – linking public health, clinical and social needs.

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