Formula Milk Supplementation on the Postnatal Ward: A Cross-Sectional Analytical Study

Area of Science:

• Public Health
• Maternal and Child Health
• Lactation Science

Background:

• Breastfeeding rates in the UK are suboptimal, with a significant proportion of infants receiving breastmilk substitutes (BMS) early in life.
• Understanding the drivers of early BMS use in UK maternity units is crucial for improving infant feeding practices.

Purpose of the Study:

• To investigate the reasons behind the high incidence of early BMS supplementation in UK maternity settings.
• To identify modifiable factors associated with non-clinically indicated BMS use.

Main Methods:

• Analysis of infant feeding records and surveys from mothers and midwives in two large UK maternity units in 2016.
• Statistical examination of factors associated with BMS initiation, including management practices and demographic variables.

Main Results:

• 28% of infants received BMS before hospital discharge, with only 10% deemed clinically necessary.
• Non-clinically indicated BMS use was significantly associated with the absence of early skin-to-skin contact (p=0.01) and lack of antenatal breastfeeding education (p=0.01).
• Variations in BMS initiation rates were linked to midwife educational level and ward environment.

Conclusions:

• Early initiation of BMS in UK maternity units is largely preventable.
• Adherence to UNICEF Baby Friendly 10 Steps, optimizing the postnatal ward environment, and targeted support for midwives and mothers may enhance exclusive breastfeeding rates.