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Ten steps to successful breastfeeding: A call for action to health care providers and communities

World Breastfeeding Week 2010

Ha Noi, 29 July 2010 – Although exclusive breastfeeding is the most complete form of nutrition for infants and small children during the first six months of life, only 10 per cent of children in Viet Nam are breastfed exclusively during this critical period of their lives. This situation calls for urgent action to promote breastfeeding, particularly by health care providers and communities in Viet Nam.

This “call for action” is being issued today as part of the launch of World Breastfeeding Week, co-organized in Viet Nam by the Ministry of Health, the United Nations and the Alive & Thrive initiative. World Breastfeeding Week is celebrated in more than 120 countries to encourage breastfeeding as an important way to improve the health and development of infants and young children. With the theme "Breastfeeding: Just 10 Steps, the Baby-Friendly Way", World Breastfeeding Week this year aims to highlight the vital role that health workers and health facilities play in promoting breastfeeding. It calls for every health facility providing maternity services and care for newborn infants to provide support to mothers in breastfeeding using the ten steps.

The ten steps to successful breastfeeding were first presented to the world in the 1989 WHO/UNICEF Joint Statement on the Protection, Promotion and Support of Breastfeeding: The Special Role of Maternity Services. Since then UNICEF and WHO have called for the implementation of the ten steps to successful breastfeeding in all maternity facilities because health workers play a critical role in influencing mothers’ decisions on how to feed their infants and young children.

In Viet Nam, only 55 per cent of mothers initiate breastfeeding in the first hour after birth. The main reasons cited for delayed initiation of breastfeeding are a belief that mothers’ breast milk production is inadequate; C-section deliveries; separation of mother and child immediately after birth; insufficient counseling from health care providers due to busy schedules; and the availability of milk formula.

Research has also found that feeding infants with water after breastfeeding is a popular practice in both urban and rural areas of Viet Nam (‘exclusive breastfeeding’ means infants receive no food or drink other than breast milk unless medically indicated). Some mothers believe that they lack sufficient breast milk to adequately nourish their children up to six months and often begin to supplement breast milk with formula milk and/or other foods at around four months of age. For those employed in the formal sector (20-30 per cent of all mothers), the need to return to work after four months of maternity leave poses a challenge to continued exclusive breastfeeding. Lack of support from family members and health workers is another barrier to mothers exclusively breastfeeding their children.

“Health personnel and health facilities play an important role in initiating breastfeeding successfully,” said Viet Nam’s Vice Minister of Health, Mr. Nguyen Ba Thuy. “Health staff at maternal and child health care facilities need to be trained to be able to help mothers to breastfeed their children within an hour after birth and to provide guidance for mothers on how to practice breastfeeding and maintain breast milk flow properly.

Efforts to encourage better breastfeeding practices in Viet Nam are part of a national programme on children and mother’s care as well as broader efforts to help ensure that children grow and reach their full potential. The country’s ‘Child Survival Action Plan’ has set out the goal to achieve a 50 per cent exclusive breastfeeding rate across the country by 2015. The Ministry of Health will work closely with line minitries and mass media to achieve the goal, recognizing that without improvements in breastfeeding rates and child nutrition, the achievement of the Millennium Development Goals in Viet Nam would be jeopardized.

The UN in Viet Nam is working with the Vietnamese government, Alive & Thrive, and other partners and communities to promote breastfeeding through a wide range of awareness raising activities, strengthening the enforcement of Decree 21 on the trading in and use of nutritious products for infants, and promoting the Baby-Friendly Hospitals Initiative - a global effort to implement practices that protect, promote and support breastfeeding.

To ensure that the Baby-Friendly Hospital Initiative is fully carried out in Viet Nam and provides a major push to breastfeeding promotion, a strong commitment from the health sector, government and international organizations is important”, said Mr. Jean Dupraz, Acting UNICEF Representative on behalf of the UN in Viet Nam. “The National Plan on Infant and Young Child Feeding would be an appropriate platform to create a detailed action plan to increase the number of baby-friendly hospitals and create a solid benchmarking system of hospital assessment and accreditation, including the monitoring of baby-friendly hospitals.

Ms. Nemat Hajeebhoy, Country Director of Alive & Thrive, stressed that: “A call for action by policy makers, health care providers and families to protect, promote and support mothers to breastfeed successfully will ensure good health of children in Viet Nam”.

For further information:

  • Ms. Nguyễn Mai Hương, Maternal and Child Health Department, Ministry of Health (Tel: 84-4-38233802, Email:

  • Ms. Nguyễn Thị Thanh Hương, Communication Officer, UN Communications (Tel: 04.39425705 - ext: 401; Email:

  • Ms. Phan Thi Hong Linh, PR & Advocacy Consultant, Alive & Thrive (Tel: 04.35739066 – ext 105; Email:



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