La Leche League

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The Good Life Dietitians have recently come across a wonderful organization- La Leche League. Their mission is to help mothers worldwide to breastfeed through mother-to-mother support, encouragement, information, and education, and to promote a better understanding of breastfeeding as an important element in the healthy development of the baby and mother.

La Leche League South Africa is a non-profit, non-sectarian volunteer organisation dedicated to providing information, encouragement and support to breastfeeding mothers through our unique mother-to-mother support network.

La Leche League Leaders are experienced breastfeeding mothers, trained and accredited by LLL, who are happy to help other mothers with questions and concerns about breastfeeding. This one-to-one approach is one of the most effective - and friendly! - ways of getting the support you need. It is important to notice that all our Leaders are mothers who volunteer their time and are therefore not always available. Should you experience any problems contacting Leaders on our list, please try again in about an hour.

 

LLL also provides support and information for women in special circumstances (premature babies, multiple births, babies with cleft of the soft palate, babies with Down's Syndrome and many others).

La Leche League South Africa is active on governmental and NGO bodies working for the promotion and protection of breastfeeding in South Africa. Our Leaders have been in teams with health professionals facilitating UNICEF-designed Lactation Management training workshops, and our Peer Counselling Programme has already trained more than 400 volunteers, largely from disadvantaged communities, to work as breastfeeding counsellors.

Membership in LLL South Africa costs R150 per annum, and offers a discount on all books bought from LLL. For any further information, help with breastfeeding problems, or if you would like to join La Leche League South Africa, please contact us at one of the following: nel.esme@gmail.com/ Liz@robinson.wcape.school.za/ nanjolly@iafrica.com/ ellen@absamail.co.za.

Province	City/Area	Leaders
GAUTENG	Edenvale	Marguerite (011) 453-7188
	Benoni	Florence (011) 425-5804 Juanita (011) 395-1864 Cecilia (011) 918-7924 Lydia 082 578 5221 Joan (011) 849-8250 Annatjie (011) 973-1900 Mara(011) 394-1549 Leslie (011) 8499214 Pretoria Leonie (012) 654-6961 Nicole (012) 345-4898 Marie-Louise (079) 116 5630 Tobie (012) 430-3334
	Randburg	Ellen 0837852524 Deirdre (011) 475-5837
	Roodepoort	Laura 0833012826 Karla 083 757 7365 Ena (011)476-3439
	Other	Ute (082) 652-6436
KWAZULU-NATAL	Durban	Jane (031) 309-1801
WESTERN CAPE	Blouberg	Elaine (021) 976-8537 Juliet (021) 556-0693
	Bonnievale	Sonja (023) 616-3192
	Durbanville	Trudy (021) 913-2816 Tiffany (021) 913-3586 Vania (021) 910 2885
	George	Deoni 0721416965
	Fish Hoek	Tammy (021) 782 9240 Jenni (021) 782-1748
	Panorama	Rosemary (021) 910-0606  Irma (021) 979-1425 Carol (021) 558-5319
	Southern Suburbs	Marilyn (021) 683-9669
	Paarl	Jonette (021) 872-5297 -
	Parow	Dilshaad (021) 930-2475/082 927 2161
	Malmesbury	Selma 022-482-2026 Hillétje (022) 482-2006 Bianca (022) 487-2824
	Rondebosch	Becky (021) 531-2485 Bridgette Poole (021) 712-5767/0834605753
	Strandfontein	Sophia (021) 393-1634
	Other	Leana 021-855-4657
EASTERN CAPE	Port Elizabeth	Nan (041) 583-1577 Naomi 072 130 9879 Pauline (041) 367-2659
	East London	Rensche 078277738
	Plettenberg Bay	Paula (044) 5332632
	Grahamstown	083 553 7719 Victoria (046) 622-4768 -
	Knysna	Vicky (044) 384-0426
FREE STATE	Kroonstad	Carlene Marais (056) 2126607
NORTHERN CAPE	Other	Esme Nel (027) 692 3041/0825645471

Breastfeeding and the HIV-positive mom

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We have stumbled across many forums and discussions, and it has come to our attention that the public is ill-informed on the facts with regards to breastfeeding and HIV.  Since December 1^st is World AIDS day, we wish to enlighten our readers on the most common questions with regards to feeding a baby in the context of HIV.

What is the best way to feed a baby?

Whether HIV negative or positive, exclusive breastfeeding for the first 6 months of a baby’s life is recommended. This involves giving a baby only breast milk and no other fluids or foods other than multivitamins or medications prescribed by health care workers.

If a mother is HIV positive, should she breastfeed?

Definitely! There is a misconception among the public that HIV-positive moms should not breastfeed.  HIV-positive moms are encouraged to exclusively breastfeed just as HIV-negative moms are. Exclusively breastfeed babies whose mothers are HIV-positive thrive and benefit just as well as babies with HIV-negative moms.

Can HIV be transmitted through breast milk?

Transmission of HIV in breast milk is as low as 1%. We now know that there is less of a chance of transmitting HIV through breast milk when antiretroviral treatment is used by either the mother or baby, compared to using no antiretrovirals. A study in Botswana showed higher survival rates among HIV-positive babies who were breastfed compared to those that were formula fed. The study also showed that 7.5% of 6 month olds who were breastfed died from diarrhea compared to 33% of formula fed babies who died from diarrhea and pneumonia. Also, research shows that there is less HIV transmission when exclusively breastfeeding a baby versus mixed feeding (feeding a combination of breast milk and infant formula).

Can HIV transmission through breast milk be prevented?

Yes HIV can be transmitted in breast milk, but to effectively reduce the transmission of HIV to the baby, the mother, baby, or both, should be placed on antiretroviral treatment. The chances of HIV transmission when a mother or baby is on antiretriovirals during breastfeeding significantly reduces the chances of HIV transmission.  

The South African government has adopted a program called the prevention of mother-to-child transmission (PMTCT). This treatment is available to all HIV-potive mothers free of charge at all government hospitals and clinics. The PMTCT guidelines give recommendations on antiretroviral use during pregnancy and breastfeeding:

§  All babies whose mothers are HIV-positive must receive antiretrovirals daily for 6 weeks after birth.

§  If the mother is already on ARV treatment, she must continue to take the treatment as per normal throughout breastfeeding. In addition, the baby must receive nevirapine for the first 6 weeks.

§  If the mother is breastfeeding (and not on prior ARV treatment) then the baby must be given nevirapine throughout the breastfeeding period, plus for one week after stopping breastfeeding.

§  If the HIV positive mother is not breastfeeding, then the baby only receive nevirapine until 6 weeks after birth.

If the baby tests HIV-positive, should the mother continue to breastfeed?

If a baby tests positive for HIV, the mother should definitely continue to breastfeed. This will continue to protect the baby against infections and disease.

If an HIV positive mother chooses not to breastfeed, what are her other options?

Every mother has the right to chose how she feeds her baby. However there is great concern with formula feeding, and mothers should be thoroughly informed by trusted health care workers on the potential risks of doing so. 

If a mother chooses to formula feed, the following criteria (called the AFASS criteria) must be met:

Affordable      The mother must be able to afford formula as well as the necessary equipment, such as bottles, teats, and sterilization.

Feasible

Acceptable     Formula feeding must be supported and accepted by the mother, guardian, caregiver, partner, and community

Safe    Formula feeding must be prepared hygienically, and frequently enough that it is safe

Sustainable    Breast milk is always available, reducing possibilities of difficulties in accessing supplies. There must be a reliable and sufficient supply of formula milk. Can the mother consistently feed the baby?

When must the HIV positive mother stop breastfeeding?

As we’ve established, whether HIV positive or not, babies should be exclusively breastfed until 6 months, after which solids are introduced.  The only difference is in the length of breastfeeding: 24 months for HIV-negative moms, and 12 months for HIV-positive moms.

§  If HIV negative: Breastfeed exclusively for 6 months. Introduce solids at 6 months and continue to breastfeed until 24 months.

§  If HIV positive: Breastfeed exclusively for 6 months. Introduce solids at 6 months and continue to breastfeed until 12 months. When the HIV positive mother stops breastfeeding, this should be done so gradually and over a period of one month.

As a final word, we encourage the public to speak to trusted health care providers, like doctors, pediatricians or dietitians, with regards to HIV and feeding a young child. Help us to pass on the correct, scientifically-based information so that South Africans stand together in support of our HIV-positive moms.

Go to the Word AIDS Day website for more information.

References

Department of Health. National Breastfeeding week (1-7 August 2011) - questions and answer guide.

Yezingane Network and UNICEF. Infant feeding in the context of South Africa- questions and answers. December 2010 (Updated July 2011).

Yezingane Network. Preventing mother-to-child-transmission of HIV (PMTCT). June 2010.