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Supplementation Practices and Donor Milk Use in US Well-Newborn Nurseries
Laura R Kair1, Carrie A Phillipi2, Allison M Lloyd-McLennan3
1Department of Pediatrics, School of Medicine, University of California, Davis, Sacramento, California; lrkair@ucdavis.edu.
Hospital Pediatrics
|August 12, 2020
Summary
Breastfeeding supplementation practices vary widely in US hospitals, with donor milk more common in high-breastfeeding facilities. Standardizing these medically indicated supplementation strategies can improve newborn care.
Area of Science:
- Neonatal care
- Lactation support
- Public health
Background:
- Current guidelines lack specificity on medically indicated supplementation for breastfeeding newborns.
- There is a need to understand current practices and provider perspectives on supplementation.
Purpose of the Study:
- To describe practice patterns for medically indicated supplementation of breastfeeding newborns in the US.
- To explore provider perspectives on these supplementation practices.
Main Methods:
- A survey of hospital representatives from the Better Outcomes through Research for Newborns (BORN) network was conducted from 2017-2018.
- Descriptive statistics and qualitative methods were used to analyze survey data on supplementation practices and provider opinions.
Main Results:
- Practices regarding supplementation criteria, pumping, and supplement types varied significantly across hospitals, particularly for late preterm infants.
- Weight loss of ≥10% was the most common criterion for supplementation, often administered via bottle-feeding.
- Donor milk use was significantly higher in hospitals with higher breastfeeding initiation rates (44% vs 4%).
Conclusions:
- Hospital strategies for medically indicated supplementation are inconsistent across the US.
- Donor milk availability is concentrated in hospitals with high breastfeeding prevalence.
- Standardizing evidence-based supplementation management can enhance care for newborns.
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