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

27 Scopus citations

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 (US)
Pages (from-to)2689-2699
Number of pages11
JournalPublic Health Nutrition
Volume18
Issue number14
DOIs
StatePublished - Jan 22 2015

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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