Vietnam champions workplace-based breastfeeding

After Nguyen Minh Thu had her second child, she did something remarkable for a Vietnamese mother – she returned to work at the Nam Chau garment factory and continued breastfeeding.

The factory where she worked had recently opened a lactation room to allow mothers to express milk during their working hours, something that had been unavailable and, to her mind, unimaginable when she had her first child.

Across Vietnam and around the world, women often face a conundrum when it comes to breastfeeding. “Women have to choose between continuing to breastfeed and returning to work,” said Paul Zambrano, associate director at Alive & Thrive East Asia Pacific, a program created by the nonprofit FHI 360. “Because in most places they can’t do both. No woman should have to choose.”

Vietnam is championing a new way forward. The country’s government has, with support from partners, focused on ensuring adequate time, space, and support for breastfeeding women to return to work.

It started in 2012 when Vietnam passed among the most generous maternity leave policies in the world, guaranteeing women six months of paid maternity leave. Two years later, Vietnam went further, passing legislation encouraging employers with more than 1,000 female employees to educate them about the benefits of continuing to breastfeed after their return to work and provide them with the time and space to do so.

Over the next five years, the Vietnam General Confederation of Labor and Alive & Thrive partnered to develop and test models for lactation support programs in 70 large workplaces across the country. Their research convinced the government in 2020 to make these supports for lactation in the workplace mandatory for large employers.

In doing so, Vietnam has positioned itself as a global leader in improving breastfeeding rates, which research shows boosts the nutrition and health of children and supports women’s empowerment and participation in the workforce. Workforce participation for women is important because it raises an economy’s growth potential, while also increasing economic empowerment and autonomy for women.

Vietnam provides a perfect test case for the potential impact of workplace-based breastfeeding support efforts. The country has long had one of the highest rates of workforce participation for women in the world, at about 72%. That is the highest rate in Asia and higher than in many high-income countries, including Sweden, New Zealand, Australia, and China.

That high rate of workforce participation has come with a cost – extremely low rates of exclusive breastfeeding for under six-month-olds. In 2014, the national rate of exclusive breastfeeding in Vietnam was estimated to be about 24%, about half the average rate in Southeast Asia. Researchers surveying the country’s factories typically found far lower rates – below 10% – when they surveyed female factory workers. Surveys of women workers by the Vietnam General Confederation of Labor found that returning to work was the chief barrier for lactating mothers.

The World Health Organization and UNICEF recommend that mothers breastfeed their babies early and exclusively for the first six months and continue to breastfeed with appropriate complementary feeding up to two years of age or beyond to support the health of the child and mother. This recommendation is based on global research demonstrating that breastfeeding carries health benefits for both mothers and babies.

Vietnam’s efforts to make workplaces more supportive for lactating mothers, which include the provision of lactation rooms, paid lactation breaks twice a day, supportive management, and behavior change programs in support of breastfeeding, has now boosted the exclusive breastfeeding rate to an estimated 45% in participating factories and offices.

Research shows that female workers who have lactation breaks are nearly 62 times more likely to continue breastfeeding. Female workers who are supported and encouraged by their colleagues or supervisors to breastfeed are 2.4 times more likely to continue doing so. And female workers with access to a dedicated lactation room are 2.4 times more likely to continue breastfeeding.

The benefits extend beyond the women and their children.

Workplaces in Vietnam with lactation programs show significantly higher retention rates (94%) than the national average (59%). And women working in settings with lactation programs report feeling more satisfied by their work, more committed to their employer, and are more productive. These workplaces have seen a reduction in turnover of women employees and the number of sick days related to child health have dropped by half for the mothers who breastfeed.

Today, two million working women across Vietnam have access to lactation education programs and lactation rooms. And the country, where one-third to one-half of the workforce is women, can position itself as a pillar of the global supply chain that supports gender equality and promotes women’s access to the workforce, said Duong Vu a program manager at Alive & Thrive.

“Vietnam’s position in the global supply chain made leaders here more willing to engage. They realized that when companies comply with Vietnam’s regulations, they become gender champions,” said Vu. “This helps boost the competitiveness of these companies and our country.”

Vu noted that achieving this result has required more than a decade of advocacy efforts over and strong partnerships with the ministries of health and labor. Vietnam was the first country in Asia and second in the world to ratify the Convention on the Rights of the Child. This laid the foundation for legislation to support women in the workplace, including its extended maternity leave and breastfeeding in the workplace regulations.

About 50 countries have regulations on lactation rooms and daycare centers in the workplace and about 35 countries have compulsory regulations. Workplaces in Cambodia, Vietnam, Egypt, Nigeria have partnered with Alive & Thrive to enhance breastfeeding-friendly workplaces.

But even in these countries with compulsory regulations, coverage gaps exist, particularly for women working in the informal sector. Furthermore, gaps exist in the uptake of maternity entitlements even in the formal sector in the countries with robust laws and supportive programs.