unsuitable breastmilk substitutes

Breastfeeding is the best feeding method for infants. Breastfeeding should be actively promoted, encouraged and protected at all times.

Products that are marketed as suitable to partially or in full replace breast milk are considered a breast milk substitute. Moms should be encouraged to exclusively breastfeed for the first 4-6 months of their baby’s life and thereafter as long as possible.

If a mom is unable to breastfeed because she has to go back to work, then only appropriate breastmilk substitutes should be considered.  Proper breastmilk substitutes are milk formulas that are regulated, quality-controlled and researched to ensure they meet a baby’s nutritional needs and are not harmful.

Many mothers in South Africa don’t realise they are feeding their babies inappropriate foods which could harm their babies, says dietician, Claire Jusling-Strydom.

“Anything that replaces breastmilk is considered a breastmilk substitute and moms should be encouraged to exclusively breastfeed for the first 6 months of their baby’s life and thereafter as long as possible, whilst introducing appropriate complementary foods,” she says.

But she says even if moms do breastfeed in the first months of their baby’s life, many introduce inappropriate foods too early and this can have devastating impacts on a baby’s health.

Unsuitable foods within the first six months of life include cow’s milk; porridge; : cereals; tea (which includes herbal teas); mageu; sour milk; coffee creamer; rooibos; condensed milk; mealie meal pap; fizzy drinks (or any other type of cold drink); squashes; toast; eggs; and long life or Ultra High Temperature (UHT) milk.

“The damage these products can do to a growing baby can have long-lasting developmental effects,” says dietician with a special interest in paediatrics, Kath Megaw.  “Breastmilk is a baby’s primary source of nutrition during the first six months and a critical source for the next six months.  In fact, breastmilk still provides calcium and good protein up to the age of about two years old.”

Kath Megaw says it is important that mothers understand the difference between complementing and substituting breastmilk.

“Complementary feeding means solid or semi-solid foods that add to the nutrition of the baby’s diet and breastmilk substitutes constitute milk/food (other than breastmilk) that will be given in place of breastmilk,” adds Megaw.  “Moms can either give partial substitutes or full substitutes.

Infant formula has been developed to mimic the results of breastfeeding as closely as possible and is formulated with babies’ specific growing and digestive needs in mind.

“Babies are not mini-adults, they have a unique physiology and require specific nutrients in specific quantities,” explains Megaw.  “Milk products that are not formulated for their special needs can be potentially harmful to the baby.”

For example, cows’ milk and goats’ milk are high in sodium and this can strain babies’ maturing kidneys.  Goats’ milk does not have sufficient Vitamin B12 and a baby fed this, can develop iron deficiency.

Megaw says if a mom is unable to breastfeed – for example, because she has to go back to work, then appropriate breastmilk substitutes are infant formula that are regulated, quality-controlled and researched to ensure they meet a baby’s needs and are not harmful.

Once baby is older than 6 months moms can also improve the quality of the solid foods by adding protein rich foods to porridge such as beans and eggs” says Megaw.

Babies between 6-9 months old should be having between 600-900ml of milk per day or 4-5 breastfeeds, while between 9-12 months this decreases to 500-700ml per day or 3-4 breastfeeds.  Between 1-2 years babies should be getting about 400-500ml of milk a day.

“A good way to find out if your baby is getting enough of the right nutrition is to weigh them regularly and chart their progress,” adds Jusling-Strydom.

She warns that even when breastfeeding rates are high, children can still suffer from malnutrition from the age of 6 months, especially when the complementary foods are not nutrient and energy dense.

In a further drive to promote breastfeeding up to 36 months of age, the Department of Health recently published draft regulations on Foodstuffs for Infants and Young Children.  This promotes exclusive breastfeeding for the first six months of life; and aims to regulate the use of complementary foods and devices introduced after six months.

“It’s so important that mothers are empowered to make the right decisions about their children’s nutrition,” says Jusling-Strydom. “Policies which promote breastfeeding are successful in that they enable children to start life with a healthy nutritional base, however, the high prevalence of stunting in some countries highlights the importance of education and awareness around adequate complementary foods as the child are weaned off breast milk.”