Effect of early limited formula on duration and exclusivity of breastfeeding in at-risk infants: An RCT

Valerie J. Flaherman, Janelle Aby, Anthony E. Burgos, Kathryn A. Lee, Michael D. Cabana, Thomas B. Newman

Research output: Contribution to journalArticle

51 Citations (Scopus)

Abstract

BACKGROUND AND OBJECTIVES: Recent public health efforts focus on reducing formula use for breastfed infants during the birth hospitalization. No previous randomized trials report the effects of brief early formula use. The objective of the study was to determine if small formula volumes before the onset of mature milk production might reduce formula use at 1 week and improve breastfeeding at 3 months for newborns at risk for breastfeeding problems. METHODS: We randomly assigned 40 exclusively breastfeeding term infants, 24 to 48 hours old, who had lost ≥5% birth weight to early limited formula (ELF) intervention (10 mL formula by syringe after each breastfeeding and discontinued when mature milk production began) or control (continued exclusive breastfeeding). Our outcomes were breastfeeding and formula use at 1 week and 1, 2, and 3 months. RESULTS: Among infants randomly assigned to ELF during the birth hospitalization, 2 (10%) of 20 used formula at 1 week of age, compared with 9 (47%) of 19 control infants assigned during the birth hospitalization to continue exclusive breastfeeding (P = .01). At 3 months, 15 (79%) of 19 infants assigned to ELF during the birth hospitalization were breastfeeding exclusively, compared with 8 (42%) of 19 controls (P = .02). CONCLUSIONS: Early limited formula may reduce longer-term formula use at 1 week and increase breastfeeding at 3 months for some infants. ELF may be a successful temporary coping strategy for mothers to support breastfeeding newborns with early weight loss. ELF has the potential for increasing rates of longer-term breastfeeding without supplementation based on findings from this RCT.

Original languageEnglish (US)
Pages (from-to)1059-1065
Number of pages7
JournalPediatrics
Volume131
Issue number6
DOIs
StatePublished - Jun 1 2013
Externally publishedYes

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Breast Feeding
Hospitalization
Parturition
Milk
Newborn Infant
Syringes
Birth Weight
Weight Loss
Public Health
Mothers

Keywords

  • Breastfeeding
  • Infant formula
  • Lactation

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Effect of early limited formula on duration and exclusivity of breastfeeding in at-risk infants : An RCT. / Flaherman, Valerie J.; Aby, Janelle; Burgos, Anthony E.; Lee, Kathryn A.; Cabana, Michael D.; Newman, Thomas B.

In: Pediatrics, Vol. 131, No. 6, 01.06.2013, p. 1059-1065.

Research output: Contribution to journalArticle

Flaherman, Valerie J. ; Aby, Janelle ; Burgos, Anthony E. ; Lee, Kathryn A. ; Cabana, Michael D. ; Newman, Thomas B. / Effect of early limited formula on duration and exclusivity of breastfeeding in at-risk infants : An RCT. In: Pediatrics. 2013 ; Vol. 131, No. 6. pp. 1059-1065.
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