IRIN is reporting that the South African government has agreed to promote a policy of exclusive breastfeeding and stop providing free infant formula. Despite the odd reporting timing (I'm pretty sure we had this conversation in SA about 6 months ago), this is a definite win for babies in South Africa and frankly, about time too. South Africa is one of the only countries where infant mortality rates are rising. It is also a country with a particularly low rate of exclusive breastfeeding, with many women preferring formula or mixed feeding. The research is clear: exclusive breastfeeding is better for the survival and health of the baby, even when the mother is HIV positive. Good to see South Africa recognising that.
Sadly, and unsurprisingly, it's not that cut and dried. While incentivising exclusive breastfeeding, or at least removing some of the disincentives, is good, what happens in the meantime to the grandmothers who are left to look after very young babies when their daughters go off to seek work in the city or become ill? These women often live in remote, rural areas and rely on that formula. Exclusive breastfeeding ties the mother to the baby. The migrant nature of much of South Africa's labour, coupled with the extended and scattered family structures, does not lend itself to this.
Also, if (as the article suggests) one of the disincentives to the use of exclusive breastfeeding is the quality and quantity of care received by new mothers in government health facilities, change is going to take quite a lot more than a policy announcement.