Nguyen Phuong Hong, Menon Purnima, Ruel Mariel, Hajeebhoy Nemat
International Food Policy Research Institute (IFPRI) Hanoi, Viet Nam.
Asia Pac J Clin Nutr. 2011;20(3):359-74.
Sub-optimal infant and young child feeding (IYCF) practices are likely a significant contributor to high undernutrition rates in Viet Nam. To date, however, there has been no comprehensive review of IYCF practices in Viet Nam. The objectives of this paper were to review: 1) patterns/trends in IYCF in Viet Nam; 2) the barriers and facilitators to IYCF practices; and 3) interventions and policies and their effectiveness. Methods used include reviewing and analyzing existing data, summarizing and organizing the evidence into broad themes based on a pre-defined conceptual framework. Findings show that the proportion of children ever breastfed is almost universal and the median duration of breastfeeding is 13-18 months. However, exclusive breastfeeding for the first six months is low (8-17%) and appears to be declining over time. Information on complementary feeding is limited, but two key challenges are: early introduction, and low nutrient quality of complementary foods. Facilitators of optimal IYCF were support from 1) government progressive policies, 2) non-profit organizations and 3) family members. Barriers to optimal IYCF included 1) the lack of enforcement of, and compliance with the code of marketing breast milk substitutes, 2) inadequate knowledge among health care providers; and 3) maternal poor knowledge. These findings indicate that the evidence base on complementary feeding is weak in Viet Nam and needs to be strengthened. The review also reinforces that program and policy actions to improve IYCF in Viet Nam must target multiple stakeholders at different levels: the family, the health system and the private sector.
婴幼儿喂养方式欠佳可能是越南营养不良率居高不下的一个重要原因。然而，迄今为止，尚未对越南的婴幼儿喂养方式进行全面审查。本文的目的是审查：1）越南婴幼儿喂养方式的模式/趋势；2）婴幼儿喂养方式的障碍和促进因素；3）干预措施、政策及其效果。所采用的方法包括审查和分析现有数据，根据预先确定的概念框架将证据归纳和整理为广泛的主题。研究结果表明，曾经接受母乳喂养的儿童比例几乎达到普遍水平，母乳喂养的中位数持续时间为13至18个月。然而，头六个月纯母乳喂养的比例较低（8-17%），而且似乎随着时间的推移在下降。关于辅食喂养的信息有限，但两个关键挑战是：过早引入辅食，以及辅食的营养质量较低。最佳婴幼儿喂养方式的促进因素包括来自以下方面的支持：1）政府的进步政策，2）非营利组织，以及3）家庭成员。最佳婴幼儿喂养方式的障碍包括：1）缺乏对母乳代用品销售守则的执行和遵守情况；2）医疗保健提供者知识不足；以及3）母亲知识匮乏。这些研究结果表明，越南关于辅食喂养的证据基础薄弱，需要加以加强。该审查还强调，越南改善婴幼儿喂养方式的方案和政策行动必须针对不同层面的多个利益攸关方：家庭、卫生系统和私营部门。
