Work outside the Home is the Primary Barrier to Exclusive Breastfeeding in Rural Viet Nam: Insights from Mothers Who Exclusively Breastfed and Worked

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Abstract
This study assessed barriers to exclusive breastfeeding in rural Viet Nam and identified how a few mothers were able to exclusively breastfeed despite barriers. A cross-sectional quantitative and qualitative assessment was carried out among 120 mothers of infants less than six months old in northern Viet Nam. Only 24% of the mothers exclusively breastfed. Adjusting for infant's age and who attended delivery, the risk of not exclusively breastfeeding was 14.0 times greater for women who had returned to work than for women who had not. Exclusively breastfeeding mothers (n = 4) who worked differed from other mothers in important ways. They all felt they had enough milk, all knew the appropriate time to introduce foods and liquids, and most were supported in their breastfeeding decisions by commune health workers and family members. This research suggests strategies that can be implemented now to increase exclusive breastfeeding in rural work environments. These include improving knowledge about the introduction of water and semi-solids, addressing perceptions of milk insufficiency, securing support from others, and presenting mothers with options for exclusively breastfeeding, even when they work outside the home.