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Study: In-hospital formula linked to earlier weaning from breastfeeding :

June 9, 2020

A new study adds to the evidence that infants don’t breastfeed as long when they have received formula in the hospital.

The Academy recommends exclusive breastfeeding for six months and continued breastfeeding with complementary foods until the child is at least 1 year. However, breastfed infants often are supplemented with formula in the hospital when it is not medically necessary.

To look more closely at the impact, researchers analyzed data on infants enrolled in the Minnesota Special Supplemental Nutrition Program for Women, Infants and Children Program. They matched infants who were exclusively breastfed to those who were both breastfed and given formula using propensity scoring (n=5,310). In a more conservative analysis of 4,836 infants, they adjusted for medically necessary supplementation.

They found infants had 2.5 to six times the risk of early weaning if they had received formula supplementation, according to “In-Hospital Formula Feeding and Breastfeeding Duration,” (McCoy MB, Heggie P. Pediatrics. June 9, 2020, https://doi.org/10.1542/peds.2019-2946).

“This finding has important clinical implications because breastfeeding duration has been shown to have a significant impact on numerous health outcomes, with a dose-response protective effect for sudden infant death syndrome, infection in infancy, and childhood obesity,” authors wrote.

They said the reduced breastfeeding duration after formula may be due to mothers’ supply dropping. Mothers also may not feel they can produce enough if they are told their infant needs formula, or the baby may develop a preference for bottle-feeding.

Authors said physicians should encourage breastfeeding and educate families about skin-to-skin contact, feeding cues and hand expression. Culturally appropriate peer counseling, doula support and support groups also can encourage breastfeeding. In addition, health care providers should stop giving breastfeeding samples and supplementation that is not medically necessary. Hospitals also can encourage breastfeeding using the World Health Organization’s “Ten Steps to Successful Breastfeeding.”

“A breastfeeding-friendly hospital environment gets infants off to the best start,” authors wrote. “For the mother-infant dyad, we need to ensure care that recognizes when breastfeeding is not going well and provides early and ongoing skilled assistance in resolving breastfeeding issues."

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