Sinapi Feeding Cup supplied to all state hospitals nationally

July 2007

Sinapi Biomedical (Sinapi), an Acorn client, was asked by the Department of Nutrition to develop a Feeding Cup, and the product was finalized during 2006. Following good success with the product in certain provincial regions, Sinapi was recently awarded the bid on the National State Tender and now provides the feeding cup to state hospitals in all 9 provinces in South Africa.

What is a Feeding Cup exactly, and when is it used?
The WHO and UNICEF promote breastfeeding as first choice of infant feeding, especially in developing countries (www.who.int; www.unicef.org). Breastfeeding is regarded as the safest and healthiest choice for feeding infants and reduces infant mortality rates, however there are instances where breastfeeding would either not be possible or where it is unsafe.

The major situation when breastfeeding is deemed unsafe is when mothers are HIV positive and infants are not. Once this is the case an infant is termed HIV exposed and mother and child take part in the PMTCT (Prevention of Mother to Child Transmission of HIV) program. Various studies have confirmed that the risk of acquisition of the HIV virus is higher when infants are breastfed, and the latest evidence in support of this is a study completed in South Africa (KZN), which showed that 14.1% of exclusively breastfed infants were infected by the HIV virus by age 6 weeks and 19.5% by age 6 months. (MTCT of HIV-1 infection during exclusive breastfeeding in the first 6 months of life: an intervention cohort study; Coovadia et al; The Lancet, Vol 369, March 31, 2007)

The alternative method of feeding is bottle feeding or cup feeding. Due to bottles being technically difficult to clean, especially in the developing world, bottles are regarded as unsafe in these regions and therefore cup feeding preferred. The UNICEF and the WHO introduced the Baby Friendly Hospital Initiative (BFHI), which stipulates an environment where breastfeeding is promoted and when this is not possible the alternative is cup feeding. A standard of prerequisites supporting this have been developed by UNICEF whereby hospitals are evaluated to obtain BFHI status. One of these prerequisites is that all bottles be removed from the infant wards. KZN and the Eastern Cape are the forerunners on BFHI status with more than 30 accredited hospitals each. The Western Cape has 14 accredited BFHI hospitals in the state and 2 private Medi Clinics are also accredited.

So, it is not difficult to conclude that a feeding cup is appropriate for countries such as South Africa: The introduction of prepared formulas and/or complementary foods to reduce the risk of transmitting the HIV virus or to circumvent nutrient inadequacies increases the risk of infection, particularly diarrhea. This increased risk is related to the greater likelihood of formula feed being contaminated during mixing and/or being fed from a contaminated bottle or cup, as is common in areas of the world without adequate sanitation, refrigeration or a dependable and safe water supply. To decrease the risk of infection with introduction of complementary foods, it is often recommended that prepared formula and complementary foods be fed with a cup, which is safer microbiologically than feeding with a bottle and nipple.

The Sinapi Feeding Cup is the first product custom-developed for cup feeding in South Africa:

It has no grooves, ridges or sharp angles inside the container so that it can be easily cleaned by hand (smallest radius that of finger)
It is manufactured from translucent plastic, which withstands autoclaving to 120ºC, boiling and exposure to the sun
It is not deeper than the length of an adult finger
It has a well-rounded rim from which to drink
It is Watertight lid to store and transport milk without spillage
There are two cup sizes – one for premature to 6 months and one for 6 months and older

Further the Sinapi Feeding Cup is used to:

Store formula- or breast milk
Mix formula milk
Be used for cup feeding
Be easily cleaned to reduce the risk of diarrhoea