Mother's milk enlisted in South Africa AIDS fight
(Reuters)
Updated: 2006-01-27 11:23

Six-month-old Matthew Coetzer bounces on his mother's knee. The bubbly blond and blue-eyed child is ready for his next meal of breast milk.

But Matthew's mother is not just feeding her own son.

In the family refrigerator are bottles of frozen milk, donations for a "bank" designed to bring the benefits of mothers' milk to orphans and sick children caught up in South Africa's devastating HIV/AIDS epidemic.

"It's a really important contribution that I can make, with minimal effort," 31-year-old Karen Coetzer said in her upscale living room in the port city of Durban, where the Ithemba Lethu milk bank has enrolled around 100 new mothers as donors.

Ithemba Lethu's milk bank, founded five years ago, has won widespread praise as an effective, grass-roots response to the AIDS crisis in South Africa, where an estimated 5 million people, or one in nine of the population, are HIV-positive.

The programme reaches across racial and economic lines in a country which, more than a decade after the end of apartheid, is both deeply polarised and increasingly overwhelmed by the extent of its AIDS crisis.

Donors to the milk bank are mostly white. The recipients, infants who have lost mothers to AIDS or who have been infected with HIV sometimes during nursing, are primarily black.

But the women involved with Ithemba Lethu say race is beside the point. "I think we need to start looking past that," said another mother, Liezel Roome, who donates to the milk bank and has adopted a five-month-old black baby boy herself.

"This land is in crisis, and this is one way that the babies who are in need right now can be helped."

"I HAVE A DESTINY"

Ithemba Lethu, which means "I have a destiny" in Zulu, was formed in 2001 when Anna Coutsoudis, a professor of paediatrics at Durban's University of Natal, was working with HIV-positive orphans and noticed one who was particularly malnourished.

Coutsoudis asked a friend who was nursing her own child for a donation of breast milk, and saw an immediate improvement.

With a grant from the United Nations Children's Fund, the bank was born. UNICEF officials say the bank could be a model for South Africa, where anti-retroviral (ARV) drug treatment for HIV-infected mothers is only now being widely introduced.

Coutsoudis says the bank provides babies with the important, immune-boosting power of mother's milk and prevents the transmission of HIV and other blood-borne diseases.

"We take milk only from healthy women, but as an extra safeguard we always pasteurise the milk as well," Coutsoudis said, demonstrating the pasteurisation machine the group uses.

"It is one of the few programmes which is trying to be innovative and break conventions. We know that these things can work. They won't work everywhere, but they can," said Marinus Gotink, chief of health and nutrition at UNICEF South Africa.

The milk from the bank is used mostly to feed the five AIDS-affected children the group cares for itself. When supplies permit, breast milk is distributed to other children's homes.

"As a nurse I know that breast milk-fed babies do very, very well," said Marian Loker, a nurse who runs the Lily of the Valley home which sometimes gets breast milk from the programme.

Gotink said the ultimate goal was to see that babies are breast-fed by their own mothers, something that could become possible as more HIV-positive mothers get ARVs which reduce the threat of transmitting the virus through breast-feeding.

In the meantime, Ithemba Lethu workers fan out around the Durban area collecting safe milk from dozens of nursing women.

BREAST IS BEST?

Mother-to-child transmission of the HIV virus -- during pregnancy, childbirth, or through breast-feeding -- is a painful part of South Africa's AIDS crisis and has led to some concern over Ithemba Lethu's focus on breast milk.

Olive Shisana, the head of South Africa's Human Sciences Research Council and a leading HIV/AIDS researcher, said studies had shown 60 percent of South African mothers breast-feed for longer than 12 months -- increasing the possibility that those who carry the HIV virus may pass along the infection.

While Ithemba Lethu's milk is safe, the idea of encouraging people to "share" breast milk or downplaying the value of infant formula is problematic, she said.

"Using somebody else's milk, in a society where we have so many communicable diseases, presents a challenge. I'm not sure whether this is a good idea or not," Shisana said.

Other critics of the programme say that donating breast milk outside of the family runs against African traditions.

But at Johannesburg's huge Chris Hani-Baragwanath hospital, the idea of safe milk banks got enthusiastic support from both new mothers and nursing staff.

"I don't think it has anything to do with cultures or traditions," said Nonhlanhla Monaheng, a consultant for new mothers at the hospital.

"It is humanity more than anything else. It is about helping each other in the difficult times that we are living in. It is about sharing what God has given us, and that is breast milk."