Formula Milk Supplementation on the Postnatal Ward: A Cross-Sectional Analytical Study

Abstract

Breastfeeding rates are low in the UK, where approximately one quarter of infants receive a breastmilk substitute (BMS) in the first week of life. We investigated the reasons for early BMS use in two large maternity units in the UK, in order to understand the reasons for the high rate of early BMS use in this setting. Data were collected through infant feeding records, as well as maternal and midwife surveys in 2016. During 2016, 28% of infants received a BMS supplement prior to discharge from the hospital maternity units with only 10% supplementation being clinically indicated. There was wide variation in BMS initiation rates between different midwives, which was associated with ward environment and midwife educational level. Specific management factors associated with non-clinically indicated initiation of BMS were the absence of skin-to-skin contact within an hour of delivery (p = 0.01), and no attendance at an antenatal breastfeeding discussion (p = 0.01). These findings suggest that risk of initiating a BMS during postnatal hospital stay is largely modifiable. Concordance with UNICEF Baby Friendly 10 steps, attention to specific features of the postnatal ward working environment, and the targeting of midwives and mothers with poor educational status may all lead to improved exclusive breastfeeding rates at hospital discharge.

Promotion and support of breastfeeding within the baby-friendly hospital initiative programme in Slovakia

“…The information on breastfeeding received by more than half (57.5%) of the respondents on their discharge from hospital was shown to be pertinent, and complied with BFHI recommendations. Our results turned out to be more favourable than those of the study by Biggs et al (2018), in which only 38% of the 102 respondents were adequately informed about breastfeeding. According to the evaluated answers of our study, less than one third of the respondents did not receive proper recommendations and advice from health providers about the frequency of breastfeeding, i.e., that the newborn should be breastfed on demand.…”

“…In the Czech Republic, women are provided with information contrary to the BFHI protocols, such as the recommendation to use glucose to get infants to latch onto the breast more easily (Pokorná et al, 2016). In the UK, it is believed that the lack of time and heavy workload of midwives might contribute to their non-compliance with the BFHI protocols, despite the training they receive regarding formula feeding (Biggs et al, 2018). Use of a pacifier feeding bottle for formula supplementation, considered to be a negative phenomenon, was revealed in our study.…”

Formula supplementation remains a risk for cow's milk allergy in breast‐fed infants

“…Yet, 43.9% of formula supplementation was administered by HCPs, not parents, a higher rate than that reported recently in the UK. 18 We found that subjective reasons explained a very high proportion (75%) of total variance in our models with 'no latch' and 'mum unwell/exhausted' emerging as the strongest predictors for formula supplementation in contrast to objective factors such as low baby weight. This distinction is important since subjective factors can be modified more easily than objective factors.…”

Breast milk alkylglycerols sustain beige adipocytes through adipose tissue macrophages

“…Because AKGs increase Lactobacillus proliferation (94), they might also contribute to this indirect metabolic effect of breastfeeding. Today nearly 60% of infants are never breastfed (95,96) and childhood obesity may have its origins, at least in part, in insufficient breastfeeding (6)(7)(8)97). Components of the manufactured infant formula might also be responsible for the negative metabolic impact of the absence of breastfeeding (98).…”