Challenges and opportunities

The inability of infants to access breastmilk in public care is affected by various factors including: lack of infrastructure and resources to promote lactation and maternal health (HIV/AIDS and associated infections). Increasing numbers of women infected with HIV/AIDS and associated illnesses, such as TB and meningitis, give birth prematurely. Often, these mothers are too ill to lactate and, in some instances, they die whilst in labour. Their infants are developmentally challenged outside of the womb, with low birth weights, premature digestive tracts, and a high risk of developing NEC. Donor breastmilk affords these babies an opportunity to live through the first few weeks of life.

The challenge is further complicated by factors of socialisation, status, stigma, lack of awareness, risks of formula substitution, lack of suitable lactation and breastfeeding facilities, and inadequate legislation to protect the rights of breastfeeding mothers, especially working mothers. 

In addition, 15 years of experience in South Africa has revealed a number of challenges to the delivery of human milk on the African continent. The rural, low-cost, human milk-banking environment is too remote from laboratories to enable safe, quality monitoring of donated breastmilk and the human milk-banking processes. Rapid technologies, combined with processing methods that do not require water or access to electricity, are a necessity.

The primary activities and developments of the SABR are designed to meet the challenges above and are divided into three programmes: Programme A: The Feed for Life Initiative which is focused on the delivery of DBM to hospitals primarily; Programme B: Make Your Hospital Breastmilk Smart which is focused on in-hospital, human milk-banking facilities. Programme C: The SOStainer: which is a mobile health container facility for mothers and children, offering a solution for improved healthcare delivery to under-served rural communities remote to clinics.