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, Yee Tak Daniel FONG, L. Y. Irene LEE, Alice SHAM, Christine LAM, Kendra M. WU, Dorothy Li BAI, Ka Lun WONG, Man Yee Emmy WONG, Noel P T CHAN, Joan E. DODGSON

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21 Citations (Scopus)

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. Copyright © 2015 The Authors.
Original languageEnglish
Pages (from-to)2689-2699
JournalPublic Health Nutrition
Volume18
Issue number14
Early online dateFeb 2015
DOIs
Publication statusPublished - Oct 2015

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Infant Formula
Breast Feeding
Public Hospitals
Hong Kong
Length of Stay
Breast
Cohort Studies
Prospective Studies

Citation

Tarranta, M., Lok, K. Y. W., Fong, D. Y. T., Lee, I. L. Y., Sham, A., Lam, C. et al. (2015). Effect of a hospital policy of not accepting free infant formula on in-hospital formula supplementation rates and breast-feeding duration. Public Health Nutrition, 18(14), 2689-2699.

Keywords

  • Breast-feeding
  • Infant feeding
  • Formula supplementation
  • Hospital practices
  • Hong Kong