Breastfeeding Trends in Cambodia, and the Increased Use of Breast-Milk Substitute—Why Is It a Danger?

Abstract

A cross-sectional analysis of the Cambodia Demographic Health Surveys from 2000, 2005 and 2010 was conducted to observe the national trends in infant and young child feeding practices. The results showed that rates of exclusive breastfeeding among infants aged 0–5.9 months have increased substantially since 2000, concurrent with an increase in the rates of early initiation of breastfeeding and a reduction in the giving of pre-lacteal feeds. However, the proportion of infants being fed with breast-milk substitutes (BMS) during 0–5.9 months doubled in 5 years (3.4% to 7.0%) from 2000 to 2005, but then did not increase from 2005, likely due to extensive public health campaigns on exclusive breastfeeding. BMS use increased among children aged 6–23.9 months from 2000 to 2010 (4.8% to 9.3%). 26.1% of women delivering in a private clinic provided their child with breast-milk substitute at 0–5.9 months, which is five times more than women delivering in the public sector (5.1%), and the greatest increase in bottle use happened among the urban poor (5.8% to 21.7%). These findings are discussed with reference to the increased supply and marketing of BMS that is occurring in Cambodia.

Pervasive promotion of breastmilk substitutes in Phnom Penh, Cambodia, and high usage by mothers for infant and young child feeding

“…Recent secondary analysis of CDHS findings from 2000 to 2010 also indicates the greatest rise in bottle use among the urban poor, a population particularly at risk for use of contaminated water during mixed feeding (Prak et al . 2014). In addition to decreased risk of morbidity (Clemens et al .…”

“…In this study, mothers who used a breastmilk substitute as a prelacteal feed with their youngest child were 3.9 times more likely to currently feed this same child breastmilk substitutes, as compared with mothers who did not use these products for prelacteal feeding. Recent secondary analysis of CDHS findings from 2000 to 2010 also indicates the greatest rise in bottle use among the urban poor, a population particularly at risk for use of contaminated water during mixed feeding (Prak et al 2014). In addition to decreased risk of morbidity (Clemens et al 1999;Dewey et al 1995) and mortality (Victora et al 1992;Labbok et al 2004;WHO 2000) for children, the benefits of breastfeeding for mother and child are wide, including reduced risk of obesity (Melnik 2014; Gillman et al 2006), allergies (Kramer 2011;Melnik 2014), asthma (Kim et al 2009) and chronic disease (Owen et al 2006;Martin et al 2005;Owen et al 2002) Additionally, a recent study found an association between breastfed children and higher intelligence and educational attainment later in life (Victora et al 2015).…”

“…Exclusive breastfeeding rates among infants less than 6 months of age increased between 2000 and 2010 from 11% to 74% but declined to 65% in 2014 (NIS 2015). A study by Prak et al notes that this initial progress in breastfeeding practices may be due to the advent of infant and young child feeding (IYCF)-focused public health campaigns; however, the study also notes the increasing use of breastmilk substitutes across Cambodia that could curtail these efforts (Prak et al 2014). In 2010, 4.7% of currently breastfed and 25.5% of nonbreastfed children below 24 months of age were being fed breastmilk substitutes (NIS 2011).…”

Point‐of‐sale promotion of breastmilk substitutes and commercially produced complementary foods in Cambodia, Nepal, Senegal and Tanzania

“…The proliferation of BMS products available for sale (more than three times the number of different products sold and manufacturers represented than the other three countries) is happening in parallel to declining exclusive breastfeeding rates in Cambodia (NIS Cambodia 2011; Prak et al . 2014; NIS Cambodia 2015). In Dakar, a similar survey found a different situation, with 20.2% of children 6–23 months of age having consumed BMS while 26.1% consumed CPCF (Feeley et al .…”

“…Despite an increased global focus on child nutrition and stunting, breastfeeding practices in Africa and Asia show room for improvement. The 2014 Demographic and Health Survey in Cambodia found that 65% of children less than 6 months of age are exclusively breastfed, a decline from the 74% in 2010 (NIS Cambodia 2011, and there is evidence that both bottle feeding (NIS Cambodia 2015) and BMS use (Prak 2014) are increasing. In Nepal, where exclusive breastfeeding through 6 months of age is generally high at 70%, early introduction of complementary foods is a concern; 3% of breastfeeding children aged 2-3 months receive some kind of solid or semi-solid food, a figure that rises to 23% by 4-5 months of age (MOHP 2012).…”