Hello Fay
Thank you, and all who wrote, for your kind words. I'm a tiny cog in this
lovely milk bank, living far away as I do, but I forwarded your comments and
we all appreciated your enthusiasm for our work
In South Africa, there are still pockets of badness regarding breastfeeding,
and pockets of goodness and niceness :-) Mostly lip service bordering on
ignorance. There is certainly a strong *government* promotion of
breastfeeding. In fact, I should have been arriving in Johannesburg in this
past hour for a National Breastfeeding Consultative meeting, but sadly it
was postponed on Friday till September.
It is going to be an exciting meeting, involving civic society as well as
government officials, and I hope we will be able to build on the policies of
BFHI, and breastfeeding promotion to all with antiretrovirals for the HIV+
mothers as in the new Western Cape protocols. We are also hoping that more
breastfeeding training will be incorporated into medical and nursing
schools, and more IBCLCs will be employed in hospitals - "we" being the
IBCLCs, who have to put ourselves on stage as major players, not just the
anonymous chorus line.
I'm not sure how BFHI operates in the rest of the world, but our policy
incorporates an extra 3 steps above the 10 Steps.....Mother-Friendly care;
the Code of Marketing of Breast Milk Substitutes and subsequent, relevant
WHA resolutions; and issues around HIV+ mothers.
A fact that astounded me when I heard it on radio the other day is that
South Africa (with a fairly low uptake of treatment; we were celebrating an
unprecedented 80% of uptake in our province) uses 25% of the world's
antiretroviral drugs. HIV lives with us; it was the reason why we started
the milk bank, which is an irony in that so many milk banks globally were
closing at the time because of HIV.
We quickly realised that a healthy HIV-affected-but-not-infected baby (ie
AIDS orphan) would use more milk than is sustainable, and so now we are
supplying mostly the state hospitals for the most needy of premature babies.
We don't get to choose, of course; the doctors prescribe and we supply what
we can. In almost all cases the mothers will be providing some milk if they
are not too ill, and the policy is to get them fully breastfeeding their own
babies as soon as possible.
The private hospitals do not "allow" breastfeeding yet, as far as I know. I
recall a premature baby boy at my local hospital who was fully supplied for
some weeks with donor milk until he went home with his HIV+ mother, and then
he went on to formula. But he was gorgeous when I saw him at his later
check ups. It was a touching time because his mother somehow was not always
able to be there in NICU, but the local donors would come and visit, and
seeing 'their' baby kept them supplying milk beyond the normal period. None
of them were very copious donors, but they soldiered on because they
believed that Baby M needed them.
There is something about milk banking that I find so very emotive. We have
to be hard-headed about screening forms and tests and hospitals paying for
milk, but underneath all that is a strong bond (in our committee certainly)
that we simply have to keep on doing this because it's RIGHT. And the donor
mothers seem to feel it even more strongly.
Best wishes to all for this lovely week.
Jacquie Nutt IBCLC
Milk Matters
www.milkmatters.org
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