Breastfeeding is widely endorsed as the best strategy for feeding newborns and young infants and is one of the most powerful tools we have to tackle child mortality. According to the medical journal, the Lancet, suboptimum breastfeeding results in more than 800, 000 child deaths annually. If we can ensure that every newborn is given breast milk immediately after birth and is fed only breast milk for the first six months of life, we can greatly increase the chance that they will survive and go on to fulfil their potential. Around one in eight of the young lives lost each year could be prevented through breastfeeding, 2 making it the most effective way to prevent diseases and malnutrition that can cause avoidable child deaths. Promotion of breastfeeding also has a vital role in the reduction of non-communicable diseases later in life.
Breastfeeding is often undervalued. Global rates of exclusive breastfeeding have remained below 40% for the past 20 years as breastfeeding has slipped down the list of political priorities. South Africa has one of the lowest rates of exclusive breastfeeding in Africa with only 28% of children exclusively breastfed at 6 weeks of age. This needs to change!
Overcoming the barriers to breastfeeding
So what needs to happen? We must ensure that women have the support they need to breastfeed and overcome the main barriers preventing them from doing so. Those barriers include inadequate support to new mothers so that they can develop the skills and confidence to breastfeed, a lack of appropriate care and support for pregnant women and lactating mothers in the workplace, and commercial, community and cultural practices which often encourage early introduction of other fluids (especially formula milk) and foods.
Tackling these barriers demands a new and concerted effort from many different groups of people, including governments, local communities and businesses. For example, governments and local communities need to take action to empower women to make their own decisions about breastfeeding, governments need to invest in strengthening health systems to support early and exclusive breastfeeding, and introduce nationwide breastfeeding-friendly policies and legislation, including maternity leave policies that enable exclusive breastfeeding in the first six months. Finally, businesses need to act responsibly, and governments need to ensure that national regulation of breast milk substitutes is strengthened and enforced.
Recent progress at home
In South Africa, we have seen recent progress. In 2011, the Department of Health, after a national consultation decided to actively promote, protect and support exclusive breastfeeding as a key public health intervention as reflected in the Tshwane Declaration. We have since taken action to demonstrate this. Last year we committed to end the provision of free formula milk at hospitals and clinics except if prescribed by a medical doctor, and also to promote the exclusive breastfeeding strategy for all children from birth to six months, including for those living with HIV. The 2013 Infant and Young Child Feeding Policy reinforces these commitments and aligns efforts to support breastfeeding.
Those are great steps forward and we need to build on those efforts to ensure that as many South African newly born children as possible receive breast milk for at least 6 months after birth.
This week is World Breastfeeding Week, which each year presents a key opportunity to put the spotlight on the importance that breastfeeding has for saving children's lives. But this can't just be a one-week effort, we need sustained political action all year round to promote this vital lifesaving tool. This week, African leaders have the opportunity to show their commitment to doing so when they meet at the International Conference on MNCH in Africa in Johannesburg to discuss how to improve health outcomes for women and babies. Breastfeeding, and the actions needed to increase this practice, must be an important part of their discussions. With enough will and commitment, we have the opportunity to ensure that every child has the best chance to fulfil their potential.
Dr. Yogan Pillay is the Deputy Director General for HIV/AIDS, TB and MCWH at the department of health and Pam Innes is the CEO of Save the Children South Africa
Yogan Pillay is the country director, South Africa and senior global director, Universal Health Coverage at the Clinton Health Access Initiative, and the national health department’s former deputy director general for communicable and noncommunicable diseases. Follow him on Twitter @ygpillay.