he time came to return to work. “I was lucky that I lived close to where I worked so I could drive home to feed him and rush back to work,” she says. Later she switched to expressing milk, which she conserved in bottles, but had to go into the company boardroom to do this in private. Deidre Zimri, operations manager for a transport company, did her expressing in the waiting room when no one was using it. Both Banzi and Zimri felt that four months’ maternity leave was not enough.
Louise Goosen, a breastfeeding consultant at Mowbray Maternity Hospital in Cape Town, says that “going back to work” is one of the most common reasons for stopping breastfeeding. But even for mothers who don’t have to juggle paid work while caring for their babies, switching to formula is a huge temptation simply because it is thought to be convenient. But even for mothers who don’t have to juggle paid work while caring for their babies, switching to formula is a huge temptation simply because it is thought to be convenient. “However we need to encourage and educate mums on the ease and importance of expressing their breast milk to give to baby while mum is at work so that baby can still get the best nutrition,” Goosen explains.
So what can be done to make it easier for women to choose the breastfeeding option? The government needs to convince industry to make it easy for mothers to carry on breastfeeding after returning to work, says Lulama Sigasana, a nutritionist working at Ikamva Labantu, a South African non-profit organization based in Cape Town. She also believes that mothers should be provided with space and time to express milk in private at work. She says the government could do more to communicate the message that breastfeeding is good. “There are already some [campaigns]” she says, noting the Baby Friendly Hospital Initiative and World Breastfeeding Awareness week, held every August, but we need more programmes to boost breastfeeding uptake and continuation.
Sigasana thinks breastfeeding advocacy should also be directed to the people who may influence a woman’s decision to breastfeed, i.e. her partner and extended family. “In most households, what grandmother says goes,” she says. “If she says the mother must breastfeed, she feels she has no choice, but if she says formula, then formula it is. It’s no use educating mothers only. There need to be nationwide campaigns aimed at everyone.”
Coutsoudis agrees, saying advocacy programmes should be extended to society as a whole so that breastfeeding can again become the “natural way to feed a baby.” And it doesn’t help when many health workers are so quick to advise formula feeding, says Coutsoudis: “The representatives from formula companies visit [health workers] often, build good relationships, and market their products.”
Without their active support, how quickly can attitudes really change? One thing is certain: health professionals will be more likely to support the underlying message if they have a basic understanding of current research. As Sigasana puts it: “We need to make sure that people who interact with mothers are giving out the correct information.” ■