Alternative hospital gift bags and breastfeeding exclusivity

Providing Low-Income Women With a Manual Pump: A Pilot Study

OBJECTIVES

Low-income, first-time mothers generally breastfeed exclusively and, overall, for a shorter average duration than high-income, multiparous mothers. A potential barrier to breastfeeding success is access to a breast pump for home use. In this pilot study, we estimated the effect of providing a manual breast pump during birth hospitalization for home use on any/exclusive breastfeeding and investigated participant attitudes about manual pumps and their breastfeeding experiences.

METHODS

Sixty low-income, first-time mothers were enrolled in a pilot randomized controlled trial. One-half received a manual breast pump and the other half received an attention control. Breastfeeding exclusivity, duration, and use of the manual pump were assessed at 6 and 12 weeks. Qualitative interviews regarding the breastfeeding experience were completed. Thirty-one women answered 13 questions that were then transcribed, coded, and grouped into themes.

RESULTS

Participants who were randomized to manual breast pump receipt during birth hospitalization had increased manual pump use at 6 weeks (13/19 [68%] versus controls 5/17 [29%]), there was no effect of pump receipt on any nor exclusive breastfeeding at 12 weeks. In qualitative analysis of the overall breastfeeding experience, participants expressed a need for additional support and had conflicting attitudes regarding breastfeeding and the pumping experience.

CONCLUSIONS

Manual breast pump receipt in hospital among low-income, first-time mothers did not affect breastfeeding exclusivity or duration. Participants reported that early and ongoing lactation support is essential. Strategies to improve breastfeeding outcomes low-income, first-time mothers are needed.

Academy of Breastfeeding Medicine Clinical Protocol #2: Guidelines for Birth Hospitalization Discharge of Breastfeeding Dyads, Revised 2022

A central goal of the Academy of Breastfeeding Medicine is the development of clinical protocols for managing common medical problems that may impact breastfeeding success. These protocols serve only as guidelines for the care of breastfeeding mothers and infants and do not delineate an exclusive course of treatment or serve as standards of medical care. Variations in treatment may be appropriate according to the needs of an individual patient. The Academy of Breastfeeding Medicine recognizes that not all lactating individuals identify as women. Using gender-inclusive language, however, is not possible in all languages and all countries and for all readers. The position of the Academy of Breastfeeding Medicine (https://doi.org/10.1089/bfm.2021.29188.abm) is to interpret clinical protocols within the framework of inclusivity of all breastfeeding, chestfeeding, and human milk-feeding individuals.

Association Between In-Hospital Pacifier Use and Breastfeeding Continuation and Exclusivity: Neonatal Intensive Care Unit Admission as a Possible Effect Modifier

BACKGROUND

Breastfeeding dyads frequently use pacifiers during the birth hospitalization, but the relationships between this exposure and breastfeeding continuation and exclusivity remain unclear.

MATERIALS AND METHODS

In this secondary analysis of cross-sectional survey data from the CDC Pregnancy Risk Assessment Monitoring System (PRAMS) from 10 U.S. states (AK, AR, CO, ME, MN, NJ, NY, OR, TX, and VT) from 2009 to 2011, we assessed to what extent pacifier use during the birth hospitalization is independently associated with any and exclusive breastfeeding ≥10 weeks.

RESULTS

A total of 37,628 mothers who were chosen by random birth certificate sampling completed surveys at ∼4 months postpartum. Adjusting for multiple pro-breastfeeding hospital practices and maternal and infant demographic characteristics, pacifier exposure during the birth hospitalization was independently associated with decreased odds of breastfeeding ≥10 weeks (adjusted odds ratio [aOR]) 0.71, 95% confidence interval [CI] 0.63-0.80, p < 0.0001) and exclusive breastfeeding ≥10 weeks (aOR 0.70, 95% CI 0.63-0.79, p < 0.0001) among infants admitted to the well-baby nursery, but not among those admitted to the neonatal intensive care unit (NICU).

CONCLUSIONS

In this population study of mothers from 10 U.S. states, pacifier use during the birth hospitalization was associated with decreased odds of breastfeeding and exclusive breastfeeding ≥10 weeks among well-newborn, but not NICU-admitted infants. Pacifier use may be a marker rather than a cause of breastfeeding difficulties, but prospective, randomized studies are needed to help clarify this. Future studies exploring pacifier exposure and breastfeeding outcomes should account for NICU admission as an effect modifier.

The Impact of Mailed Samples of Infant Formula on Breastfeeding Rates

INTRODUCTION

Decades of research supports the health benefits of breastfeeding. Prior studies have shown that hospital discharge bags containing free samples of infant formula are associated with decreased breastfeeding exclusivity. This study aims to determine if receiving a free sample of infant formula in the mail has an impact on breastfeeding duration and exclusivity.

MATERIALS AND METHODS

This was a cohort study analyzing data from the Infant Feeding Practices Study II. The main outcomes of interest were any breastfeeding through 12 months of age and exclusive breastfeeding through 6 months of age. The main predictor of interest was receipt of a free sample of infant formula in the mail around the time of the infant's birth. Logistic regression models were developed to evaluate the association between the outcomes and predictor of interest at each month.

RESULTS

This study included 3,031 infants; mothers of 1,741 (57.4%) received a sample of infant formula in the mail. There was no difference in the likelihood of any breastfeeding at each month among those who received formula in the mail compared with those who did not. There was also no difference in exclusive breastfeeding through 5 months; however, by 6 months of age infants whose mothers received formula in the mail were less likely to be exclusively breastfed (odds ratio = 0.57; 95% confidence interval, 0.37, 0.89).

CONCLUSIONS

Receiving infant formula in the mail decreases the likelihood of exclusive breastfeeding by 6 months of age while having no impact on the duration of any breastfeeding.