The following information is to be used as a guide and at the discretion of the end-user and should not replace a doctor’s opinion.
OVERVIEW
Breast milk contains antibodies, living immune cells and nutrients that adapt to your baby’s changing needs, and a large body of research links exclusive breastfeeding to a lower risk of gastrointestinal infections, respiratory illness and, in some studies, sudden infant death syndrome.
The World Health Organisation recommends exclusive breastfeeding (breast milk only, no water, formula or solids) for the first six months of life, followed by continued breastfeeding alongside appropriate complementary foods for up to two years or beyond.
But “recommended” doesn’t mean “required,” and it certainly doesn’t mean “easy.” There’s no single “right” way to do this; there’s only what’s healthy and sustainable for you and your baby. However you end up feeding your baby, the first few weeks are an adjustment for both of you.
WHY BREASTFEEDING IS SO SRONGLY RECOMMENDED
Breastfeeding is one of the most effective, low-cost interventions available for reducing child mortality globally, which is why health authorities promote it so consistently. Other benefits include:
- For your baby: Lower risk of infections and illness in infancy, and links to reduced rates of obesity and type 2 diabetes later in childhood.
- For you: Faster postpartum weight normalisation, and breastfeeding for over a year has been linked to roughly a 20–25% lower lifetime risk of breast cancer.
WHY BREASTFEEDING ISN’T ALWAYS EASY
It’s a myth that breastfeeding should come naturally and painlessly from day one. It’s a learned skill, for both you and your baby, and most mothers hit at least one bump along the way. Common early challenges include:
A useful check: if your baby is producing 6–8 wet nappies a day and gaining weight steadily, your supply is very likely fine, even if your breasts feel soft or your baby feeds often. Frequent feeding (including cluster feeding) is normal baby behaviour, not proof of insufficient milk.
WHAT TO DO IF BREASTFEEDING ISN’T POSSIBLE
Not every mother can, or should, breastfeed. That’s a medical reality, not a failure. Reasons vary widely and can include insufficient glandular tissue, certain long-term medications, some maternal illnesses, prior breast surgery, or simply a supply that doesn’t recover despite good support.
In South Africa specifically, mothers living with HIV are guided by national Department of Health protocols: current guidance supports exclusive breastfeeding alongside consistent antiretroviral treatment, which brings transmission risk down to very low levels. This differs from the approach of some high-income countries, reflecting South Africa’s specific health context. This decision should always be made with your doctor or HIV care team.
When breastfeeding isn’t an option, or a mother chooses not to, infant formula is a safe, nutritionally complete alternative when prepared correctly. Formula-fed babies grow up healthy; the key is following preparation instructions carefully (correct water-to-powder ratio, safe water, sterilised equipment) and discussing the right formula type with your paediatrician or clinic sister.
Combination feeding (breast milk and formula together) is also a legitimate, common choice, not an all-or-nothing decision.
WHAT TO DO IF YOU’RE STRUGGLING WITH BREASTFEEDING
The single most important step is to ask for help early! Breastfeeding problems rarely resolve on their own, and small issues are far easier to fix before they become entrenched. You don’t need to “push through” pain or struggle in silence.
And if, after trying, breastfeeding still isn’t working or isn’t right for you, whether for medical, physical or personal reasons, switching to formula, in full or in part, is a legitimate and safe decision. A fed, loved baby and a mother who isn’t running on empty matters more than any single feeding method.
HOW LONG SHOULD YOU BREASTFEED?
WHO and UNICEF guidance recommends exclusive breastfeeding for the first six months, then continuing to breastfeed alongside solid foods for up to two years of age or beyond, for as long as it suits both mother and baby. There’s no penalty for stopping earlier if that’s what’s right for your circumstances, and no obligation to stop at any particular point either. The guidelines describe a ceiling of benefit, not a rule.
South African context
South Africa’s own exclusive breastfeeding rate has climbed substantially, from under 10% in 2011 to around 32% nationally by the mid-2010s, but still sits well below the World Health Assembly’s 50% target. Most mothers who start out exclusively breastfeeding stop well before six months. If you’re finding it hard, you are in good company, not falling short of some easy norm the rest of the country is meeting.
THE BONITAS MOTHER & CHILD BENEFIT
Bonitas builds breastfeeding support directly into its maternity benefit:
- Up to four postnatal consultations with a midwife after delivery, one of which can specifically be used for a consultation with a lactation specialist.
- A 24/7 maternity advice line, plus Babyline, a round-the-clock helpline for medical advice about your baby.
- Access to the Bonitas Maternity Programme, including online antenatal classes and postnatal follow-up support.
- Benefits vary by plan (BonEssential, Primary Select, BonComprehensive and others), so be sure to check your plan’s benefit guide.
Call the number on your membership card or log in to the Bonitas member portal to confirm your plan’s maternity and lactation consultation benefits before booking.
For more breastfeeding support:
- La Leche League South Africa offers free mother-to-mother breastfeeding support via local leaders.
- For a certified lactation consultant, the Lactation Consultants of South Africa (LACSA) directory can help you find one in your area.
FURTHER READING
Visit these sites to learn more: