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Journal of Human Lactation
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Reasons for In-Hospital Formula Supplementation of Breastfed Infants From Low-Income Families

Jennifer A. F. Tender, MD, IBCLC

Division of General Pediatrics at Children's National Medical Center

Jayarsi Janakiram, MS, RD, LD

Children's National Medical Center

Elda Arce, MD

Department of Adolescent Medicine

Rubina Mason, RN, IBCLC

Washington Adventist Hospital

Talita Jordan, MD

Children's National Medical Center

Jennifer Marsh, PhD, JD, MSN

Biostatistics & Informatics Unit & George Washington University School of Medicine & Health Sciences Departments of Pediatrics, Epidemiology, & Biostatistics

Sarah Kin

Georgetown University School of Medicine

Jianping He, MS

Children's National Medical Center

Rachel Y. Moon, MD

Division of General Pediatrics at Children's National Medical Center

In-hospital formula supplementation of breastfed infants negatively impacts breastfeeding duration. Infants from low-income families have some of the lowest exclusive breastfeeding rates in the United States. The objectives of this study were to identify (1) reasons low-income breastfeeding mothers begin in-hospital formula supplementation and (2) risk factors for in-hospital formula supplementation. We surveyed 150 low-income mothers in a Washington, DC, clinic. Sixty percent had initiated breastfeeding, and 78% of these breastfed infants received formula supplementation in the hospital. There was no clear medical need for supplementation for 87% of the breastfed infants receiving supplementation. Infants of mothers who did not attend a prenatal breastfeeding class were almost 5 times more likely to receive in-hospital formula supplementation than those infants whose mothers had attended a class (OR, 4.7; 95% CI, 1.05-21.14). Improved knowledge about breastfeeding among nursing and medical providers is important to minimize unnecessary formula supplementation for breastfed infants. J Hum Lact. 25(1):11-17.

Key Words: breastfeeding • supplementation • WIC • exclusivity

This version was published on February 1, 2009

Journal of Human Lactation, Vol. 25, No. 1, 11-17 (2009)
DOI: 10.1177/0890334408325821
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