Effect of a hospital policy of not accepting free infant formula on in-hospital formula supplementation rates and breast-feeding duration

Marie Tarrant, Kris Y.W. Lok, Daniel Y.T. Fong, Irene L.Y. Lee, Alice Sham, Christine Lam, Kendra M. Wu, Dorothy L. Bai, Ka Lun Wong, Emmy M.Y. Wong, Noel P.T. Chan, Joan E. Dodgson

Research output: Contribution to journalArticlepeer-review

39 Citations (Scopus)

Abstract

Objective To investigate the effect of public hospitals in Hong Kong not accepting free infant formula from manufacturers on in-hospital formula supplementation rates and breast-feeding duration. Design Prospective cohort study. Setting In-patient postnatal units of four public hospitals in Hong Kong. Subjects Two cohorts of breast-feeding mother-infant pairs (n 2560). Cohort 1 (n 1320) was recruited before implementation of the policy to stop accepting free infant formula and cohort 2 (n 1240) was recruited after policy implementation. Participants were followed prospectively for 12 months or until they stopped breast-feeding. Results The mean number of formula supplements given to infants in the first 24 h was 2·70 (sd 3·11) in cohort 1 and 1·17 (sd 1·94) in cohort 2 (P<0·001). The proportion of infants who were exclusively breast-fed during the hospital stay increased from 17·7 % in cohort 1 to 41·3 % in cohort 2 (P<0·001) and the risk of breast-feeding cessation was significantly lower in cohort 2 (hazard ratio=0·81; 95 % CI 0·73, 0·90). Participants who non-exclusively breast-fed during the hospital stay had a significantly higher risk of stopping any or exclusive breast-feeding. Higher levels of formula supplementation also increased the risk of breast-feeding cessation in a dose-response pattern. Conclusions After implementation of a hospital policy to pay market price for infant formula, rates of in-hospital formula supplementation were reduced and the rates of in-hospital exclusive breast-feeding and breast-feeding duration increased.

Original languageEnglish
Pages (from-to)2689-2699
Number of pages11
JournalPublic Health Nutrition
Volume18
Issue number14
DOIs
Publication statusPublished - Jan 22 2015
Externally publishedYes

Keywords

  • Breast-feeding
  • Formula supplementation
  • Hong Kong
  • Hospital practices
  • Infant feeding

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Nutrition and Dietetics
  • Public Health, Environmental and Occupational Health

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