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Hospital Practices Influence Which Moms Will Breast-Feed

Offers of water, formula supplementation cut likelihood new mothers will achieve goals

FRIDAY, March 20 (HealthDay News) -- Hospital practices such as providing formula or water to supplement breast-feeding significantly reduce the number of mothers who breast-feed only, U.S. researchers report.

They analyzed national survey data from 1,573 mothers who gave birth in a hospital to a single infant in 2005. The women were asked retrospectively about their breast-feeding intentions, infant feeding practices at one week, and hospital practices.

The study found a significant difference between the numbers of mothers who said they intended to exclusively breast-feed and those who actually did so one week after giving birth. Among first-time mothers, 70 percent said they intended to exclusively breast-feed, but only 50 percent did so one week after giving birth.

The data suggests that more than 400,000 infants a year are born to mothers in the United States who intend to exclusively breast-feed but don't achieve that goal, the researchers said.

Hospital practices strongly influenced whether mothers followed through on their breast-feeding goals. Those who weren't offered water or formula supplementation were much more likely to achieve their intention to exclusively breast-feed -- 4.4 times more likely among first-time mothers and 8.8 times more likely among mothers who'd previously given birth.

The study found that 49 percent of first-time mothers who intended to exclusively breast-feed said their babies were given water or formula supplementation, and 74 percent reported being given free formula samples or offers.

The researchers also identified other hospital practices that influenced breast-feeding. For example, first-time mothers who gave birth in hospitals that practiced at least six of seven recommended steps to encourage breast-feeding -- such as helping mothers get started and not giving pacifiers to babies -- were six times more likely to achieve their goal of breast-feeding only than mothers at hospitals that followed one or none of the practices meant to encourage breast-feeding.

The study was published online in the American Journal of Public Health.

"Why are those hospital practices that have been repeatedly shown to increase breast-feeding among new mothers not more consistently instituted in United States hospitals? A large proportion of mothers stop exclusive breast-feeding within the first week, and that action was strongly related to hospital practices," wrote study leader Eugene Declercq, a professor of maternal and child health at Boston University School of Public Health, and colleagues.

They noted that the American Academy of Pediatrics and other medical groups recommend that infants consume only mother's milk for at least the first six months of life.

"Very often, research studies yield conclusions that don't translate easily into changes in practice or policy," Declercq said. "In this case, the message is loud and clear -- hospital practices can make a difference in early breast-feeding success and, in particular, every effort should be made to avoid supplementation of healthy babies of mothers who intended to exclusively breast-feed."

More information

The American Academy of Family Physicians offers breast-feeding advice.

-- Robert Preidt

SOURCE: Boston University School of Public Health, news release, March 19, 2009

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