Hostname: page-component-cd9895bd7-q99xh Total loading time: 0 Render date: 2024-12-23T01:38:40.809Z Has data issue: false hasContentIssue false
  • English
  • Français

Breast-feeding in sub-Saharan Africa: outlook for 2000

Published online by Cambridge University Press:  02 January 2007

Alexander RP Walker  and
Fatima I Adam
Alexander RP Walker*
Affiliation:
Human Biochemistry Research Unit, School of Pathology of the University of the Witwatersrand, and the South African Institute for Medical Research, PO Box 1038, Johannesburg 2000, South Africa
Fatima I Adam
Affiliation:
Human Biochemistry Research Unit, School of Pathology of the University of the Witwatersrand, and the South African Institute for Medical Research, PO Box 1038, Johannesburg 2000, South Africa
*
*Corresponding author: Email [email protected]
Rights & Permissions [Opens in a new window]

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.

The World Health Organization (WHO) has stressed that 1.5 million infants die annually, unnecessarily, from deprival or from insufficiency of breast milk. Hence, the need for its maximal use, very particularly in impoverished populations, such as those in sub-Saharan Africa. In many developed populations, a generation ago the practice was very low, but now it has risen considerably. In contrast, in Africa and in most developing populations, despite the far greater need for breast-feeding, the practice is tending to decrease, especially among urban mothers. While the most common reasons given concern insufficiency of breast milk and employment of mothers, the latter, especially urban mothers, are under strong and increasing pressure to use proprietary replacement foods. These are often made up unsatisfactorily and are contaminated. Also influential are the often less than enthusiastic, and confusing, attitudes of staff at clinics and hospitals, albeit, due in part to their very heavy workloads. Additionally, there is societyp's relatively indifferent attitude to breast-feeding. Currently, a hugely adverse factor is the danger of human immunodeficiency virus (HIV) transference from seropositive mothers to their infants – in some African countries almost half of antenatal mothers are infected. Chances of early control of the infection are remote. However, apart from this danger, and from the pressure from replacement food companies, the outlook for breast-feeding practice in many African countries is unlikely to improve significantly until greater encouragement is given from State, local and other health authorities.

Keywords

Breast-feeding benefitsDeveloped populationsAfrican populationsBreast milk substitutesHIV
Type
Research Article
Information
Public Health Nutrition , Volume 3 , Issue 3 , September 2000 , pp. 285 - 292
Copyright
Copyright © CABI Publishing 2000

References

1Costello, A, Sachdev, HS. Protecting breast feeding from breast milk substitutes. BMJ 1998; 316: 1103–4.CrossRefGoogle ScholarPubMed
2World Health Organization. Infant and Young Child Nutrition. Geneva: WHO, 1993.Google Scholar
3Golding, J, Emmett, P, Rogers, IS. Breast feeding and infant mortality. Early Hum. Develop. 1997; 49 (Suppl.): S143–55.Google Scholar
4Hendershot, GE. Trends in breastfeeding. Pediatrics 1984; 74 (Suppl.): 591–602.Google Scholar
5Faber, M, Oelofse, A, Kriek, JA, Benadé, AJS. Breastfeeding and complementary feeding practices in a low socioeconomic urban and low socioeconomic rural area. South Afr. J. Food Sci. Nutr. 1998; 9: 200–8.Google Scholar
6Moodley, J, Saitowitz, R, Linley, L.A review of the literature on breast-feeding – policy and research issues. S. Afr. Med. J. 1999; 89: 681–7.Google Scholar
7Jelliffe, DB, Jelliffe, EFP. ‘Breast is best‘: modern meanings. N. Engl. J. Med. 1977; 297: 912–5.CrossRefGoogle ScholarPubMed
8Cuthbertson, WFJ. Evolution of infant nutrition. Br. J. Nutr. 1999; 81: 359–71.CrossRefGoogle ScholarPubMed
9Plank, SJ, Milanesi, ML. Infant feeding and infant mortality in rural Chile. Bull. World Health Organ. 1973; 48: 203–10.Google ScholarPubMed
10Bwibo, NO. Breastfeeding: past, present and future. East Afr. Med. J. 1995; 72: 145–6.Google ScholarPubMed
11Jackson, R. Doctors and Diseases in the Roman Empire. London: British Museum Press, 1988; 86–111.Google Scholar
12Department of Health and Social Security. Present-Day Practice in Infant Feeding. Department of Health and Social Security Report on Health and Social Subjects No. 9. London: Her Majesty's Stationery Office, 1974; 38.Google Scholar
13Fomon, SJ. Reflections on infant feeding in the 1970s and 1980s. Am. J. Clin. Nutr. 1987; 46 (Suppl. 1): 171–82.CrossRefGoogle Scholar
14Richardson, BD. Breast versus bottle feeding. S. Afr. Med. J. 1978; 53: 1010.Google ScholarPubMed
15Leary, PM. Infant feeding today. S. Afr. Med. J. 1976; 50: 1271–2.Google Scholar
16Ryan, AS, Rush, D, Krieger, FW, Lewandowski, GE. Recent declines in breast-feeding in the United States, 1984 through 1989. Pediatrics 1991; 88: 719–27.CrossRefGoogle ScholarPubMed
17Vestermark, V, Hogdall, CK, Plenov, G, Birch, M, Toftager-Larsen, K.The duration of breast-feeding. A longitudinal prospective study in Denmark. Scand. J. Soc. Med. 1991; 19: 105–9.CrossRefGoogle ScholarPubMed
18Cadwell, K.Reaching the goals of ‘Healthy People 2000‘ regarding breastfeeding. Clin. Perinatol. 1999; 26: 527–37.CrossRefGoogle ScholarPubMed
19Wylie, J, Verber, I.Why women fail to breast-feed: a prospective study from booking to 28 days post-partum. J. Hum. Nutr. Diet. 1994; 7: 115–20.Google Scholar
20Gelfand, M. Medicine in Tropical Africa. Edinburgh: E & S Livingstone, 1961; 114–5.Google Scholar
21Walker, ARP. Infant feeding practices in South Africa. S. Afr. Med. J. 1978; 54: 820–2.Google Scholar
22Watson, AR. Breast versus bottle feeding. S. Afr. Med. J. 1978; 54: 118.Google Scholar
23Population Reference Bureau. Breastfeeding Patterns in the Developing World. Washington, DC: United States Agency for International Development, 1999.Google Scholar
24Perez-Escamilla, R.Update on the breastfeeding situation in Africa. Nutr. Res. 1993; 13: 597–609.Google Scholar
25Jooste, PL, Langenhoven, ML, Kriek, JA, Kunneke, E, Nyaphisi, M, Sharp, B.Nutritional status of rural children in the Lesotho Highlands. East Afr. Med. J. 1997; 74: 680–9.Google ScholarPubMed
26Steyn, NP, Badenhorst, CJ, Nel, JH, Ladzani, R.Breast-feeding and weaning practices of Pedi mothers and the dietary intakes of their preschool children. S. Afr. J. Food Sci. Nutr. 1993; 5(1): 10–3.Google Scholar
27Roberts, GJ, Cleaton-Jones, PE, Richardson, BD, Sinwell, RE, Lucas, VS. Breast and bottle feeding in rural and urban South African children. J. Hum. Nutr. Diet. 1995; 8: 255–63.CrossRefGoogle Scholar
28Delport, SD, Becker, PJ, Bergh, A.Growth feeding practices and infections in Black infants. S. Afr. Med. J. 1997; 87: 57–61.Google ScholarPubMed
29Bamisaiye, A, Oyediran, MA. Breast-feeding among female employees at a major health institute in Lagos, Nigeria. Soc. Sci. Med. 1983; 17: 1867–71.CrossRefGoogle Scholar
30Ighogboja, IS, Odumodu, CU, Olarewaju, RS. Breastfeeding pattern in Jos, Nigeria, before baby friendly hospital initiative. J. Trop. Pediatr. 1996; 42: 178–9.Google Scholar
31El Bushra, HM, Salih, MA, Satti, SA, el F Ahmed, M, Kamil, IA. Infant-feeding practices in urban and rural communities of the Sudan. Trop. Geogr. Med. 1994; 46: 309–12.Google Scholar
32Ibrahim, MM, Persson, LA, Omar, MM, Wall, S.Breast feeding and the dietary habits of children in rural Somalia. Acta Paediatr. 1992; 81: 480–3.Google Scholar
33Franklin, RR, Bertrand, WE, Mock, NB, Nkamany, K, McCaw, A.Feeding patterns of infants and young children in Kinshasa, Zaire. J. Trop. Pediatr. 1993; 29: 255–9.Google Scholar
34Izatt, SD. Breastfeeding counseling by health care providers. J. Hum. Lact. 1997; 13: 109–13.CrossRefGoogle ScholarPubMed
35Abels, J.Breast-feeding. BMJ 1949; 1: 154.Google Scholar
36Antonov, AN. Children born during the siege of Leningrad in 1942. J. Pediatr. 1947; 30: 250–9.CrossRefGoogle ScholarPubMed
37Smith, CA. Effects of maternal undernutrition upon the newborn infant in Holland (1944–1945). J. Pediatr. 1947; 30: 229–43.Google Scholar
38Williams, CD. Nutritional conditions among women and children in internment in the civilian camp at Singapore. Proc. Nutr. Soc. 1946; 5: 127–33.Google Scholar
39WHO Expert Committee. Nutrition in Pregnancy and Lactation. Technical Report Series No. 302. Geneva: World Health Organization, 1965.Google Scholar
40Vogel, AM, Mitchell, EA. The establishment and duration of breastfeeding. Part 1: hospital influences. Breastfeed. Rev. 1998; 6: 5–9.Google Scholar
41Pantazi, M, Jaeger, MC, Lawson, M.Staff support for mothers to provide breast milk in pediatric hospitals and neonatal units. J. Hum. Lact. 1998; 14: 291–6.CrossRefGoogle ScholarPubMed
42Bella, H.Are health workers adequately trained to manage and promote breastfeeding? Saudi Med. J. 1998; 19: 441–5.Google ScholarPubMed
43Trowell, HC. Non-Infective Disease in Africa. London: Edward Arnold, 1960; 327–31.Google Scholar
44Jelliffe, DB, Jelliffe, EFP. The uniqueness of human milk. An overview. Am. J. Clin. Nutr. 1971; 24: 1013–7.CrossRefGoogle ScholarPubMed
45Power, DJ, Willoughby, W, de Waal, RH. Breastfeeding in Cape Town. S. Afr. Med. J. 1979; 56: 718–21.Google Scholar
46Maasdorp, J, Loenig, W.Are breast-feeding problems iatrogenic? S. Afr. Med. J. 1989; 77: 397.Google Scholar
47Health Systems Trust. South African Health Review. Durban, South Africa: Health Systems Trust, 1997; 209–10.Google Scholar
48Annotation. War on baby foods. Lancet 1974; i: 719–20.Google Scholar
49Leading article. The infant-food industry. Lancet 1976; ii, 503.Google Scholar
50WHO/UNICEF. The WHO/UNICEF International Code of Marketing of Breastmilk Substitutes. Geneva: World Health Organization, 1981.Google Scholar
51Simini, B.Breast-milk-substitute business booms in Italy. Lancet 1999; 353: 1077.CrossRefGoogle Scholar
52Perera, T.National code of marketing of formula milks is not properly enforced in Sri Lanka. BMJ 1999; 318: 1140.CrossRefGoogle Scholar
53Taylor, A.Violations of the international code of marketing of breast milk substitutes: prevalence in four countries. BMJ 1998; 316: 1117–22.Google Scholar
54Molbak, K, Gottschau, A, Aabyy, O, Hojlyng, N, Ingholt, L, da Silva, AP. Prolonged breastfeeding, diarrhoeal disease, and survival of children in Guinea-Bissau. BMJ 1994; 308: 1403–6.CrossRefGoogle ScholarPubMed
55Department of National Health. South African Code of Ethics for the Marketing of Breast Milk Substitutes. Pretoria: DNHPD, 1986.Google Scholar
56Waterlow, JC, Thomson, AM. Observations on the adequacy of breastfeeding. Lancet 1979; ii: 238–42.Google Scholar
57Victora, CG, Vaughan, JP, Martines, JC, Baecelos, LB. Is prolonged breast-feeding associated with malnutrition? Am. J. Clin. Nutr. 1984; 39: 307–14.Google ScholarPubMed
58Fawzi, WW, Herrera, MG, Nestel, P, el Amin, A, Mohamed, KA. A longitudinal study of prolonged breastfeeding in relation to child malnutrition. Int. J. Epidemiol. 1998; 27: 255–60.CrossRefGoogle Scholar
59Simondon, KB, Simondon, F.Mothers prolong breastfeeding of undernourished children in rural Senegal. Int. J. Epidemiol. 1998; 27: 490–4.Google Scholar
60Cousens, S, Nacro, B, Curtis, V, et al. Prolonged breast-feeding: no association with increased risk of clinical malnutrition in young children in Burkina Faso. Bull. World Health Organ. 1993; 71: 713–22.Google ScholarPubMed
61Prentice, A.Extended breast-feeding and growth in rural China. Nutr. Rev. 1994; 52: 144–6.Google Scholar
62Nduati, R.Breastfeeding: a complex intervention in the 21st century. East Afr. Med. J. 1998; 75: 441–2.Google Scholar
63Wilkinson, D, Floyd, K, Gilks, CF. Antiretroviral drugs as a public health intervention for pregnant HIV-infected women in rural South Africa: an issue of cost-effectiveness and capacity. AIDS 1998; 12: 1675–82.Google Scholar
64Amanor Wilks, D.Zimbabwe attempts to prevent health crisis. Lancet 1996; 347: 609.CrossRefGoogle Scholar
65Working Group on Mother-to-Child Transmission of HIV. Rates of mother-to-child transmission of HIV-1 in Africa, America and Europe: results from 13 perinatal studies. J. Acquir. Immune Defic. Syndr. Hum. Retrovirol. 1995; 8: 506–10.CrossRefGoogle Scholar
66Bobat, R, Coovadia, H, Moodley, D, Coutsoudis, A.Mortality in a cohort of children born to HIV-1 infected women from Durban, South Africa. S. Afr. Med. J. 1999; 89: 646–8.Google Scholar
67World Health Organization. Consensus Statement from the WHO/UNICEF Consultation on HIV Transmission and Breastfeeding. Geneva: Global Programme on AIDS, 1992.Google Scholar
68Kuhn, L, Mathews, C, Fransman, D, Dikweni, L, Hussey, G.Child feeding practices of HIV-positive mothers in Cape Town, South Africa. AIDS 1999; 13: 144–6.Google ScholarPubMed
69Shaffer, N, Chuachoowong, R, Mock, PA, et al. Short-course zidovudine for perinatal HIV-1 transmission in Bangkok, Thailand: a randomised controlled trial. Lancet 1999; 353: 773–80.Google Scholar
70Dabis, F, Msellati, P, Meda, N, et al. Six-month efficacy, tolerance and acceptability of a short regimen of oral zidovudine to reduce vertical transmission of HIV in breastfed children in Côte d'Ivoire and Burkina Faso: a double-blind placebo-controlled multicentre trial. Lancet 1999; 353: 786–92.Google Scholar
71Wilkinson, D, Karim, SSA, Coovadia, HM. Short course antiretroviral regimens to reduce maternal transmission of HIV. BMJ 1999; 318: 479–80.Google Scholar
72World Bank. World Development Report, 1993 – Investing in Health. New York: Oxford University Press, 1993.Google Scholar
73Söderlund, N, Zwi, K, Kinghorn, A, Gray, G.Prevention of vertical transmission of HIV: analysis of cost effectiveness of options available in South Africa. BMJ 1999; 318: 1650–6.Google Scholar
74Kinghorn, AW. Projections of the Costs of Anti-Retroviral Infections to Reduce Mother-to-Child Transmission of HIV in the South African Public Sector. HIV Management Services Technical Report. Johannesburg: HIV Management Services, 1998.Google Scholar
75Coutsoudis, A, Pillay, K, Spooner, E, et al. Influence of infant-feeding patterns on early mother-to-child transmission of HIV-1 in Durban, South Africa: a prospective cohort study. Lancet 1999; 354: 471–6.CrossRefGoogle ScholarPubMed
76Newell, M-L. Breastfeeding and HIV infection: a global perspective. Hosp. Med. 1999; 60: 778–9.Google Scholar
77Newell, M-L. Infant feeding and HIV-1 transmission. Lancet 1999; 354: 442–3.Google Scholar
78Editorial. Half the story. HIV may have started there, but Africa shouldn't bear the burden. New Sci. 1999; 161: 3.Google Scholar
79Logie, D.AIDS cuts life expectancy in sub-Saharan Africa by a quarter. BMJ 1999; 319: 806.Google Scholar
80Logie, D.Unexpected always happens. Lancet 1996; 347: 1819–20.Google Scholar
81Medical Officer of Health. Annual Report, Vol. 2. Cape Town: 1996/1997; 2.Google Scholar
82Malik, ANJ, Cutting, WAM. Breast feeding: the baby friendly initiative. BMJ 1998; 316: 1548–9.Google Scholar
83Davies-Adetugbo, AA. Promotion of breast feeding in the community: impact of health educational programme in rural communities in Nigeria. J. Diarrhoeal Dis. Res. 1996; 14: 5–11.Google ScholarPubMed
84Kaufman, JS, Asuzu, MC, Rotimi, CN, Johnson, OO, Owoaje, EE, Cooper, RE. The absence of adult mortality data for sub-Saharan Africa: a practical solution. Bull. World Health Organ. 1997; 75: 389–95.Google Scholar
85News. African research – a key role. Afr. Health 1999; 21: 40.Google Scholar
86Haffejee, IE. Breast-feeding – advantages and methods of promotion. Contin. Med. Edu. 1990; 8: 1072–7.Google Scholar
87Wagstaff, LA, Chimere-Dan, OD, Ramontja, RM. A survey of health issues in a South African urban community – comparing findings from formal and informal dwellers. South Afr. J. Epidemiol. Infect. 1997; 12: 55–60.Google Scholar
88Lamb, WH, Foord, FA, Lamb, CMB, Whitehead, RG. Changes in maternal and child mortality rate in three isolated Gambian villages over 10 years. Lancet 1984; ii, 1819–20.Google Scholar
89Abbasi, K.The World Bank and world health focus on South Asia – II. India and Pakistan. BMJ 1999; 318: 1132–5.Google Scholar
90 Anonymous. Infant mortality – United States, 1992. Morbid. Mortal. Weekly Rep. 1994; 43: 905–9.Google Scholar