1. In-Hospital Formula Supplementation in Appalachian Women Intending to Exclusively Breastfeed.
- Author
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Alqudah, Elham, Davis, Amy, Berzingi, Seher, Webster, Katherine, Thompson, Stephanie, Evans, Cortney, and Cross, Kimberly
- Subjects
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INFANT formulas , *STATISTICS , *LACTATION , *STATISTICAL significance , *CONFIDENCE intervals , *CROSS-sectional method , *MULTIVARIATE analysis , *MULTIPLE regression analysis , *AGE distribution , *WOMEN , *RETROSPECTIVE studies , *TERTIARY care , *MANN Whitney U Test , *FISHER exact test , *RACE , *DIETARY supplements , *T-test (Statistics) , *BREASTFEEDING , *PARITY (Obstetrics) , *CHI-squared test , *MEDICAL referrals , *DESCRIPTIVE statistics , *ODDS ratio , *MARITAL status , *DATA analysis software , *EDUCATIONAL attainment - Abstract
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. Significance: What is already known on this subject? Exclusive breastfeeding is recognized as the ideal feeding method for infants. Newborns receiving formula in-hospital are at higher risk for early breastfeeding cessation. Rural residence and/or in the Appalachian region negatively impact breastfeeding rates. What this study adds? Predictors for in-hospital formula supplementation in women desiring to exclusively breastfeed included high school level educational, primiparity, and C-section delivery. Lactation consultation did not associate with decreased initiation of formula supplementation. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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