Knowledge, attitudes, and practices of breastfeeding women in Krong, Kep municipality, Cambodia / by Hilary M. Wren.

Abstract

South-Eastern Asia has the highest levels of undernourishment among children in Asia. Cambodia remains one of the least developed and poorest countries in this region; the probability of a child dying before age five is roughly 1 in 10. Given this information, there is an international expectation that Khmer mothers of newborns initiate and maintain exclusive breastfeeding for the recommended six months. There is also a concomitant expectation that Cambodian society will provide these mothers with essential health services, education, and support systems in order to ensure that breastfeeding is a success. The purpose of this study was to; 1. Determine mothers’ knowledge related to infant feeding. 2. Determine attitudes that affect mothers’ decisions to initiate breastfeeding and to continue exclusive breastfeeding for the recommended six months minimum. 3. Determine current breastfeeding practices and to identify cultural barriers to breastfeeding. 4. Determine if there are existing breastfeeding promotion programs and what, if any, changes could be made to these health promotion programs to reduce the suggested barriers to breastfeeding. Descriptive statistics were used to organize and summarize the information obtained from a sample (n = 141) o f the population. Analysis was used first to determine whether or not a mother chose to breastfeed, and second to determine for how long a mother breastfed exclusively. Reasons why mothers chose to breastfeed or chose not to breastfeed/to discontinue breastfeeding were also analyzed. The results from the KAP study suggest most Khmer mothers have a high level of confidence regarding their breastfeeding skills. Most women are not shy to breastfeed in public and feel a strong sense of belonging to their communities. Similarly, Khmer mothers are more likely to breastfeed if they are older, well-educated, and feel supported. Likewise, a mother’s decision not to breastfeed/to discontinue breastfeeding is largely influenced by the social inequalities in her environment. The decision not to breastfeed cannot be attributed solely to any one factor yet each contributing factor is greatly compounded by the injustice of poverty. The conditions in which Cambodian mothers must make decisions for their health and the health or their children are appalling. Moreover, professional breastfeeding support programs do not exist in Krong Kep, Cambodia. Unlike in Canada where almost all women have access to many health promotion programs (Healthy Babies, Healthy Children, La Leche League, prenatal classes, etc.) mothers in Cambodia do not have this luxury. It is extremely hard for Cambodian mothers to overcome the barriers to breastfeeding without the correct support and without access to culturally sensitive public health breastfeeding programs. Lastly, breastfeeding in Cambodia is a cultural experience between mother and child. Khmer women are experts in their own culture and health promotion programs must take a humble approach to traditional practices such as roasting and the use of traditional medicines following childbirth. Khmer mothers must not be induced to breastfeed through guilt and thus international recommendations regarding breastfeeding initiation and duration should be examined in a Cambodian context. Further research and respectful cross-cultural dialogue is needed in order to enable Khmer mothers to increase control over health based decisions in their lives and to and improve maternal and child health in Cambodia.