Philani Child Health & Nutrition Project
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Breast feeding of new infants is not universally practised in the informal settlements outside Cape Town and there are many reasons for this. New mothers have to go to work where having a baby with you is not acceptable, some prefer to leave the baby with their mothers, and teenagers who give birth want to return to school and be with their friends, unencumbered by the demands of a little baby.

To deal with this problem, the Department of Health of the Western Cape, started a breastfeeding support programme at many of their clinics. In 2009, the Department approached Philani to take over the running of this programme at seven clinics in Eastern Khayelitsha so this is now integrated into Philani’s services.

The Programme

The objective of this programme is to promote breast feeding in mothers-to-be as well as with those who have given birth at the seven clinics. Each clinic has a Breast Feeding Peer Counsellor who is responsible for counselling and educating mothers about the benefits of exclusive breastfeeding for six months, then continuing breastfeeding despite the introduction of solids for another two years or more.

An important aspect of the education involves mothers who are HIV+ (30% of pregnant women). Because HIV+ can be transmitted to the baby through breast milk, it is important for these mothers to understand what their choices are. If they breastfeed exclusively for six months with no other supplements to the child’s diet (including no formula), the child stands an excellent chance of not acquiring the virus. However, they must commit to doing this for the entire period. If they cannot make this commitment, it is better for them to formula feed from the start, thus preventing HIV transmission, but having to be alert to the inherent problems of formula feeding including using clean water, keeping bottles and utensils clean and sterilized (something that is very difficult to do in an informal settlement) and being able to pay for the formula. It is not an easy decision for mothers to make.

All mothers also benefit from the Peer Counsellors’ support for problems they may experience with breast feeding such as engorgement, sore nipples, and insufficient milk. Having this support enables many mothers to maintain the practice of breastfeeding, thus giving their infants a better chance of growing up well nourished and healthy.

When these mothers are discharged from the clinics after the birth of their babies, they are referred for ongoing support to Philani’s Outreach Programme.


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