Breastfeeding and Race: South Africa

*** Welcome March Carnival of Breastfeeding readers.***

I find myself in a strange situation. I am one of my race, yet not of my culture. I fit in to a race that is not mine – yet am part of its culture. But let me start at the beginning and explain myself a little better…

I am a South African, but I have been living in the UK for the last seven years. I am married to a Scottish South African, and we have a London-born English South African 17-month old girl – as fair-skinned as they come.

We left London in October last year, on our daughter’s first birthday for South Africa, where we have spent the last five and a half months. In just two weeks, we return to England.

In South Africa, I have discovered that I am not part of my culture any longer, and that having a child has separated me from my race.

See, I am white. In South Africa, white women rarely breastfeed for very long, if at all. In five and a half months, I have not seen another white woman breastfeeding – although I have met one who breast feeds her toddler, I just didn’t see it.

On average, South African women breastfeed their children for 16 months. The median duration of breastfeeding ranges from 5 months for Asian women, 0.6 months for white women, and 11 months for coloured women to 17 months for African women (DoH 1998) Fertility and Childbearing in South Africa.

(Please note that the term ‘coloured’ in the South African context refers to people of mixed race.)

What are the reasons for this?

Well, for many years, formula feeding was seen as an expression of wealth. Only the poor breastfeed. Only the backward, who still live in mud huts or shanties breastfeed. That and private health care.

South Africa has an extreme poverty problem, and it breaks my heart – and in fact angers me slightly- when I pass a beggar holding a placard: Please help. Have 8 month old. Need clothes, formula and money. God blesses those who bless others. With the cost of formula in South Africa, I find it criminal that breastfeeding isn’t driven and funded as much as formula is.

But I digress.

One thing in South Africa that is exceptionally affordable is relaxation. One day I was sitting in a chair having a shoulder, neck and head massage, talking to the masseuse about babies. This is how the conversation went.

Me: Oh, don’t go to near my boobs, I might squirt milk everywhere.

Black masseuse (Surprised): Oh, you breastfeed? How old is your baby?

Me: She’s 15 months

Black masseuse (more surprised): Sho, sho, sho! 15 months? You don’t give her formula?

Me: No, I don’t. My milk is the best thing for her

Black masseuse: Yes, but I think white people don’t breastfeed

Me: Often, they don’t. But I do. I also co-sleep

Black masseuse: Co-sleep?

Me: Yes. She sleeps in the bed with me and her daddy

Black masseuse (stops massaging momentarily): She doesn’t sleep in her cot?

Me: No. She doesn’t have a cot. She’s slept with us since birth.

Black masseuse: But white people put the baby in the other room?

Me: Yes, sadly, mostly, they do. But we don’t.

Black masseuse: Sho,sho,sho. It’s better for baby. We sleep with our babies till they are (she rocks her hand from side to side) maybe five years old.

Me: Yes. I know. And you’ll love this, but my baby doesn’t really use a pram either.

Black masseuse: You carry her?

Me: Yes. In a sling. Normally on my front, but if I have to clean the house or do dishes, on my back.

Black masseuse, laughing, Sho, sho, sho! No. Your baby might be white on the outside but on the inside, she is an African.

Your baby might be white on the outside but on the inside, she in an African

Those words resonated in my head, and they have stuck with me ever since.

In a society where doctors are gods, medical aid is a must have, and government health care is overtaxed; in a society with an 80% caesarian rate amongst private hospitals and 20% in public hospitals; in a society where WHO codes are not enforced or recognised and extreme corruption permeates from the top down, including through medical professionals œmaking deals with formula companies; in a society where HIV gives men an average life expectancy of 49 years, and women only slight more at 52 years; in a society where HIV positive mothers could dramatically improve the health of their infants by exclusively breastfeeding them for six months; in a society such as this, 12% of the babies are breastfed for less than four months, 8% for less than six. While the 2003 DHS report states that 66% are breastfed for 12 – 15 months (amazingly, primarily in the poverty stricken, uneducated, predominantly African parts of the country) yet only 31% are breastfed for the WHO recommended two years. (ChildInfo)

It’s no wonder HIV, TB and poverty are killing my country, and leaving children in charge of families.

My heart bleeds for my people. My foolish, “educated” race. And I thank God that by some miracle of fate, I might be white on the outside, but on the inside, African.

For more posts on this topic, see below:

Motherwear’s Breastfeeding Blog:  Breastfeeding and Race: Why we need more lactation consultatns of color

Motherhood Actually: Breastfeeding and Race: Cambodian Americans

Silent Yet Leading: Breastfeeding in Ghana

(will be updated on 14 March 2010)