A nation-wide study on the common reasons for infant formula supplementation among healthy, term, breastfed infants in US hospitals

Full Description: In-hospital infant formula supplementation of breastfed infants reduces breastfeeding duration, yet little is known about common reasons for infant formula supplementation. Longer durations of breastfeeding are associated with health benefits, including reduced risk of sudden infant death syndrome and various infections for the child. Longer durations of breastfeeding are also associated with reduced risk for hypertension, type 2 diabetes, breast cancer, and ovarian cancer for the mother. Despite this evidence, 19% of US breastfed infants born in 2017 were supplemented with infant formula in the first 2 days of life. Understanding the common reasons for in-hospital infant formula supplementation is an important step in supporting the recommendation of exclusive breastfeeding for the first 6 months of life and continued breastfeeding for the first year of life for mother-infant dyads in the US.

We examined common reasons for in-hospital infant formula supplementation of healthy, term, breastfed infants in the US. Hospital data were obtained from the 2018 Maternity Practices in Infant Nutrition and Care survey (n=2,045), which is completed by hospital staff. An open-ended question on the common reasons for in-hospital infant formula supplementation was analyzed using thematic qualitative analysis and the frequencies for each reason were reported; 7 categories were identified. The 7 categories reported by hospital staff included medical indications (70.0%); maternal request/preference/feelings (55.9%); lactation management-related issues (51.3%); physical but non-medically indicated reasons (36.1%); social influences (18.8%); perceived cultural/societal/demographic factors (8.2%); and medical staff/institutional practices (4.7%). These findings suggest that a variety of factors should be considered to address infant formula supplementation. Lactation support delivered in a timely and culturally sensitive manner may reduce in-hospital infant formula supplementation.

The interactive communication methods will first include graphical presentation of the results and examples of each common reason for in-hospital infant formula supplementation. Second, this presentation will review existing literature on the topic. Third, this presentation will review potential system-level solutions that can be implemented to reduce in-hospital infant formula supplementation.

This presentation relates to conference theme by reporting recent results on reasons for infant formula supplementation and reviewing potential systemic-level solutions that can be implemented to reduce the trend of infant formula supplementation.

Abbreviated Description: We examined common reasons for in-hospital infant formula supplementation of healthy, term, breastfed infants in the US reported by hospital staff. Responses to an open-ended question on the 2018 Maternity Practices in Infant Nutrition and Care survey (n=2,045) were analyzed. The most reported reasons were medical indications (70.0%); maternal request/preference/feelings about breastfeeding such as frustration or lack of confidence (55.9%); lactation management-related issues (51.3%); physical but non-medically indicated reasons (36.1%); social influences (18.8%); perceived cultural/societal/demographic factors (8.2%); and medical staff/institutional practices (4.7%). Underlying many of the most common reasons for infant formula supplementation is a potential lack of lactation support.