Breastfeeding: crucially important, but increasingly challenged in market-driven world, February 2023, Lancet series

‘Breastfeeding is a mother’s gift to herself, her baby, and the earth.’- Pamela K. Wiggins, lactation consultant and author.

Breastmilk is unique. Dubbed the Golden Liquid in the health world. Breastmilk is dynamic, adaptive, and unique to the mother, infant, stage of growth, and health status. It literally adapts and evolves to ensure optimal growth of the infant and numerous studies over the years have proven this. The WHO aims to have 70% of infants exclusive breastfeeding by 2030 but why when formula milk is so readily available?

Breastfeeding promotes bonding between mom and baby, healthy brain development as well as reducing the susceptibility of diarrhoeal and respiratory diseases in the baby.

Breastfeeding helps protect your baby from these diseases in several ways:

1.    Adapts when the mom’s body realizes there is an infection.

2.    Transfers immune bodies to the baby via the breastmilk.

3.    Traditionally cleaner than bottle feeding, no formula and bottles mean no need for sterile cleaning conditions.

 But for moms, it also helps to protect them from chronic diseases such as:

1.    Certain types of cancer i.e. breast and ovarian.

2.    Cardiovascular disease.

3.    Diabetes mellitus type 2.

But there are more benefits for both moms and baby, including these 4:

1.    Cost-effective

2.    Increased or promoted bonding between mom and baby.

3.    Helps to regulate baby’s appetite and sleep schedule.

4.    Helps mom to lose additional weight she might have gained.

Being a new mother, irrespective of whether it is the first, second or fourth, can be stressful. Worrying about whether the milk has been mixed correctly; if it is the correct temperature; if it is mixed correctly are some more things to worry about when formula feeding.

The World Health Organization (WHO) as well as South African regulations recommends exclusive breastfeeding (only giving the baby breastmilk and when needed, medication) for 6 months, followed by breastfeeding and complementary feeding. But the milk formula industry is a multi-billion-dollar industry that can afford to spend millions on marketing formula milk on various platforms.

There are many key barriers that do not support breastfeeding in multiple ways and on various levels; these include 7:

1.    Income growth and urbanization: As people migrate towards cities, and receive income increases, somehow the concept of breastfeeding is seen as ‘old ways’ or ‘for poor people’.

2.    Labour markets that poorly accommodate women report rights and care. Paid maternity leave vs unpaid maternity leave. Some countries don’t even have maternity leave.

3.    Poor health care that continues to undermine breastfeeding: i.e. not encouraging kangaroo care, allowing mom and baby to sleep in the same room.

4.    Mental health- Postpartum depression is a thing! The inability to emotionally connect to your infant does negatively affect your ability to produce BM.

5.    Mom’s perception of not producing enough milk- known as SRIM (self-reported insufficient milk). Not producing enough milk is rarely the case.

6.    Personal history, this is specifically for moms who couldn’t breastfeed with previous babies, or who suffered from things breast-related problems (engorgement, cracking, bleeding).

7.    Misunderstanding/miseducation- Especially with regards to HIV. In South Africa, HIV-positive moms are still advised to exclusively breastfeed if they are compliant with their ARVs.

So, in a world with so many barriers, encourage moms to breastfeed wherever and whenever baby wants to. It may be something small to you, but to that mom and baby, it may help them choose the breast for the rest of their infant journey.

Shelldon Athena Breda, registered dietitian, M.Sc.