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APHA Scientific Session and Event Listing

Ann M. Dozier, RN, PhD¹, Cynthia R. Howard, MD, MPH², Cynthia K. Childs, MFA, MPH¹, and Ruth A. Lawrence, MD³. (1) Community and Preventive Medicine/Division Public Health, University of Rochester, 601 Elmwood Ave - Box 664, Rochester, NY 14642, 5852732592, ann_dozier@urmc.rochester.edu, (2) Pediatrics, Rochester General Hospital, 1425 Portland Ave, Rochester, NY 14621, (3) Pediatrics, University of Rochester, 601 Elmwood Ave - Box 777, Rochester, NY 14642

Rates of immediate post-discharge formula initiation among breastfeeding (BF) mothers differed significantly between two similar hospitals both with well-defined breastfeeding support programs, (one baby friendly designated (BFH); one community hospital (CH)). As early formula introduction is known to effect BF duration we examined whether this relationship could be explained by maternal BF factors.

In-hospital baseline data from two BF mother cohorts (BFH=428; CH=414) demonstrated no significant differences across demographics, BF goals and influences on infant feeding decisions .

Among mothers who decided prenatally to BF (n=825), when queried prior to hospital discharge, 88% anticipated using pumped breastmilk, 34% anticipated using formula. Identical proportions from each hospital cohort indicated that they would start using pumped breastmilk immediately (24%). Formula use post-discharge differed significantly with more CH mothers (46% (n=68)) indicating immediate initiation compared with only 25% of BFH mothers (n=35) (p<.05).

Using logistic regression with immediate formula supplementation of BF as the dependent variable the effect of hospital was maintained while controlling for effect of prenatal feeding decision, prior BF experience and breastfeeding confidence (Likert scale 1-4). Maternal BF goal, trimester of BF decision, plans to use pumped breastmilk, having changed mind during pregnancy and the hospital BF experience were not significantly associated with plans to initiate supplementation and therefore not included in the model.

Hospital practices such as those in the Baby Friendly Hospital Initiative appear to have a distinct influence on when BF mothers introduce formula which may help to explain the known contribution to longer BF duration.

Learning Objectives:

• At the end of this presentation, participants will
• -have a better understanding of early initiation of formula among breastfeeding mothers
• -be able to state potential implications for support to breastfeeding mothers

Keywords: Breastfeeding, Infant Health

Presenting author's disclosure statement:

Not Answered