High rates of mixed breastfeeding practices and early introduction of the formula is found among low-income women, reports a new study. The findings of the study are published in the journal Public Health Nutrition.
The World Health Organization and the American Academy of Pediatrics recommends exclusive breastfeeding for the first six months of life.
Assistant Professor Dr. Sina Gallo led the study with colleagues from the Loudoun County Health Department and Georgetown University. Published in Public Health Nutrition, they found that 61% of infants in their sample received formula in the first few days of life. More than half of the mothers reported the use of formula due to perceived insufficient milk supply. Going back to work was also commonly cited as a reason for introducing formula, and some cultural beliefs may have encouraged the use of a mix of both breast milk and formula.
The researchers suggested that most early breastfeeding problems can be addressed with education about when and how much to breastfeed and culturally appropriate support from clinicians. Gallo explains, "The main reason for the introduction of the formula was a perceived insufficient milk supply which is likely a preventable reason and education on sufficient breastmilk in the first few days, as well as improved baby-friendly hospital practices such as skin-to-skin and feeding in the first hour, can help mitigate this practice."
This study investigated the feeding patterns of 190 low-income, predominantly Hispanic immigrant women who attended two WIC clinics in Loudoun County, Virginia. Eighty-one percent were living below the federal poverty line, and food insecurity was high.
"The early rates of introduction of formula in the population surveyed is alarming 17 percent reported giving formula at the first feed and 45 percent before they left the hospital. This is the time when support systems should be in place to help mothers exclusively breastfeed, yet many are choosing formula feeding at this time," explained Gallo.
The researchers explained that in most cases it is possible for new mothers to adapt to exclusive breastfeeding, with education intervention from WIC counselors, as well as changes in WIC policies to encourage and support breastfeeding.
"Our study aims to inform policymakers of the best way to help minority mothers earning low incomes to adopt exclusive breastfeeding. WIC already provides an expanded food package for exclusively breastfeeding mothers as well as access to lactation counselors. However an increased focus on intense lactation support in the first weeks, including limiting formula as a part of the WIC package for the first month to special circumstances may further help support mothers to meet breastfeeding recommendations," Gallo noted.