In-Hospital Formula Feeding and Breastfeeding Duration

McCoy, Marcia Burton; Heggie, Pamela

doi:10.1542/peds.2019-2946

Cited by 60 publications

(81 citation statements)

References 51 publications

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“…Qualitative research suggests mothers may perceive DHM as a bridge to overcome initial breastfeeding difficulties (Kair & Flaherman, 2017), rather than as a failure on their part when formula is used. When used in the context of optimal lactation support, DHM use in neonatal intensive care unit (NICU) can support maternal breastfeeding (Adhisivam et al, 2017; Kantorowska et al, 2016; Wilson et al, 2018), whereas the early introduction of IF is correlated with early breastfeeding cessation (Chantry, Dewey, Peerson, Wagner, & Nommsen‐Rivers, 2014; McCoy & Heggie, 2020). Two randomized controlled trials evaluated early, controlled supplementation with IF or DHM for newborns with significant weight loss, finding neither form of supplementation‐influenced breastfeeding duration (Flaherman, Cabana, McCulloch, & Paul, 2019; Kair, Flaherman, & Colaizy, 2019).…”

Section: Introductionmentioning

confidence: 99%

Use of donor human milk in nonhospitalized infants: An infant growth study

Bramer

Boyle

Weaver³

et al. 2021

Maternal & Child Nutrition

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When mother's own milk (MOM) is unavailable or insufficient, donor human milk (DHM) is recommended as the next best alternative for low birthweight infants. DHM use for healthy, term infants is increasing, but evidence for growth and tolerability is limited. This retrospective study evaluated growth in term infants in the community who received DHM from a UK milk bank. Mothers of infants receiving DHM between 2017 and 2019 were contacted (n = 49), and 31 (63.2%) agreed to participate. Fourteen infants received DHM as a supplement to other feeds (MOM and/or infant formula) and 17 were exclusively fed DHM where breastfeeding was impossible (range: 3-6 weeks). Growth was assessed by deriving z-scores using the WHO standard for infant growth and compared with 200 exclusively breastfed infants. Multivariate regression analysis revealed no feeding method-specific association between z-score and age, nor between weight and age, suggesting that z-scores and growth velocity were not affected by feeding exclusive MOM, supplemental DHM or exclusive DHM. DHM was well-tolerated with no adverse events that led to early cessation. After receiving supplemental DHM group, 63% of infants whose mothers had no physical barrier to breastfeeding (5/8 infants) were exclusively breastfed. This novel study reports adequate growth outcomes of healthy nonhospitalized infants receiving DHM, either as the sole milk source or supplement. Prospective studies are needed to confirm whether DHM is a suitable feeding alternative for term infants in the community, optimal durations, as well as the impact of DHM availability on breastfeeding rates and maternal mental health.

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Section: Introductionmentioning

confidence: 99%

Use of donor human milk in nonhospitalized infants: An infant growth study

Bramer

Boyle

Weaver³

et al. 2021

Maternal & Child Nutrition

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“…Such a result can be attributed to long hospital stay, resulting in greater exposure to conditions that can inhibit EBF, and to the feeding practice during hospital stay, which would indicate the influence of health practices and services [54]. Similarly to previous studies, the use of infant formula during hospitalization resulted in shorter EBF, which provides greater protection and health recovery [55][56][57], while EBF during hospitalization predicts longer EBF duration [54,58]. McCoy & Heggie [55]…”

Section: Plos Onementioning

confidence: 83%

The effect of risk at birth on breastfeeding duration and exclusivity: A cohort study at a Brazilian referral center for high-risk neonates and infants

et al. 2021

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Background and aim Both breastfeeding and the use of human milk are strategies that provide better conformation to health throughout an individual’s life and bring countless short- and long- term benefits, which are well established in the scientific literature. For at-risk newborns (NBs), these strategies are crucial interventions to enable neonatal survival with better quality of life due to the distinctive and complex composition of human milk, which serves as personalized food-medicine-protection. However, there is limited knowledge about breastfeeding practices in high-risk NBs. The aim was to estimate the duration of EBF and to investigate the effect of risk at birth on EBF discontinuity in the first six months of life’. Methods This cohort study included 1,003 NBs from a high-risk referral center, followed up from birth to the sixth month of life, between 2017 and 2018. Correspondence and cluster analysis was used to identify neonatal risk clusters as the main exposure. The object of interest was the time until EBF discontinuity. The Kaplan-Meier methods and the Cox proportional hazards model were used to estimate the hazard ratio and 95% confidence intervals. Results The prevalence and median duration of EBF decreased proportionally in the three groups. The multiple model revealed a gradient in EBF discontinuity, which was 40% higher in risk group 1 and 111% higher in risk group 2 compared to healthy full-term NBs. Additionally, EBF during hospitalization predicted a longer median duration of this practice for high-risk NBs. Conclusion This study confirms a high proportion of high-risk NBs who have EBF discontinued before six months of life. The risk of EBF discontinuity is higher in risk groups, with a gradual effect even when adjusted by several factors. Effective interventions are needed to promote, protect, and support breastfeeding in different profiles of risk-at-birth groups.

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“…As we lacked statistical power to examine severity of household food insecurity in relation to breastfeeding outcomes and to conduct multivariable analyses, further research on food insecurity and breastfeeding outcomes among vulnerable women in Canada is warranted. The 5Ps CPNP lactation support program, and the national CPNP in general, focuses on providing community-based support, but the use of formula inhospital is a predictor of breastfeeding outcomes, especially among vulnerable women [52][53][54]. In-hospital formula use among study participants was common (60%) and higher than provincial data from Ontario (43%) [55].…”

Section: Discussionmentioning

confidence: 99%

Breastfeeding rates are high in a prenatal community support program targeting vulnerable women and offering enhanced postnatal lactation support: a prospective cohort study

Francis

Mildon

Stewart

et al. 2021

Int J Equity Health

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Background In Canada, 91% of all mothers initiate breastfeeding, but 40–50% stop by 6 months and only 34% breastfeed exclusively for 6 months, with lower rates among socially and/or economically vulnerable women. The Canada Prenatal Nutrition Program (CPNP) aims to support breastfeeding among vulnerable women, but there is no formal framework or funding for sites to integrate proactive postnatal breastfeeding support. This research aimed to i) describe infant feeding practices among clients of one Toronto CPNP site using charitable funds to offer a lactation support program (in-home lactation consultant visits, breast pumps); ii) determine whether breastfeeding outcomes at 6 months differ based on maternal sociodemographics and food insecurity; and iii) assess utilization of the lactation support program. Methods Infant feeding practices were collected prospectively at 2 weeks, 2, 4 and 6 months postpartum via telephone questionnaires (n = 199). Maternal sociodemographics were collected at 2 weeks and food insecurity data at 6 months postpartum. Program monitoring records were used to determine utilization of the lactation support program. Results Ninety-one percent of participants were born outside of Canada; 55% had incomes below the Low-Income Cut-Off; and 55% reported food insecurity. All participants initiated breastfeeding, 84% continued for 6 months and 16% exclusively breastfed for 6 months. Among breastfed infants, ≥76% received vitamin D supplementation. Approximately 50% of infants were introduced to solids before 6 months. Only high school education or less and food insecurity were associated with lower breastfeeding rates. Overall, 75% of participants received at least one visit with a lactation consultant and 95% of these received a breast pump. Conclusions This study provides initial evidence that postnatal lactation support can be delivered within a CPNP site, with high uptake by clients. While all participants initiated breastfeeding and 84% continued for 6 months, adherence to the recommended 6 months of exclusive breastfeeding was low. Further research is needed to better understand the barriers to exclusive breastfeeding and how to support this practice among vulnerable women. Study registered at clinicaltrials.gov as NCT03400605.

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In-Hospital Formula Feeding and Breastfeeding Duration

Cited by 60 publications

References 51 publications

Use of donor human milk in nonhospitalized infants: An infant growth study

Use of donor human milk in nonhospitalized infants: An infant growth study

The effect of risk at birth on breastfeeding duration and exclusivity: A cohort study at a Brazilian referral center for high-risk neonates and infants

Breastfeeding rates are high in a prenatal community support program targeting vulnerable women and offering enhanced postnatal lactation support: a prospective cohort study

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