Government will no longer distribute free infant formula feed at health facilities, in an effort to promote exclusive breastfeeding, Health Minister Aaron Motsoaledi said.

"It is undeniable that breastfeeding is the very best way to nourish babies, there is, literally, no substitute for it," he said at the close of a two-day breastfeeding summit in Centurion, Pretoria, according to a copy of his speech.

This was why the health department was adopting World Health Organisation recommendations for promoting exclusive breastfeeding, including for HIV-positive mothers.

"South Africa is one of only 12 countries in the world where infant mortality has been on the increase," he said.

Promoting breastfeeding was a central strategy for reducing child mortality, and recommended even for HIV-positive mothers, he said.

Breast milk substitutes would only be recommended by health practitioners to mothers who, for medical reasons, could not breastfeed.

Breastfed babies were better protected against infections such as diarrhoea, respiratory illnesses, allergies and ear infections, and at lower risk of malnutrition. Adults who had been breastfed as infants were at lower risk for chronic lifestyle diseases such as obesity, coronary heart disease and type two diabetes. Mothers who breastfed their children had a reduced risk of developing breast and ovarian cancer. They returned to their pre-pregnancy weight more easily, and the likelihood of falling pregnant again while breastfeeding was reduced.

Despite these benefits, a 2008 survey found only 25.7 percent of local children under six months were exclusively breastfed. Over 50 percent were mixed-fed (feeding both breast and formula or other substances such as tea, water or porridge). Twenty-four percent were fed on infant formula.

Motsoaledi said barriers to exclusive breastfeeding included the aggressive promotion of formula by manufacturers, mothers not being able to breastfeed while at work, and babies being left in the care of relatives who relied on formula feeding.

Family and community support, including male support, for breastfeeding was lacking.

Some health facility practices and policies which obstructed breastfeeding including delayed initiation of breastfeeding, issuing formula to mothers, poor counselling, and discharging mothers soon after delivery, before breastfeeding had been established.

Confusion remained around the risks of HIV transmission and breastfeeding, and systemic efforts to promote exclusive breastfeeding were lacking.

Motsoaledi said he would draw up regulations to enforce the international code of marketing of breast milk substitutes.

Breastfeeding would also be promoted via ward-based outreach teams, a strengthened school health programme, and district-based clinical specialist teams.

He called on all three spheres of government, traditional leaders and healers, business and labour, NGOs and civil society to support exclusive breastfeeding.