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 language | English |
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Pages (from-to) | 2689-2699 |
Number of pages | 11 |
Journal | Public Health Nutrition |
Volume | 18 |
Issue number | 14 |
DOIs | |
Publication status | Published - Jan 22 2015 |
Externally published | Yes |
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