Birth and newborn care policies and practices limit breastfeeding at maternity facilities in Vietnam

Nguyen, Tuan Thanh; Cashin, Jennifer; Tran, Hoang Thi; Hoang, Thu Trang; Mathisen, Roger; Weissman, Amy; Murray, John Charles Scott

doi:10.3389/fnut.2022.1041065

Cited by 5 publications

(3 citation statements)

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“…A potential explanation could be that this hospital is a referral facility that receives clients with high-risk pregnancies within the province and from other provinces in the central part of Vietnam ( 19 ). Cesarean births and vaginal births with episiotomy are barriers to breastfeeding ( 20 – 22 ). A study from eight countries in the Western Pacific region showed that where mothers received early and uninterrupted skin-to-skin contact in a supportive environment such as rooming-in practice and prohibiting formula use as policy, the breastfeeding rate was still high ( 23 ).…”

Section: Discussionmentioning

confidence: 99%

Characteristics and factors influencing the volume of breastmilk donated by women to the first human milk bank in Vietnam

Tran,

Nguyen,

Nguyen

et al. 2023

Front. Glob. Womens Health

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BackgroundDonor human milk (DHM) is essential to the operation of human milk banks (HMB). This study examined characteristics and factors associated with higher volumes of DHM donation at the first HMB in Vietnam.MethodData from an online HMB monitoring system collected between February 2017 and July 2022 included demographic characteristics, child information, the timing of donation, and the volume of DHM. Higher volume is defined as equal to or greater than the median DHM volume per donor of 14.4 liters (L). Potential contributors to higher DHM volume were examined using the chi-square test in univariate and multivariable logistic regression analysis.ResultsDuring the 5.5-year operation, this HMB recruited 517 donors with an average age of 28.6 years. Approximately 60.9% of donors had a college or higher degree and 97.3% gave birth in Da Nang city. Of these donors, the prevalence of cesarean birth was 48.2%, preterm births was 40.2%, and 27.9% had babies with a birth weight of less than 1,500 g. There was a similar proportion of donors between the hospital (48.2%) and community (51.8%). On average, hospital donors started their donations 15 days after birth when their newborns were 33.9 weeks corrected age compared to 63 days and 47.7 weeks among community-based donors. The overall median volume of DHM per donor was 14.4 L over a period of 46 days. The amount and duration were higher in community-based donors (17.5 L in 72 days, 300 ml/day) than those in the hospital (8.4 L in 30 days, 258 ml/day). More than 37% of donors contacted the HMB themselves; the remainder were introduced by health professionals. Factors associated with higher volumes of DHM included higher education (OR: 1.77; 95% CI: 1.09, 2.87), having a full-term newborn (OR: 2.46; 95% CI: 1.46, 4.13), and community-based donors (OR: 2.15; 95% CI: 1.22, 3.78).ConclusionsMothers with higher education and from the community donate more breastmilk over a longer duration than those with lower education and from the hospital. Breastfeeding protection, promotion, and support should be offered to all mothers with specialized breastfeeding support for mothers of preterm and sick infants. This will ensure mothers have sufficient breastmilk for their newborns and potentially surplus breastmilk for donation.

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Section: Discussionmentioning

confidence: 99%

Characteristics and factors influencing the volume of breastmilk donated by women to the first human milk bank in Vietnam

Tran,

Nguyen,

Nguyen

et al. 2023

Front. Glob. Womens Health

Self Cite

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“…Our experience suggests that, through training and routine monitoring, hospitals in Vietnam can apply a policy of selective episiotomy and reduce the practice, particularly among multiparous women. Global and country-specific evidence suggests that reducing unnecessary episiotomies will further improve breastfeeding rates [ 4 , 9 ]. However, key barriers to policy and practice change remain.…”

Section: Discussionmentioning

confidence: 99%

“…A recent cross-sectional household survey of mothers of infants in three diverse settings in Vietnam showed a similarly high prevalence of episiotomy. Among women giving birth vaginally, 83% reported receiving an episiotomy, and those who received the procedure were significantly less likely to initiate breastfeeding within the first hour as recommended [9]. Countries in the region use different means of data collection.…”

Section: Introductionmentioning

confidence: 99%

Promoting Respectful Maternity Care by Reducing Unnecessary Episiotomies: Experiences from Centers of Excellence for Breastfeeding in Vietnam

Vu,

Ta,

Aasen

et al. 2023

Healthcare

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(1) Background: Routine episiotomy is not recommended by international guidelines; however, it occurs at a high rate in Vietnam. (2) Methods: A process to reduce unnecessary episiotomies was developed and implemented as part of the Centers of Excellence for Breastfeeding initiative, which aims to deliver high-quality breastfeeding and early essential newborn care services within a supportive policy environment. The aim of this project report is to outline the steps undertaken to reduce episiotomies, the experience in pilot hospitals, and the process towards changing policy. (3) Results: During the 14 months following the change in episiotomy policy, pilot hospital records showed no infant death or injury. Monthly monitoring data from four pilot hospitals showed that the prevalence of episiotomy was substantially lower than the average in national hospitals in Vietnam. Facilitators to reducing the episiotomy rate include the incentive of Centers of Excellence for Breastfeeding designation and supportive hospital leadership. Challenges include the ambiguity of Vietnam’s national guideline on episiotomy and lack of routine monitoring on the episiotomy rate and indications. (4) Discussion: Our experience suggests that through training and routine monitoring hospitals can apply a policy of selective episiotomy and reduce the practice, particularly among multiparous women, and improve breastfeeding rates.(5) Conclusions: Sharing our experience of implementing this process and offering four areas for action will hopefully contribute to expanded use of mother-friendly, evidence-based care as policy and routine practice in Vietnam and similar settings.

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Inequalities in large‐scale breastfeeding programmes in Bangladesh, Burkina Faso and Vietnam

Sanghvi,

Godha,

Frongillo

2024

Maternal & Child Nutrition

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Inequalities in breastfeeding programmes and practices have slowed global progress in providing the life‐saving protection of breastfeeding for millions of infants despite well‐known life‐long impacts. As breastfeeding interventions are scaled up, inequalities in coverage and breastfeeding practices should be tracked, particularly in disadvantaged groups, who are likely to suffer the most serious health and developmental impacts of poor childhood nutrition. The literature provides evidence of inequalities in breastfeeding practices, but research is limited on socioeconomic disparities in the coverage of breastfeeding interventions. This paper (1) compares inequalities in breastfeeding practices in intervention and nonintervention areas and (2) documents inequalities in programme coverage by type of intervention. We disaggregated endline evaluation surveys in Bangladesh, Burkina Faso and Vietnam, where rigorous evaluations had documented significant overall improvements, and analysed whether inequalities in breastfeeding practices and programme coverage differed by treatment areas. We used Erreygers index to quantify inequalities and found that breastfeeding practices were largely pro‐poor; intervention coverage was not consistently pro‐poor. While counselling coverage often favoured women from the poorest quintile, public education/media coverage consistently favoured better‐off women. Inequalities favoured more educated mothers in the coverage of combined interventions. None of the programmes had explicit equality objectives. The results indicate the need for introducing specific actions to reduce inequalities in breastfeeding policies and programmes. This is a priority unfinished agenda for nutrition programming.

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Birth and newborn care policies and practices limit breastfeeding at maternity facilities in Vietnam

Cited by 5 publications

References 50 publications

Characteristics and factors influencing the volume of breastmilk donated by women to the first human milk bank in Vietnam

Characteristics and factors influencing the volume of breastmilk donated by women to the first human milk bank in Vietnam

Promoting Respectful Maternity Care by Reducing Unnecessary Episiotomies: Experiences from Centers of Excellence for Breastfeeding in Vietnam

Inequalities in large‐scale breastfeeding programmes in Bangladesh, Burkina Faso and Vietnam

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