“This baby is getting hungry and not getting enough food! She’s always crying because you’re not giving her food so that she can grow well!”  These words rang in the ears of first-time mom Thandi Mhlanga as she prepared soft porridge to feed her three-week-old baby. 

Mhlanga was diagnosed with diabetes during her first pregnancy. Filled with anxiety about managing the illness, she did not prepare for breastfeeding and all its potential challenges. 

“I also started mixing this with formula milk and feeding the baby these two things at the same time. I became scared that I’m not giving my baby enough food and that she would go hungry like my mother said,” she recalls.

But at six months old her baby would often get the flu and her recovery was lengthy. “She would recover for about one or two weeks and then the flu would come back. I had to go to the clinic very frequently because of this,” she says. 

Breastfeeding and healthy growth

Mhlanga is from Nkomazi in the Ehlanzeni district in Mpumalanga. The community stunting profile shows that only 23% of these children are exclusively breastfed. Exclusive breastfeeding means feeding your baby breast milk only and not any other foods or liquids (including formula and water). 

A recent survey by Grow Great in the district which also covered Bushbuckridge, Mbombela, and Thaba Chweu area, identified stunting, acute malnutrition, wasted, and underweight children as concerned. 17% of children under the age of five years old were stunted. 

Grow Great’s Flourish is trying to teach mothers in the area how to prepare for, feed and take care of their babies. It has six hosts in different parts of the Ehlanzeni district who hold antenatal and postnatal care classes for mothers. They hope to end stunting by 2030 through breastfeeding promotion and healthy feeding practices. 

Zinhle Ngwenya, Manager and Trainer of the hosts says many mothers opt for formula feeding even though they are unemployed and can’t afford it. This is because they don’t know enough about breastfeeding. 

“When I started in 2018, most moms did not believe that a baby would not go hungry if you breastfeed exclusively,” she says. 

Formula vs breastfeeding

She says women who opt to feed formula but can’t afford it, end up mix-feeding by adding other ingredients like Weetbix, or soft porridge. Or they add more water and less formula. Some end up feeding the baby solid food before they are six months old. The babies are left underfed and lacking in nutrition.

Ngwenya says the classes help the mother unlearn these feeding practices and the lessons their mother taught them about infant care.

“It seems as though stunting is generational because moms do what they have seen or what they were told by their mothers, grandmothers, and other elders. We talk and share about different experiences and what they did for each mom. They learn how to introduce healthy food to the baby. We offer support for the babies that mothers lack in their immediate environment.”

Mhlanga, now a mother of two, is an example of this. She joined Flourish during her second pregnancy. 

“Attending the classes helped me understand that diabetes does not stop you from breastfeeding. I breastfed exclusively for six months and only introduced solids afterwards. With this baby, I was not at the clinic frequently for flu or other complications. I believe breastfeeding was the best I could’ve done for him.”

Low breastfeeding numbers 

Although South Africa’s exclusive breastfeeding rate grew from 10.2% to 23.8% in 2017 it still has one of the lowest rates in Africa. 

Staša Jordan, the Founder and Executive Director of the South African Breastmilk Reserve, blames these low numbers on high rates of severe infection, the critically understaffed public health system and the high number of caesarean (C-section) births. 27% of births in South Africa’s public health facilities are C-section births.

Jordan says after a C-section mothers and babies can be separated for about six hours during the recovery process. While vaginal births encourage early initiation of breastfeeding through skin-to-skin contact which takes place within an hour from birth. 

“Where we do not have enough nurses to assist mothers, one on one support for mothers in the postnatal ward is lacking. What they do to minimise the risk is they have to first have to bath the baby then they top up the baby with formula milk,” she says.

Helping others on their breastfeeding journey

Mhlanga’s experience inspired her to become a Flourish host. She has hosted classes since November 2020 where she shares her experiences with those who need support.  

Ngwenya shares the advice that she’s taught and gathered from mothers in her experience as a Flourish host.

• Breast milk is the first choice for feeding because it is a powerful source of nutrition and immunity.
• If you opt for formula make sure you can afford it, follow the feeding instructions exactly the way they are written on the packaging, and keep all containers clean with regular washing.
• When a baby is between zero to six months old they only need breastmilk. Introduce solids like mashed fruit, vegetables, and soft porridge after six months.
• Stick to one way of feeding and do not mix feed because this can cause multiple infections. 
• Take them to the clinic for their regular check-ups, deworming, and immunisations.  – Health-e News