‘Heads, you use our formula, Tails, you use our formula’

Today, breastfeeding rates remain much lower than in the mid-20th century. This was when the creation and advertising formula milk intensified. When the formula milk business boomed round about then, continuously increasing, especially in highly populated lower-middle-income and upper-middle-income countries such as South Africa.

But why? Because massive companies such as Nestle, Nan, and Alpha can spend billions on marketing, often shamelessly, exploiting the anxieties of parents. Let's throw some inadequate support for breastfeeding in healthcare systems, work settings and households.

Questions to ask yourself:

1.    Does my place of work provide a safe, clean space to express breastmilk?

2.    Is this space private?

3.    Is there a fridge where the expressed breastmilk can be stored?

4.    Is expression time solely during lunch breaks?

Currently, about half a billion mothers are denied adequate maternity protection- protection from losing their job due to pregnancy, paid maternity leave, a safe space to express and store breastmilk). By displacing breastfeeding, as a biopsychosocial system of nutrition and nurture with commercial supply chains across populations, companies based in Europe and America now have the entire world to market to. Instead of only spreading among the wealthier consumers in urban areas, they can now sell their products in poorer countries and communities.

Another way is by expanding the perceived boundaries of diet-related requirements. Initially just for 0-6 months, there are now so many different products available all announcing their superiority over one another and traditional foods. There are even formula milk for children 3 years and older.

Did you know that depending on the country, infants may be weaned onto solid foods from 4-6 months old? In South Africa, the guideline is 6 months. By 1 year, ‘eating out of the pot’ is what we advise, this means that your child should be eating everything that the rest of the family cooks. This means that there is no need for any additional supplemental drinks.

Unfortunately, money talks, formula companies have billions to invest in marketing, and lobbying against breastfeeding protecting laws and regulations. Funding CPD (continuing professional development) activities, corporate gifts, even donating formula samples to hospitals and clinics in impoverished communities. In some countries, they even provide formula milk for free once you have given birth.

According to the World Health Organization only 79 countries prohibit the promotion of breast-milk substitutes in health facilities. Only 51 have laws prohibiting the distribution of free or low-cost infant formula supplies within the health care system.

In practice, we dietitians are even ethically advised not to use branded pens and notepads because they could give a subliminal impression to expectant, anxious and other parents. Some of these companies even give healthcare providers lavish gifts like overseas holidays, cars etc. It is the same principle as when you buy someone supper and drinks, there is usually a non-verbal expectation of return and unfortunately most governments don’t have the man-power or funds to combat this level of spending.

So how do we improve the breastfeeding numbers in the world?

We support women who breastfeed. Mom’s who breastfeed and work, are doing what is known as care work which are any tasks which are typically gendered to females and have tasks such as cleaning, cooking, childcare. We support them on small, medium and large scales.

• Small scale:  by being supportive partners and friends. By cooking meals while they wash the kids, by helping out with homework. By not making a fuss when you see a woman breastfeeding her child in public.

• Medium scale: providing a safe place to breastfeed whilst at work. Providing a place to store expressed breastmilk and give them enough time to express and enjoy lunch. Advocating for

• Large scale: Continuing to advocate for breastfeeding in hospitals and clinics by ALL healthcare providers (nurses, dietitians and doctors). Have governments actively promote and or even fund (where possible) family friendly work environments and provide paid maternity leave, recommendation by the experts is 18 weeks at full compensation instead of the current average of 14 weeks at two thirds which most countries recommend.

Ladies, if you have children, did you breastfeed them? What was your experience?

Gentlemen, what did you do to make things lighter, easier and less stressful for your partner?

Until next time, your virtual registered dietitian

Shelldon Athena Breda