According to the 2019–2020 National Nutrition Survey conducted by the National Institute of Nutrition, the proportion of infants exclusively breastfed during the first six months of life increased from 22.7% in 2015 to 45.4% in 2020, nearly doubling in just five years. This achievement reflects the effectiveness of various coordinated policies and measures, including six months of maternity leave, Decree No. 100/2014/ND-CP on the marketing and use of nutritional products for young children, the implementation of hospital initiatives promoting excellence in breastfeeding practices, and the continued expansion of breastfeeding counseling and support networks.

Nevertheless, these figures also indicate that much remains to be done. Currently, more than half of Vietnamese infants are still not exclusively breastfed during their first six months of life, while according to the Ministry of Health, over 80% of mothers are unable to continue breastfeeding until their children reach 24 months of age. International studies also suggest that only when the exclusive breastfeeding rate exceeds 70% can a country significantly reduce its disease burden and healthcare costs. This highlights the numerous barriers that must still be overcome to make breastfeeding a widespread practice.

When Mothers Feel Powerless in Their Breastfeeding Journey

Tran Thi My Duyen, a factory worker at a company in Tay Ninh Province who lives in My An Commune, Tay Ninh Province, said that after completing her six-month maternity leave, she returned to work but continued making efforts to maintain her breast milk supply. Every day, she takes time to express milk at regular intervals and carefully stores it to bring home for her baby.

"Since returning to work, my time has become much more limited, but I always try to arrange my schedule so I can express milk on time and bring it home for my baby. I hope other mothers, whenever circumstances allow, will try to breastfeed for as long as possible. Although it takes a little more effort, seeing my child healthy and developing well makes everything worthwhile," Ms. My Duyen shared.

However, not every mother has the conditions needed to continue breastfeeding after returning to work. Le Thi Dung, a resident of Thanh Xuan Ward, Hanoi, said that because she had taken nearly a month off work before giving birth, she was forced to return to her job when her baby was just over three months old. To help her baby gradually adjust, she began introducing infant formula about two weeks before returning to work.

However, the distance between her home and workplace was more than 10 kilometers, the company had no refrigerator for storing expressed breast milk, and she could not return home during her lunch break. On many occasions, when her breasts became painfully engorged, she had no choice but to express and discard the milk. Meanwhile, her baby gradually became accustomed to bottle-feeding at home. After only about a month back at work, work-related pressures and her baby's reduced breastfeeding caused her milk supply to gradually decline. Before reaching six months of age, the baby had almost completely stopped breastfeeding.

Facing a similar situation, Tran Khanh Ly, a resident of Cam Le Ward, Da Nang, said that having to return to work early prevented her from continuing exclusive breastfeeding as she had hoped. This has left her with a persistent sense of guilt.

"There were nights when I couldn't sleep because I felt I hadn't fully fulfilled my role as a mother. I also worried that my baby would miss out on the comfort of being held, soothed and breastfed as before," Ms. Khanh Ly confided.

Multiple Barriers Disrupt the Breastfeeding Journey

According to Millieu Insight, three main factors may cause more than half of Vietnamese children to miss out on essential nutrients found in breast milk. The first is time: nearly 60% of mothers in Vietnam return to work early, before six months postpartum. Many struggle to maintain breastfeeding, not because they lack determination, but because they lack support. The next factor is health. One in three births is delivered by cesarean section, which may affect both the development of the infant's gut microbiota and the mother's recovery and ability to breastfeed effectively.

Speaking to a reporter from Vietnamese Children Magazine, Hoang Thi Duc Ngan, PhD, a physician overseeing the Community Nutrition Department at the National Institute of Nutrition, said that the pressure to earn a living is currently one of the greatest barriers to breastfeeding. According to her, many mothers, particularly those working in the informal sector, self-employed workers and small business owners, do not receive full maternity benefits. As a result, they are forced to return to work when their babies are only 2–4 months old, making it difficult to maintain exclusive breastfeeding.

In addition, many mothers still have limited knowledge and practical breastfeeding skills. In numerous cases, incorrect breastfeeding positions or improper infant latch cause nipple pain and cracking, leading mothers to mistakenly believe they have an "insufficient milk supply" or have "lost their milk" and hastily introduce infant formula. According to the expert, however, most of these difficulties can be resolved if mothers receive proper breastfeeding guidance and continue breastfeeding frequently.

Furthermore, insufficient support from families and workplaces is another important factor. Many mothers wish to maintain their milk supply but lack the conditions necessary to express and store breast milk because their workplaces do not provide lactation rooms or milk storage facilities, do not allow suitable breaks, or because they have not received adequate understanding and support from family members. Some also encounter misconceptions such as "breast milk does not provide enough nutrients" or "breast milk is not good," making them more likely to discontinue breastfeeding before the recommended time.

Hoang Thi Duc Ngan, PhD, also noted that infant formula advertising and marketing are among the factors significantly influencing many families' breastfeeding decisions. According to a report by the World Health Organization (WHO), advertising messages lacking scientific evidence remain prevalent in Vietnam, including claims that formula milk helps children grow taller, become more intelligent or develop more rapidly. These marketing campaigns often exploit parental anxieties, particularly among mothers who must return to work soon after childbirth, prompting many families to supplement or replace breast milk with infant formula even when it is not genuinely necessary.

According to the expert, the consequences extend beyond infants losing access to valuable breast milk. Many families, especially low-income households, must also bear the additional costs of purchasing infant formula. In the longer term, an increased risk of childhood illness also means families may face higher healthcare and medical treatment expenses.

Early Loss of Milk Supply Deprives Infants of Valuable Immune Protection

According to Hoang Thi Duc Ngan, PhD, physiologically, breast milk production operates on a "supply-and-demand" mechanism, meaning that the more frequently and effectively an infant breastfeeds, the more milk the mother's body produces. Conversely, when mothers must return to work early and cannot breastfeed directly or maintain regular milk expression, stimulation of the mammary glands is interrupted. Milk production then gradually declines and may stop entirely within a short period. In addition, introducing bottle-feeding too early may reduce an infant's desire to breastfeed directly, creating a vicious cycle in which the milk supply continues to decrease.

According to the expert, early cessation of breastfeeding not only affects maternal milk production but also directly influences children's health and development. Many infants are switched to formula feeding before the recommended time. In some localities, infants are even given powdered cereal, porridge or rice water before reaching six months of age, when their digestive systems are not yet fully developed. This increases the risk of diarrhea, respiratory infections and malnutrition, as well as the risk of overweight and obesity later in life.

"More importantly, infants lose access to valuable antibodies and immune factors found in breast milk, components that no infant formula has yet been able to fully replace," Hoang Thi Duc Ngan, PhD, emphasized.

Children are not the only ones affected. Early weaning also deprives mothers of numerous health benefits. Many studies have demonstrated that continued breastfeeding helps reduce the risk of breast cancer, ovarian cancer and type 2 diabetes, while also contributing to a lower risk of postpartum depression.

Currently, the trend of women returning to work soon after childbirth is relatively common and is one of the factors directly affecting the continuation of breastfeeding. Although Vietnam's Labour Code provides female employees with six months of maternity leave, a policy considered progressive and exceeding the minimum 14 weeks stipulated by the International Labour Organization (ILO) Maternity Protection Convention, in practice, this policy primarily applies to workers in formal employment relationships.

Meanwhile, a substantial proportion of Vietnamese women work in the informal sector, including small-scale trading, agriculture, seasonal employment, self-employment and digital platform-based work. For these workers, taking maternity leave means losing their income, forcing many to return to work when their babies are only 2–3 months old. Even in the formal sector, many mothers choose to return to work before the end of their maternity leave because of financial pressures or concerns about their job security.

Given these circumstances, Hoang Thi Duc Ngan, PhD, believes that to increase the proportion of infants exclusively breastfed during the first six months of life, Vietnam needs not only to maintain maternity policies but also to introduce additional practical support measures for postpartum women, particularly those working in the informal sector and mothers who must return to work early due to economic pressures.

Ensuring Breastfeeding Requires a Collective Effort from Society

Speaking to Vietnamese Children Magazine, Associate Professor Nguyen Trong Hung, PhD, a physician and Director of the Center for Nutrition Counseling, Rehabilitation and Obesity Control at the National Institute of Nutrition, said that, in practice, a mother's ability to maintain breastfeeding is influenced by numerous factors, including knowledge, health status, postpartum leave, working conditions, self-confidence and support from family members.

At the family level, the role of fathers and other family members is particularly important. Sharing childcare responsibilities, helping mothers get adequate rest, ensuring appropriate nutrition and providing emotional encouragement can help mothers reduce stress, maintain their milk supply and feel more confident throughout their breastfeeding journey.
In addition, the healthcare system needs to further strengthen counseling and support for mothers during pregnancy, childbirth and the postpartum period. Guidance on initiating breastfeeding within the first hour after birth, support for proper infant latch techniques, and assistance in addressing difficulties such as blocked milk ducts, nipple pain or concerns about insufficient milk supply should be based on scientific evidence, helping families acquire the knowledge necessary to sustain breastfeeding.

According to the expert, creating breastfeeding-friendly workplaces is also a decisive solution. Government agencies and businesses should ensure that female employees can take maternity leave in accordance with regulations, provide suitable spaces for expressing and storing breast milk, and implement supportive policies when mothers return to work. These measures are important in helping many mothers continue breastfeeding after their maternity leave ends.

At the same time, communication efforts should be intensified to change public perceptions, recognizing breastfeeding not merely as an individual family's choice but also as an investment in public health and the country's future. Policies to protect, promote and support breastfeeding should be integrated into national nutrition strategies, contributing to reducing malnutrition, improving the quality of human resources and promoting sustainable development.

According to the expert, to improve breastfeeding rates, Vietnam needs to move away from an approach that relies on "mothers making efforts on their own" toward building a comprehensive support system in which families, healthcare facilities, workplaces and communities share responsibility. When mothers are provided with favorable conditions for breastfeeding, not only do children benefit in terms of health and comprehensive development, but families, society and the economy also gain long-term and sustainable benefits.

Sharing this view, Hoang Thi Duc Ngan, PhD, stated that whether a child is exclusively breastfed during the first six months of life depends not only on the mother's determination but also reflects the level of support provided by her family, workplace, healthcare facilities and social policies.

According to the expert, the family is the first "pillar of support" that helps mothers maintain breastfeeding. Husbands should share household chores and childcare responsibilities so mothers have time to rest, rather than adding pressure through beliefs such as "if there isn't enough breast milk, just use a bottle." Grandparents should also update their knowledge of childcare in line with current recommendations instead of following outdated practices, such as introducing complementary foods or giving infants water before six months of age.

In addition, healthcare facilities need to effectively implement breastfeeding support measures immediately after birth, including skin-to-skin contact, early initiation of breastfeeding within the first hour, counseling on breastfeeding techniques and ongoing support for mothers throughout their breastfeeding journey. In particular, counseling networks at hospitals and commune health stations, along with remote counseling services, should proactively support mothers preparing to return to work, a period considered a "golden window" for maintaining breast milk supply.

Hoang Thi Duc Ngan, PhD, also emphasized that mothers themselves need to acquire knowledge and practical skills during pregnancy concerning milk production, correct breastfeeding techniques, breast milk expression and storage, as well as appropriate nutrition and rest. Upon returning to work, mothers should maintain regular milk expression while increasing direct breastfeeding in the mornings, evenings and on days off to sustain their milk supply.

From an employer's perspective, according to the expert, businesses must fully comply with legal regulations supporting female employees with young children, including ensuring breastfeeding breaks, providing spaces for expressing and storing breast milk, and allowing flexible working arrangements. In practice, businesses that establish breastfeeding-friendly workplaces not only help employees feel secure and committed to their jobs but also contribute to improved productivity and reduced employee turnover and childcare-related absences.
Furthermore, the government should continue improving policies that support postpartum women, extending protection to informal-sector workers, strengthening controls over the marketing of breast milk substitutes, and intensifying communication efforts to eliminate prejudices and misconceptions surrounding breastfeeding.

"Breast milk is a child's 'first vaccine' and the best nutritional foundation during the first 1,000 days of life. To ensure that more infants are exclusively breastfed during their first six months as recommended, every mother, whether working in a factory, an office, a field or a market, needs support from her family, workplace and society as a whole. We must not allow the pressure to earn a living to become a barrier that disrupts the breastfeeding journey," Hoang Thi Duc Ngan, PhD, emphasized.

Although awareness of the benefits of breast milk continues to improve, the gap between targets and reality shows that a mother's efforts alone are not enough. To ensure that every child has the opportunity to be exclusively breastfed during the first six months of life, a coordinated support ecosystem is needed, encompassing national policies, the healthcare system, businesses, families and communities.