In Viet Nam, mothers are finding layers of support to breastfeed
STORIES FROM THE FIELD
By Andy Brown
© UNICEF Viet Nam/2013/Truong
Breastfeeding is the world's most effective and least costly life-saver. It plays a critical role in reducing child mortality, protecting against infectious diseases, and preventing stunting, a form of chronic malnutrition that affects 165 million children globally. Along with providing many health benefits to the child, breastfeeding also aids in the mother's recovery and has been shown to reduce post-partum depression and to lower the risk of ovarian and breast cancers later in life.
World Breastfeeding Week 2013 takes place 1–7 August and this year focuses on support for mothers, because more mothers breastfeed when they receive support, counselling and education in health centres and in their communities.
A programme in Viet Nam provides support for mothers to breastfeed, from community to health centre to hospital – to government.
AN GIANG PROVINCE, Viet Nam, 2 August 2013 – Nguyen Anh Dao breastfeeds 4-month-old Minh Anh at their home in Binh Thanh Dong commune, An Giang province.
Minh Anh is strong and healthy. She can stand up in her mother's lap. "I started breastfeeding in the health centre where I gave birth," Dao says. "The doctor put the baby on my breast after delivery. Afterwards, the village health worker talked to me about breast milk. She told me that it contains good nutrients and is best for my baby's health."
Dao is one of many mothers who have been encouraged by the local commune to breastfeed their babies exclusively, as part of a programme supported by UNICEF. She is fortunate to have a supportive environment. Some new mothers face resistance from grandparents, who prefer traditional methods such as mixing water with sugar and rice powder. Other mothers have to return to work in the fields and stop breastfeeding exclusively before the recommended six months.
Dao has just returned to work, herself, but is able to continue breastfeeding. She works at the People's Committee office, which is next door to the health centre and close to her home. "I breastfeed my daughter in the mornings before work," she says. "Sometimes I take her to the office with me, but usually I come home two or three times a day to feed her."
Binh Thanh Dong commune is in the Mekong Delta region of southern Viet Nam. It's a rural area where most people are rice farmers. Behind the houses are wide green paddy fields. The fields are dotted with the graves of ancestors, housed in small but well-tended family graveyards.
At a community centre near Dao's house, mothers meet for a breastfeeding support group. It's led by Nguyen Thi Tuyet Phung, who starts by reviewing the learning from the last meeting. Then the mothers talk about their difficulties. One has painful nipples after breastfeeding. Another is concerned that her friend's baby, who is fed on infant formula, is fatter than her own. Their questions are answered by a nurse from the nearby health centre. "Don't worry if your baby is not as fat as your friend's," she says. "The important thing is that he is healthy."
Phung was invited to join by staff at the health centre. "I attended training sessions on breastfeeding," she says. "I liked it very much. I gained knowledge for myself and my family. Now, I can share my knowledge with other villagers, and they believe me because they know I work with the health centre."
Mother, community, government
The support group and health centre are supported by UNICEF, as part of a nationwide programme to promote breastfeeding. UNICEF provides training for health workers and volunteers, materials such as posters and leaflets, and refreshments for mothers who join the meetings. The rate of exclusive breastfeeding in Binh Thanh Dong commune has risen from 0.5 per cent at the start of the programme to 27.5 per cent.
UNICEF Nutrition Specialist Nguyen Dinh Quang says breastfeeding is essential for early childhood development. "In the first six months, the most important thing is the baby's brain development," he explains. "We know that breast milk is best for that."
One aim of the programme is to change the behaviour of mothers in small villages. "It's very challenging," Quang continues. "Many things influence behaviour, and we can't go to every village. That's why we work with the health centre to create the community support groups. The collaborators learn the best practice and share it with other mothers."
UNICEF has also lobbied the government to bring in new laws to ban the advertising of formula for children under 2 years old, and to give new mothers the right to six months of maternity leave so that they can exclusively breastfeed for the recommended time.
Nearby, at Phu Tan District Hospital, rice farmer Dang Thi Thao sits in a recovery room that she shares with five other new mothers. She breastfeeds her three-day-old baby girl. "Her grandfather is still thinking about what to call her," she says.
Thao is assisted by Dr. Huynh Thi Bich Thuy, Chief of the Obstetrical Department, who provides counselling on how to hold the baby and how to tell when she is full. "I've breastfed both my children," says Thao. "I feel happy and satisfied when I do it. The older boy Tuy is now at kindergarten and is very healthy."
The hospital joined UNICEF's breastfeeding programme in 2009. About 90 per cent of women in the district give birth at the hospital, so it's an important place to start. The hospital has developed a regulation with 10 steps for successful breastfeeding. "For example, we have a rule that a health worker should help every mother to breastfeed within one hour of giving birth," Dr. Thuy says.
Not all parents find it so easy to breastfeed, but UNICEF's Quang says it is possible even in the most difficult of circumstances. "I know from my own experience," he says. "My son was two months premature, and, by the time he came home, my wife's breast milk had dried up. We went round the hospital collecting spare milk from lactating mothers. We spent one week doing that while he sucked on my wife's nipples until the milk started flowing again."
He adds, "If we can breastfeed successfully, anyone can."