Mother Rocham Sa Moeun, 27, is breastfeeding her child during an integrated outreach activity in Kechong commune’s Palai village of Ratanakkiri province’s Borkeo district. Antoine Raab/UNICEF Cambodia
The world has never been as focused on vaccines as it is right now, and yet we still underestimate the most powerful immunisation tool for early childhood– breastfeeding. This is largely because so many people consider breastfeeding to be exclusively a concern for new mothers. In fact, it concerns us all if we care about the health of our youngest generation.We must make it easier for all new mothers to breastfeed. That’s why this year’s World Breastfeeding Week is themed Protect Breastfeeding: A Shared Responsibility.
Breastmilk in fact acts as a baby’s first vaccine, providing critical protection against multiple serious diseases, and keeping babies well-nourished and healthy. Making breastfeeding nearly universal could save the lives of more than 820,000 children under the age of five each year, globally, and prevent an extra 20,000 deaths from breast cancer every year in mothers. These are health benefits we should all be supporting.
Indeed, the Royal Government of Cambodia has long recognised the importance of breastmilk and worked with partners to increase the prevalence of breastfeeding over several decades. The figures speak for themselves: in 2000 just 11 per cent of infants were exclusively breastfed, but this rose to 74 per cent in 2010. What is troubling is that this progress is slipping backward to a 65 per cent, according to a DHS survey from 2014.
Why is this important progress reversing? There are multiple challenges, but we’ll focus on three. They have one thing in common – it will take the whole of society to overcome them.
The first challenge is one that might be obvious to mothers but not to others: breastfeeding isn’t always easy. It can be challenging and exhausting, even for women who are fully supported to breastfeed. Mothers can be confused when there is different advice from friends, family, coworkers, and media about how long to breastfeed, the use and benefits of formula, when and how to return to work, and whether breastfeeding is safe during Covid-19. A mother will feel much more confident to breastfeed whether at home, work or in the community at large when everyone reinforces the same supportive messages and creates a safe environment.
Second, legislation needs further development in two areas: aggressive marketing of infant formula and workplace protection for pregnancy, maternity leave, and breastfeeding. Despite an important national law being passed in 2005 to regulate the marketing of breastmilk substitutes like infant formula, aggressive practices and low law enforcement have nonetheless contributed to the decline in exclusive breastfeeding. National standardsin the private sector concerning maternity leave and compensationhave been established but fall below International Labour Organisation’s (ILO) recommendations and are not always fully implemented. Further, the rights of breastfeeding mothers upon returning to work have yet to be established. We entirely agree with Minister of Health Mam Bun Heng when he recently announced to the media: “The ministry calls on all stakeholders to promote breastfeeding at both the national and sub-national levels.” More needs to be done to strengthen the protection of breastfeeding, and we all have a part to play in that.
Third, the ongoing Covid-19 pandemic has made breastfeeding even more complex for new mothers, particularly with misinformation or widespread unclear messaging. A mother might be afraid of infecting her child through direct contact or breastmilk. She may question whether she can get vaccinated and breastfeed at the same time. Even a mother who wants the absolute best for her child may not know how or where to get the right answers.(For more information, visit: https://www. unicef.org/cambodia/stories/breastfeeding-safely-during-covid-19-pandemic or https://www. unicef.org/coronavirus/breastfeeding-safely-during-covid-19-pandemic).
So how can we work together to support mothers and families? How do we address the three challenges above?
First, it’s critically important that family, friends, employers, media, and government all recognise their role in supporting breastfeeding. We aren’t just helping mothers and their babies; we are helping create a better and healthier future for Cambodia.Together we can ensure children reach their full potential by receiving proper nutrition during critical early childhood development.Accepting that this is a shared goal is the first step, and then it is up to those of us who provide information on breastfeeding to ensure that the messages are clear and consistent.
Second, when it comes to legal frameworks, easy access to accurate information and clear channels to ask questions and report violations are much needed. Better public information showing which authority to approach with concerns and how to access the right information would be a great start, but stronger legislation and sufficient staff to handle complaints and concerns are also needed. Workplaces play a particularly important role. Established national standards for maternity leave and compensation stand to be strengthened to 18 weeks of fully paid leave. These standards must be clearly communicated to employers and employees and followed by behaviour change campaigns to ensure buy-in and compliance. Strong private sector collaboration will be essential to ensure that the policy becomes reality and a user friendly, transparent system for reporting marketing and workplace violations would send a clear message that breastfeeding is protected in Cambodia.
Third, health care workers need resources to effectively support mothers to breastfeed, particularly clear information on how breastfeeding is, or is not, affected by Covid-19. UNICEF and the World Health Organisation are working side-by-side with the health ministry to vet information and share with the public. We know today that it is safe to breastfeed during Covid-19, breastfeeding mothers can get vaccinated against Covid-19, and even Covid-positive mothers can continue to breastfeed provided they wear a medical mask, wash their hands thoroughly, and keep all surfaces regularly sanitised. The numerous benefits of breastfeeding substantially outweigh the potential risks of illness associated with the virus.
As World Breastfeeding Week comes to a close, we join the global call forall families, healthcare workers, employers and government offices to act in support of breastfeeding mothers and their babies. Children reaching their full potential paves the way towards a healthier future for the whole nation.
Foroogh Foyouzat is UNICEF Representative to Cambodia
