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Nutrients. 2018 May 14;10(5). pii: E608. doi: 10.3390/nu10050608.

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

Author information

1
Brighton and Sussex Medical School, Brighton BN2 5BE, UK. K.Biggs1@uni.bsms.ac.uk.
2
Royal United Hospital, Combe Park, Bath BA1 3NG, UK. Katherine.hurrell@nhs.net.
3
Department of Paediatrics, Imperial College Healthcare NHS Trust, London W2 1NY, UK. ellie.matthews@imperial.nhs.uk.
4
Department of Paediatrics, Saint-Petersburg State Paediatric Medical University, 194353 Saint-Petersburg, Russia. doctor.khaleva@gmail.com.
5
inVIVO Planetary Health, Group of the Worldwide Universities Network (WUN), 6010 Park Ave, West New York, NJ 07093, USA. doctor.khaleva@gmail.com.
6
Department of Paediatrics, Imperial College Healthcare NHS Trust, London W2 1NY, UK. daniel.munblit08@imperial.ac.uk.
7
inVIVO Planetary Health, Group of the Worldwide Universities Network (WUN), 6010 Park Ave, West New York, NJ 07093, USA. daniel.munblit08@imperial.ac.uk.
8
Faculty of Pediatrics, I. M. Sechenov First Moscow State Medical University, 119991 Moscow, Russia. daniel.munblit08@imperial.ac.uk.
9
Department of Paediatrics, Imperial College Healthcare NHS Trust, London W2 1NY, UK. r.boyle@nhs.net.
10
inVIVO Planetary Health, Group of the Worldwide Universities Network (WUN), 6010 Park Ave, West New York, NJ 07093, USA. r.boyle@nhs.net.

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.

KEYWORDS:

attitudes; breastfeeding; formula supplementation; justification of supplementation; knowledge; midwifery

PMID:
29757936
PMCID:
PMC5986488
DOI:
10.3390/nu10050608
[Indexed for MEDLINE]
Free PMC Article

Conflict of interest statement

K.B., K.H., E.M., and E.K. declare no conflict of interest. R.J.B. is supported by the National Institute for Health Research Biomedical Research Centre (BRC), having received research grant income from Danone in relation to studies of the value of prebiotics in allergy prevention, and Airsonette to evaluate temperature-controlled laminar airflow for asthma. He has also given paid lectures for the companies. D.M. has received consultancy payment from Dairy Goat Co-Operative (NZ) Ltd. and has given paid lectures for the Merck Sharp & Dohme (MSD). The founding sponsors/pharmaceutical companies had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, and in the decision to publish the results.

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