Short-term formula supplementation does not affect 6-month breastfeeding prevalence

  • Flaherman VJ & al.
  • JAMA Pediatr
  • 3 Jun 2019

  • International Clinical Digest
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Takeaway

  • A structured formula supplementation for at-risk neonates did not affect prevalence of breastfeeding at 6 months, but outcomes for 12 months were less positive in this randomized controlled trial .

Why this matters

  • The CDC urges breastfeeding to 6 and 12 months, but only about half of US infants reach the 6-month mark.

Key results

  • 65% of supplemented infants were breastfeeding at 6 months, vs 73% who were not supplemented:
    • Absolute difference, −12% (95% CI, –26% to 3%; P=.12).
    • Relative risk with supplementation: 0.85 (95% CI, 0.69-1.04).
  • 12-month results: 29.6% for supplemented infants vs 48.1% for control infants (risk difference, –18%; 95% CI, −34% to −3%).
  • Factors influencing duration of breastfeeding: marital status, intended duration.
  • Formula at age 1 week showed a strong association with breastfeeding outcomes:
    • Risk differences at 6 months: –53.8 (95% CI, –70.9 to –36.7);
    • At 12 months: –46.9 (95% CI, –60.0 to –33.9).  

Study design

  • Trial at 2 centers, with 164 infant-mother dyads, at risk because of low milk production, newborn weight loss, or ≥75 percentile for age.
  • Outcomes by phone survey.
  • Funding: Healthcare Resources and Services Administration/Maternal Child Health Bureau.

Limitations

  • Specific infant population enrolled, delivered at academic medical centers with strong breastfeeding support.

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