title: Factors Associated with Supplemental Formula Feeding of Breastfeeding Infants During Postpartum Hospital Stay.
abstract: To determine reasons potentially amenable to interventions that mothers choose to supplement breastfeeding with formula in the immediate postpartum period.
  
  
  
  We distributed surveys to all mothers in the postpartum unit who delivered a live newborn on day of maternal discharge to assess feeding behaviors during their inpatient admission. We evaluated, when applicable, their reasons for supplementation and examined cultural and demographic information to uncover trends for formula use and potential areas for provider intervention.
  
  
  
  Seven hundred twelve of 1,400 mothers responded, of which 478 (65%) reported supplementing breastfeeding with formula (BF+F). The most common reasons for formula supplementation were perception of inadequate milk supply (36.4%), desire for sleep (35.4%), and a plan to breast and bottle feed (35.2%). Exclusive breastfeeding (EBF) was associated with primiparous status (OR 1.95; 95% CI 1.3-3.0), higher education level (OR 2.6; 95% CI 1.7-3.9), and having been breastfed as an infant (OR 1.54; 95% CI 1-2.37). Mothers who experienced skin-to-skin contact also had higher rates of EBF (29.5% versus 19.9%). Factors associated with exclusive formula feeding included single marital status, birth of mother in the United States, Catholic religion, multiparity, and cesarean delivery. Religious and cultural factors also played important roles in maternal feeding behaviors.
  
  
  
  Clinicians can anticipate risk factors for formula use in mothers who plan to breastfeed and tailor counseling appropriately to increase EBF rates.
authors.affiliation: Division of Neonatology, Department of Pediatrics, Staten Island University Hospital , Staten Island, New York.
authors.forename: Joanna
authors.initials: J
authors.lastname: Pierro
authors.affiliation: Division of Neonatology, Department of Pediatrics, Staten Island University Hospital , Staten Island, New York.
authors.forename: Bdair
authors.initials: B
authors.lastname: Abulaimoun
authors.affiliation: Division of Neonatology, Department of Pediatrics, Staten Island University Hospital , Staten Island, New York.
authors.forename: Philip
authors.initials: P
authors.lastname: Roth
authors.affiliation: Division of Neonatology, Department of Pediatrics, Staten Island University Hospital , Staten Island, New York.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Blau
mesh_terms: D000328:Adult; D001903:Bottle Feeding / Q000706:statistics & numerical data; D001942:Breast Feeding / Q000706:statistics & numerical data; D004522:Educational Status; D005247:Feeding Behavior / Q000523:psychology*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007227:Infant Nutritional Physiological Phenomena; D007231:Infant, Newborn; D060127:Kangaroo-Mother Care Method; D008425:Maternal Behavior / Q000523:psychology*; D009034:Mother-Child Relations; D009035:Mothers / Q000193:education / Q000523:psychology*; D009518:New York; D010351:Patient Discharge; D049590:Postpartum Period / Q000523:psychology*; D011247:Pregnancy