How Formula Could Increase Breast-Feeding Rates

One of the surprising ways to boost breast-feeding rates among new moms may involve formula, according to the latest research.

With a growing body of evidence supporting the benefits of breast-feeding for both mom and baby, public-health experts celebrate each time a hospital receives “baby-friendly” status, which indicates the facility endorses steps that encourage breast-feeding such as not separating moms and babies after delivery and offering formula only if it’s deemed medically necessary.

But a small study published in the journal Pediatrics suggests that giving newborns a little bit of formula actually helps boost breast-feeding rates. The formula primer may give moms the assurance they need to keep pursuing breast-feeding, say the study’s authors.

Not surprisingly, many breast-feeding experts are taking issue with the findings, worried the results may undermine public-health messages that breast milk alone is best for babies.

The study, from University of California, San Francisco (UCSF), followed 40 newborn babies who had lost at least 5% of their birth weight by the time they were 36 hours old. The American Academy of Pediatrics (AAP) notes that weight loss in an infant’s first days is typical as they become accustomed to feeding; average weight loss is about 7%. But lead author Dr. Valerie Flaherman, an assistant professor of pediatrics and epidemiology and biostatistics at UCSF, focused on this group since other data suggests that infants who lose this much are more likely to lose more weight; when babies drop 10% of their birth weight, pediatricians become concerned that the infants may be at risk of other health problems.

For the trial, Flaherman and her colleagues assigned half the babies a couple days of birth to receive two teaspoons of formula after each breast-feeding, via a syringe so as not to encourage “nipple confusion,” a condition in which a baby has trouble transitioning between breast and bottle. Mothers were instructed to discontinue the formula supplementation once their milk supply appeared, which generally takes two to five days. The other half were exclusively breast-fed unless the doctor ordered formula.

• The proportion of babies breastfed at birth in the UK rose by 5%, from 76% to 81%.

• The initial breastfeeding rate in 2010 was highest in England at 83% (compared with 74% in Scotland, 71% in Wales, and 64% in Northern Ireland). Exclusive breastfeeding at six weeks was 24% in England and 22% in Scotland, compared to 17% in Wales and 13% in Northern Ireland.

• Across the UK, at three months, the number of mothers breastfeeding exclusively was 17% (up from 13% in 2005) and at four months, it was 12% (up from 7% in 2005). However, exclusive breastfeeding at six months remains at around 1%.

• Rates of 'any breastfeeding' showed a rise. At six weeks, the number of women breastfeeding at all was 48% in 2005 and 55% in 2010, while at six months they were 25% in 2005 and 34% in 2010.