by Pindelwa Mda, Nutrition Division, Nestlé S.A.

I am a South African and a mother who breast fed her son until 12 months of age.

I have been a manager with Nestlé for over 5 years and am currently an infant food marketing director at our headquarters in Switzerland. Part of my job involves making sure that we follow the WHO Code in our marketing materials and practices. Since I have lived nearly all my life in South Africa, I have strong feelings about the topic of motherhood and infant feeding in my country as well as in other parts of Africa, having also worked for Nestlé in Ghana.

What I read in Europe often has little to do with the reality of what African women face on a daily basis in trying to do the best for their children. I refer here not only to professional women, like myself, but also to the women of the villages where I grew up. I have thus written these personal views on Infant Feeding in South Africa.

Mothers in Rural South Africa

In rural South Africa, women largely depend on income from their husbands who often work in big cities and mines. In most communities, there is no running water except for water from streams, windmills and tanks where people store rainwater. Many people live far from clinics and hospitals - I used to live in a rural community where the nearest clinic was 8km away and the nearest hospital was 34km away. There was only one bus a day to the clinic and there was no guarantee that you would get to see a doctor on that day. Most women preferred to get advice from community elders - mothers and grandmothers who had been through child birth and infant feeding.

Even though some rural mothers are illiterate, they are intelligent enough to know that breastfeeding is the best way to feed a baby and that it costs nothing. If for any reason a mother cannot breast-feed (as it is sometimes the case), alternatives are found. For mothers with very limited income, infant formula is not even a consideration. Mothers use alternatives such as fresh cow's milk, rooibos (bush tea), maize-meal porridge and samp water (water drained from cooked, crushed corn). Whether these are the best alternatives to breast-milk is questionable, but they are used out of necessity and are introduced immediately the mother's milk is insufficient or unavailable.

Mothers in Urban South Africa

Urban life has different complications. The legacy of apartheid is that most black South Africans live in townships far away from the cities. A number of non-professional women work as domestic servants in white homes and as factory labourers. They are sometimes the sole breadwinners in the family. For them to be on duty by 7 or 7.30 a.m., it means leaving their homes around 4 a.m. Infants are often left in the care of their grandmothers, other family members, neighbours or childminders.

Many of these women do not get any maternity leave. If they go on leave, they have to bring a relative or friend to stand in for them until they come back otherwise they risk losing their jobs. To secure their employment, they go back to work shortly after giving birth. Even though some mothers express breast-milk to be fed to their babies during the day, differences in traditions and customs mean that some people do not feel comfortable handling other women's breast-milk.

Professional women, who have to juggle between being career women and mothers, generally still need the services of childminders. Most companies do not have nurseries in work places so that mothers can bring in their babies and breast-feed if they choose to. In addition, some well-educated professional women simply can not breast-feed, whether because of inverted nipples, not having enough milk, stress or other reasons. They will often choose infant formula instead of the alternatives commonly used in rural areas.

Self-determination for African Women

African women are still battling to satisfy their basic physiological needs like food and shelter. We are battling with unemployment, poverty, polio, malaria, HIV and AIDS. Solutions will involve choice and self-determination for African women, rather than instructions from the West.

The same is true of infant feeding. It is about education and information rather than right or wrong. For many South African women, breastfeeding is simply not an option, whether because of working hours, contagious diseases or other medical reasons. Such women need to know about alternatives - illiteracy and poverty does not mean we are incapable of using our brains or our maternal instincts. South African women do want information and education, but we also want the final choice to be ours.