Thursday, January 10, 2013

Breastfeeding in Cambodia is the new ‘normal’

Boeung is breastfed by his mother (centre) at a Mother Support Group in Svay Rieng
© UNICEF Cambodia/2012/Cori Parks
Children in Cambodia are reaping the benefits of ten years’ successful promotion of breastfeeding. As a result of a multi-faceted strategy that addressed family and community practices, policies and the health system, the rate of exclusive breast-feeding rose from 11% in 2000 to 74% in 2010. An innovative and engaging media campaign, coupled with extensive health-worker training and the establishment of Mother Support Groups resulted in healthy children and a reduction in the infant mortality rate.

Much Boeung was born four months ago in Trapaing Chhouk village, Svay Rieng province (125 kilometres south-east of Cambodia’s capital, Phnom Penh). Like his four year old sister, he was exclusively breastfed soon after birth. His mother, 24 year old Touch Srey Aun, was encouraged to do so by a member of the Mother Support Group network that actively promotes exclusive breastfeeding from 0 to 6 months as part of Cambodia’s Baby-Friendly Community Initiative. Srey Aun says, “I had no problem breastfeeding my babies.  We started talking about it as soon as I found out that I was pregnant.  The village ‘Model Mother’ and my mother told me what to expect so that when each of my babies were born, we got started right away.”

‘Roasting’ no longer the norm

A decade ago in Cambodia, it was normal to practice ‘ang pleung’ or ‘roasting,’ following the birth of a child. According to Sok Neang, a senior midwife at the Svay Ang Health Centre, “In the first few days, mothers [were] kept warm by layering clothing and staying in a small room on a bed over hot coals.”  It was believed that would help the mother heal more quickly and ensure no lingering side effects from the pregnancy. The mothers also used to consume a wine and herb concoction to help them stay warm.  Neang says, “We discourage both practices because the hot and smoky room dampens the baby’s desire to breastfeed and the alcohol is not good for either the mother or the baby.  Instead, we promote early and exclusive breastfeeding and encourage the mothers to eat more and take vitamin A and iron supplements”

The new ‘normal’ in Cambodia is to breastfeed babies within the first hour after birth and to give them nothing but breast milk for the first six months. This way babies are not exposed to dirty water and receive the perfect balance of nutrition from breast milk. Caretakers no longer give water and using infant formula is not common.

Mother Support Group network assists new mothers

Members of the Mother Support Group are a vital source of accurate information, advice and reassurance for expecting and new mothers. Trained by health centre staff they address issues including child survival, nutrition, childhood illness and women’s reproductive health. The network was launched by the Cambodia Ministry of Health in 2004 with UNICEF and other partners. UNICEF continues to support the network and training of these volunteers with funding from the Spanish Government through the MDG Joint Programme for Children, Food Security and Nutrition.

During a meeting of the Mother Support Group, in Srey Aun’s village, Model Mother Mrs. Ou Bopha recounts how she coped as a new mother before the advent of the network.  “When my son, who is now 33 years old, was born in 1979, we believed that the baby should not receive breastfeeding in the first three days thinking that the colostrum was bitter and clear and not good for the baby.  Everyone thought so.  Instead, I would tip a spoon of rice water into his mouth, but he didn’t usually want it.  It was so difficult.  When he wouldn’t open his mouth or take it, I would pinch his leg to make him cry so I could get it in.” 

Bopha shares her experience to show how far Cambodia has come. With her training and knowledge she teaches new mothers that the “clear milk” [colostrum] is good for boosting the baby’s immune system and is also good for the mother’s milk flow. As she points to the three newest babies in the village Bopha says, “My [son] was very sick and small [as a child] but these babies are very healthy.  We want our young mothers to breastfeed their babies.”

By Cori Parks

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