In-Hospital Formula Supplementation in Appalachian Women Intending to Exclusively Breastfeed,Maternal and Child Health Journal

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In-Hospital Formula Supplementation in Appalachian Women Intending to Exclusively Breastfeed
Maternal and Child Health Journal ( IF 1.8 ) Pub Date : 2023-11-15 , DOI: 10.1007/s10995-023-03830-1
Elham Alqudah ₁ , Amy Davis ₂ , Seher Berzingi ₂ , Katherine Webster ₂ , Stephanie Thompson ₃ , Cortney Evans _{1,

4} , Kimberly Cross _{1,

4}

Affiliation

Objective

In-hospital formula supplementation places infants at risk for early breastfeeding cessation. The study’s aim was to identify predictive and protective factors for in-hospital formula supplementation in individuals documented as wanting to exclusively breastfeed and residing in a geographic region with adverse social determinants of health and low breastfeeding rates. Additionally, we wished to determine if lactation consultation served as a protective factor against supplementation.

Methods

In this cross-sectional study, we retrospectively reviewed 500 randomly selected charts of newborns born in a 12 month period at a regional tertiary care hospital. We included healthy, full-term neonates having a recorded maternal decision to exclusively breastfeed. Maternal-newborn dyad characteristics were compared between those exclusively breastfeeding and those with in-hospital formula supplementation.

Results

Of the 500 charts, 70% of individuals desired to exclusively breastfeed. Overall, 41% of breastfed newborns were supplemented with formula before discharge, and 32% of women met with lactation consultants prior to supplementation. No statistically significant association was present between exclusive breastfeeding at discharge and meeting with a hospital lactation consultant (p = 0.55). When controlling for the confounders of maternal demographics and lactation consultation, significant associations with formula supplementation included Cesarean delivery (odd ratio: 2.08, 95% confidence interval: 1.04–4.16), primiparity (2.48, 1.27–4.87), and high school level of education (2.78, 1.33–5.78).

Conclusions

Maternal characteristics of high school level educational, primiparity, and Caesarean delivery place individuals at risk for in-hospital formula supplementation in individuals wishing to exclusively breastfeed. Addressing barriers to exclusive breastfeeding is essential to enhance maternal and newborn health equity.

中文翻译：

打算纯母乳喂养的阿巴拉契亚妇女的住院配方奶粉补充剂

客观的

住院期间补充配方奶粉会使婴儿面临早期停止母乳喂养的风险。该研究的目的是确定那些想要纯母乳喂养且居住在健康问题社会决定因素不利且母乳喂养率低的地理区域的个体在院内补充配方奶的预测和保护因素。此外，我们希望确定哺乳咨询是否可以作为补充补充剂的保护因素。

方法

在这项横断面研究中，我们回顾性审查了 500 个随机选择的在地区三级护理医院 12 个月内出生的新生儿的图表。我们纳入了健康的足月新生儿，这些新生儿均记录了母亲决定纯母乳喂养的情况。比较了纯母乳喂养和院内配方奶粉补充的母婴二元特征。

结果

在 500 份图表中，70% 的人希望纯母乳喂养。总体而言，41% 的母乳喂养新生儿在出院前补充了配方奶，32% 的女性在补充前会见了哺乳顾问。出院时纯母乳喂养与与医院哺乳顾问会面之间不存在统计学上的显着关联（p = 0.55）。当控制母亲人口统计数据和哺乳咨询的混杂因素时，与配方奶补充剂的显着关联包括剖腹产（优势比：2.08，95%置信区间：1.04-4.16）、初产（2.48、1.27-4.87）和高中水平教育（2.78，1.33–5.78）。