The Association Between Type of Supplementation in the Newborn Nursery and Breastfeeding Outcomes at 2 and 6 Months of Age

Abstract

Background: Supplementation in the newborn nursery has been associated with shorter breastfeeding duration. However, supplementation may at times be necessary. Research Aim: To determine the association between type of supplementation in the newborn nursery (mother’s own milk, formula, donor human milk) and breastfeeding outcomes at 2 and 6 months of age. Methods: This was a prospective, longitudinal, observational multi-group cohort study. In total, 2,343 surveys were sent to parents who, prior to delivery, indicated intent to exclusively breastfeed. Participants were grouped by type of nursery supplementation. Surveys asked about breastfeeding outcomes when infants were 2 and 6 months old. Our final analytic sample included data from 1,111 healthy newborns ≥ 35 weeks. We used multiple logistic regression to compare future breastfeeding outcomes for infants who were exclusively directly breastfed or who received supplementation during their birth hospitalization. Results: Both the donor human milk and formula groups had decreased breastfeeding at 2 and 6 months compared to the exclusively directly breastfed group. Notably, for infants who received formula compared to donor human milk, the odds of breastfeeding at 2 and 6 months were 74% and 58% lower, respectively ( OR = 0.26, 95% CI [0.12, 0.56] at 2 months; OR = 0.42, 95% CI [0.19, 0.94] at 6 months). The donor human milk group had lower odds of breastfeeding at both follow up times compared to the mother’s own milk group. Conclusion: Among those who intend to breastfeed, supplementation with donor human milk instead of formula in the newborn nursery may support longer breastfeeding.

Analysis of Factors Contributing to Exclusive Breastfeeding Failure in the Province of Aceh, Indonesia

“…Similarly, a study in the Philippines by [11] identified factors such as inadequate maternal knowledge, physical discomfort during breastfeeding, and the influence of formula milk advertising as barriers to achieving exclusive breastfeeding practices [11]. Studies conducted in the United States and Australia by [12,14] also highlighted factors such as low education level, low socioeconomic status, lack of social support, and negative perceptions of breastfeeding as contributing to the failure of exclusive breastfeeding.…”

“…Individual factors such as limited knowledge and understanding of the benefits and techniques of exclusive breastfeeding, physical discomfort or difficulties in breastfeeding, and maternal health issues such as breast infections or hormonal problems can hinder the achievement of optimal complete breastfeeding practices [10,11]. Additionally, social and cultural factors play a significant role, such as social support from family and the surrounding environment, cultural habits or norms that do not support exclusive breastfeeding, and the influence of community perceptions towards breastfeeding practices [12,13]. The economic factor can also be a barrier, especially if the mother has to work or has limited access to healthcare and adequate support [14,15].…”

Use of Donor Human Milk in Populations Other than Preterm Very Low Birthweight Infants

“…Cohort studies comparing breastfeeding rates before and after a practice change to supplementation with DHM have reported higher exclusive breastfeeding rates at 2 and ≥6 months. 25,26 A large secondary analysis (n = 1631) of national-level survey data in Finland found infants supplemented with DHM were more likely to be exclusively breastfeeding at 0-1, 2-3, and 4-5 but this was only statistically significant at 4-5 months. 27 However, a prospective observational study found rates of any breastfeeding were similar between DHM and IF groups at 1 month postpartum.…”

“…Studies examining the effect of DHM supplementation on breastfeeding rates following hospital discharge have also had conflicting results. Cohort studies comparing breastfeeding rates before and after a practice change to supplementation with DHM have reported higher exclusive breastfeeding rates at 2 and ≥6 months 25,26. A large secondary analysis (n = 1631) of national-level survey data in Finland found infants supplemented with DHM were more likely to be exclusively breastfeeding at 0-1, 2-3, and 4-5 but this was only statistically significant at 4-5 months 27.…”