|
|
Free Formula: A Danger of Disastrous Proportions
Professor Coovadia on the policy of providing free
formula in Africa. For several reasons, providing free formula represents a
serious blow to the battle against HIV/AIDS.
The dangers of breast milk have been exaggerated in the fight against HIV/AIDS according to Professor Coovadia, Head of the Wellcome Trust's Africa Centre in KwaZulu Natal. Professor Coovadia is a prominent leader in the fight against HIV/AIDS and one of the joint winners of the Nelson Mandela Award for Health and Human Rights. "Provisional research suggests that safe breast-feeding may be possible. This challenges established thinking about maternal transmission of the HIV virus and provides hope for the poor whose only realistic option is to breast-feed." On providing free formula he says, "Any policy of providing free formula for mothers at risk of passing HIV to their newborn babies is hazardous." Why?
Studies show that breast milk can provide all the nutrition the baby requires for healthy development within its first 6 months of infancy and that breast milk is best. The practice of mixing breast-feeding with formula feeding is known to be less beneficial to babies than
breast-milk alone (exclusively). Yet, 95% of mothers do. There are other and more significant dangers associated with mixing breast-feeding with formula feeding in Africa, where there is an overwhelming risk of contamination of baby formula from the use of contaminated water, unsterilised bottles, and poor hygiene. It is common knowledge that contaminated bottles causes infections in babies, diarrhoea, pneumonia and in rural Africa,
a cause of a high percentage of infant mortality. Studies in Uganda, Tanzania and Durban show that bottle-feeding results in higher cases of infant mortality than with those solely breast-fed for the first six months of infancy, even if the mother is HIV positive, says Professor Coovadia. Providing free formula then poses some serious dangers.
It destroys the culture of breast-feeding by sending a strong message to all mothers, HIV positive or not, that it is better for the child to be bottle-fed than to be breast-fed. Professor Coovadia believes that by giving free formula we are losing a balance: the balance between breast-feeding and its advantages and the balance between bottle-feeding and its serious disadvantages to the child's health. On formula feeding, the United Nations policy is that the only time when formula feeding is recommended is when the mother is able to obtain formula, when she can safely prepare it hygienically and when she can provide it safely (in sterilised bottles) to her child. A woman who is able to buy her own formula is likely to be economically stable and will have constant access to the facilities required to hygienically and safely bottle-feed her child. These women therefore probably do not require free formula. Disadvantaged and poor women who will not have access to nor the means to continuously prepare and provide for the safe bottle-feeding of her child, are better off breastfeeding exclusively for 6 months and then switching to local and family food.
What exactly is the cost involved in providing free formula to a country such as South Africa? We are looking at a figure of about R50 million Rand. Can this be sustained and maintained for any great length of time? In a continent with a high poverty rate and lack of food, there is always the danger in providing something for free, that it will be abused. For example, what stops a mother from continuing breast-feeding and using the infant formula for consumption?
The established belief is that an HIV positive mother, who breast-feeds her baby, poses a 30% risk of the baby becoming infected too. This may not be true. Professor Coovadia believes that this percentage of risk is inaccurate. It may reflect the risk; say after 2 years of breast-feeding a child. Even after 2 years of breastfeeding, the risk due to
breast-feeding is not 30% but nearer 16%. Research suggests that an HIV positive mother who breast-feeds for the first 6 months presents a risk of between 5% and 8% that the child will become infected with HIV. This figure makes a strong case for breast-feeding where mothers are HIV positive.
Consider the following for rural Africa:
- A high mortality rate associated with babies at risk of infection from contaminated bottles
- A healthier baby when breast-fed solely for the first 6 months of its infancy
- A small risk (between 5% and 8%) that the baby may contract HIV from its infected mother through breast-feeding.
Professor Coovadia thus believes that the risks of providing free baby formula far outweighs the risks of sole breast-feeding amongst HIV positive mothers in rural Africa.
Providing free baby formula will compromise the policy of breast-feeding in HIV positive mothers as well as those who are
not. Considering the high mortality rates, a policy to provide free formula is not only dangerous, but one that makes very little sense. "It is a danger of disastrous proportions for any developing nation".
|
