World Breastfeeding Week is celebrated every year in more than 120 countries from 1-7 August, and aims to highlight the huge benefits that breastfeeding brings to the health of both babies and mothers. The World Alliance for Breastfeeding Action (WABA) organises the event and collaborates with the World Health Organisation (WHO) and The United Nations Children’s Fund (UNICEF) to ensure that aid is provided to deserving communities.  World Breastfeeding Week has the dual purpose of improving and protecting the health of infants, while supporting the rights of women to breastfeed anywhere and at any time.

South Africa has one of the lowest breastfeeding rates on the African continent. Approximately 67% of infants initiate breastfeeding within one hour of birth, however only 32% are exclusively breastfed with a mean exclusive duration of 2.9 months. Breast milk contains important nutrients, immunological properties and other bioactive substances that are important for an infant’s growth, health and development. Additionally, breastfeeding reduces the risk of infectious diseases and obesity while promoting cognitive development in children. Women who breastfeed have a reduced risk of developing chronic diseases such as hypertension, type 2 diabetes and cancer. The WHO and UNICEF recommend exclusive breastfeeding of infants from birth to 6 months, followed by initiation of complimentary foods with continued breastfeeding for two years. The South African National Department of Health has embraced the WHO guidelines and recommends that all women exclusively breastfeed their babies regardless of their HIV status. The Department of Health has discouraged the distribution of formula milk at public health facilities except for medical reasons. In 2016, Health Minister Aaron Motsoaledi set a target for South Africa of at least 50% of mothers breastfeeding for at least six months after the infant is born. If children are breastfed according to WHO guidance, approximately 600 000 lives could be saved globally each year; the majority being children under the age of six months who die ofdiarrhoea , pneumonia, and malnutrition.

Despite the numerous benefits on human health, lactating mothers in South Africa are often required to overcome numerous barriers to initiate and sustain breastfeeding. In higher-income societies, there is still considerable cultural stigmatisation of the practice of breastfeeding. Other factors such as the belief that formula feeding is more convenient and socially acceptable, and that women’s bodies are inadequate and cannot produce sufficient volume and/quality milk have been identified as barriers. A study evaluating factors impeding excusive breastfeeding practices in a low-income area in the Western Cape identified seven themes during data analysis:¹

1. The perception that infants needed water, gripe water and Lennon’s Behoedmiddel

2.  The concern that milk alone does not satisfy an infant

3. Inadequate infant feeding education and support by the health system

4.  The lack of community-based postnatal support

5. Convention and family influence

6.  Mothers separated from their infants

7.  Local beliefs about maternal behavior and breastfeeding.

There is a growing body of evidence that barriers to breastfeeding can be overcome if adequate attention and resources are implemented.  Hospitals should create an environment in which breastfeeding can thrive. Skin-to-skin contact, immediately after birth, and early initiation of exclusive breastfeeding sets up a good foundation for breastfeeding success. Workplace policies are important for overcoming structural barriers. South Africa’s Code of Good Practice on the Protection of Employees during Pregnancy and After the Birth of a Child secures breastfeeding breaks of 30 minutes twice per day each working day for the first six months of a child’s life. Beyond six months, breastfeeding women should engage their employers to arrange support for breastfeeding.

Breastfeeding provides an important mechanism to promote the health of infants, mothers and communities worldwide. Multiple role-players such as policymakers, healthcare providers and community members need to work together to create an environment that facilitates and supports breastfeeding worldwide.