engleski

Predictors of in-hospital formula supplementation among healthy term newborns

Background Although the importance of breastfeeding is well known, the use of breast milk substitutes is widespread, commencing as early as the first few days after birth. This practice has been found to be associated with shorter duration of any and exclusive breastfeeding. Objective To explore the extent of supplementation at the University Hospital of Split Maternity Unit and determine which maternal, infant and practice characteristics are associated with in-hospital supplementation of healthy, term infants. Methods This cohort study included a random sample of 342 mothers who gave birth to healthy, term newborns between April and July 2011, at the University Hospital of Split, Croatia. Data were collected using 1) ‘every feed’ charts and 2) UNICEF questionnaires for monitoring Baby- Friendly hospitals. Data were processed using descriptive statistics. For categorical data and testing differences in proportion, T test for independent samples, Mann - Whitney U test and Chi-square test (χ2) were used. Values were considered significant if P < 0.05. Results During the first 48 hours and entire hospital stay 49.5% and 62.8% of newborns, respectively, received supplements, with the median number of hours from birth when it was first given being 24.5 hours. Maternal risk factors found to be associated with in-hospital supplementation were primiparity (χ2 = 7.8, P = 0.005), smoking prior to pregnancy (χ2 = 8.6, P = 0.014) and intention to use a pacifier (χ2 = 6.55, P = 0.038). The median number of months mothers breastfed their previous child was 3 months shorter in the supplementation group (Z = 2.9, P = 0.004). Hospital practices that were negatively associated with exclusive breastfeeding in the hospital were: caesarean birth under general anaesthesia (χ2 = 31, P < 0.001) and wrapping the newborn at birth (χ2 = 6.9, P = 0.009). Conclusion In-hospital supplementation rates of healthy, term newborns remain unacceptably high. Women whose infants were found to be at increased risk of supplementation, i.e., primips, smokers and those intending to use a pacifier, need additional support and information. Hospital practices associated with supplementation, i.e., caesarean section under GA and wrapping the baby at first contact should be kept to a minimum. Ongoing training of hospital staff on the importance of exclusive breastfeeding and how it can be supported is needed.

breastfeeding ; supplementation ; risk factors ; hospital practices ; Croatia

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