South Africa has one of the lowest breastfeeding rates in the world; only about 8% of women breastfeed their babies. A 2009 study revealed that 62 out of 1,000 South African children had died before reaching the age of five, and this number had not changed since 1999 despite improvements in shelter, water, health, and general living conditions. While most of these children died of respiratory infections, the underlying cause was malnutrition.
Exclusive breastfeeding is the single best way to nourish a child and provide it with immunity, but the culture in South Africa remains focused on mixed feeding. When breast feeding is practiced at all, breast milk is usually combined with formula, tea, and water. However, several initiatives are using new techniques to promote and encourage breastfeeding in the country.
The South African Breastmilk Reserve (SABR) was founded in 2003 to help collect and distribute breast milk to vulnerable infants, and underwent their first donated breastmilk pilot in 2007 at the Netcare Cuyler Hospital. Today, SABR is partnered with the South African Department of Health and Netcare and has 44 milk banks that supply about 100 hospitals across the country.
Potential donors undergo a health screening at a hospital or clinic, and then express their milk into sterile jars. The milk is then sent to central human milk banks to be tested, pasteurized, frozen, and stored. The donated milk is then made available to babies whose mothers have died or who are too ill to breastfeed.
Breastmilk protects babies from both short-term illness and a range of adverse health outcomes throughout their lives. SABR estimates that there are now 2,000 to 3,000 donors nationwide who are donating breastmilk. This past year it fed more than 2,800 babies, and overall has helped save the lives of more than 8,000 infants.
While SABR’s program has been very successful, pasteurizing the donated milk comes with a hefty price tag of about $18,000. That’s why a team of researchers from the University of KwaZulu-Natal, the University of Washington, and the global health organization PATH have created a mobile phone app called FoneAstra. For just $700, FoneAstra uses a probe to monitor when the milk reaches the correct temperature during pasteurization. It then sends text messages to a mobile phone and prints labels confirming the results via Bluetooth.
The FoneAstra monitor won the 2015 GSK and Save the Children’s Healthcare Innovation Award, which aims to help support and scale up innovations that reduce child deaths. The team behind FoneAstra plans to use the award to set up family health posts that will provide donated breast milk, train breastfeeding counsellors, and promote breastfeeding and parenting skills. These counsellors will help to battle misconceptions in South Africa about breastfeeding and demonstrate that it is healthy and safe for infants.
While the number of South African babies in need of breastmilk is still high, both SABR and the creators of FoneAstra are successfully spreading the message encouraging mothers to donate surplus milk. Women like Khanye Nzama in KwaZulu-Natal listened and defied her own family to breastfeed her children. In 2012, she became a regular milk donor because she wanted to make a difference and give something to make the world better.
The simple mission to provide infants in need with safe, pasteurized breastmilk is dramatically improving the chances of survival for South African babies. As new moms are educated about the benefits of breastfeeding, that success will only continue to grow on communities across South Africa.