title: In-hospital formula supplementation of breastfed babies: a population-based survey.
abstract: BACKGROUND
  In-hospital formula supplementation of breastfed newborns is commonplace despite its negative association with breastfeeding duration. Although several studies have described the use of formula supplementation, few have explored the factors that may be associated with its use. The aim of this study was to explore factors associated with in-hospital formula supplementation using data from a large Australian population-based survey.
  
  
  METHODS
  All women who gave birth in September and October 2007 in two Australian states were mailed questionnaires 6 months after the birth. Women were asked how they fed their baby while in hospital after the birth. Multivariable logistic regression was used to explore specified a priori factors associated with in-hospital formula supplementation.
  
  
  RESULTS
  Of 4,085 women who initiated breastfeeding, 23 percent reported their babies receiving formula supplementation. Breastfed babies had greater odds of receiving formula supplementation if their mother was primiparous (adj. OR=2.16; 95% CI: 1.76-2.66); born overseas and of non-English-speaking background (adj. OR=2.03; 95% CI: 1.56-2.64); had a body mass index more than 30 (adj. OR=2.27; 95% CI: 1.76-2.95); had an emergency cesarean section (adj. OR=1.72; 95% CI: 1.3-2.28); or the baby was admitted to a special care nursery (adj. OR=2.72; 95% CI: 2.19-3.4); had a birthweight less than 2,500 g (adj. OR=2.02; 95% CI: 1.3-3.15) or was born in a hospital not accredited with Baby-Friendly Hospital Initiative (BFHI) (adj. OR=1.53; 95% CI: 1.2-1.94).
  
  
  CONCLUSIONS
  The number of factors associated with in-hospital formula supplementation suggests that this practice is complex. Some results, however, point to an opportunity for intervention, with the BFHI appearing to be an effective strategy for supporting exclusive breastfeeding.
authors: School of Nursing & Midwifery, Monash University, Clayton, Victoria, Australia.
authors: Mary Anne
authors: MA
authors: Biro
authors: Georgina Ann
authors: GA
authors: Sutherland
authors: Jane Susanne
authors: JS
authors: Yelland
authors: Pollyanna
authors: P
authors: Hardy
authors: Stephanie Janne
authors: SJ
authors: Brown
mesh_terms: D000293:Adolescent; D000328:Adult; D001315:Australia; D001903:Bottle Feeding / Q000706:statistics & numerical data*; D001942:Breast Feeding / Q000706:statistics & numerical data*; D004034:Diet Surveys; D005260:Female; D006293:Health Promotion; D006760:Hospitalization; D006761:Hospitals / Q000706:statistics & numerical data; D006801:Humans; D007224:Infant Care / Q000379:methods* / Q000706:statistics & numerical data; D041943:Infant Formula / Q000706:statistics & numerical data*; D007227:Infant Nutritional Physiological Phenomena; D007231:Infant, Newborn; D016015:Logistic Models; D016017:Odds Ratio; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D055815:Young Adult