Boban Marija, Zakarija-Grković Irena
1 Department of General Practice, Split and Dalmatia County Health Centre , Split, Croatia .
2 Department of Clinical Skills, University of Split School of Medicine , Split, Croatia .
Breastfeed Med. 2016 Nov;11:448-454. doi: 10.1089/bfm.2016.0039. Epub 2016 Aug 22.
In-hospital formula supplementation is a common practice and has been shown to be a strong determinant of shorter exclusive and any breastfeeding.
To investigate the reasons for and circumstances in which in-hospital formula supplementation occurs and whether the stated reasons are medically acceptable.
This prospective cohort study was conducted among 342 mother-infant pairs from April to July 2011 at the Department of Obstetrics and Gynecology, University Hospital of Split, Croatia. Data were collected based on "every feed" charts and WHO/UNICEF "Questionnaire for Monitoring Baby-Friendly Hospitals". We used WHO/UNICEF Baby-Friendly Hospital Initiative and Academy of Breastfeeding Medicine documents on indications for supplemental feeding.
During the first 48 hours and entire hospital stay, 49.5% and 62.8% of infants, respectively, received supplements, given on average 16.68 ± 18.6 hours after delivery. In 94.1% of supplemented infants, healthy newborns were given artificial milk, of which 5.9% of mothers had not been notified. The most common maternal reasons for supplementing were "lack of milk" (49.8%), a "crying baby" (35.5%), "cesarean section" (11.5%), newborn weight loss (10.6%), and sore nipples (10.1%). Of all the given reasons, 24.6% were categorized as being medically acceptable. Primiparas were 1.3 times more likely to supplement in hospital, whereas multiparas were 1.3 times more likely to exclusively breastfeed.
In our study, most reasons for formula supplementation of healthy term newborns were not standard acceptable medical reasons, indicating a need for improved maternal support, revision of hospital policies, and training of hospital staff.
住院期间补充配方奶是一种常见做法，并且已被证明是缩短纯母乳喂养和任何母乳喂养时间的一个重要决定因素。
调查住院期间补充配方奶的原因和情况，以及所述原因在医学上是否可接受。
这项前瞻性队列研究于2011年4月至7月在克罗地亚斯普利特大学医院妇产科对342对母婴进行。数据基于“每次喂养”图表以及世界卫生组织/联合国儿童基金会的“爱婴医院监测问卷”收集。我们使用了世界卫生组织/联合国儿童基金会爱婴医院倡议以及母乳喂养医学学会关于补充喂养指征的文件。
在出生后的头48小时内和整个住院期间，分别有49.5%和62.8%的婴儿接受了补充喂养，平均在分娩后16.68±18.6小时给予。在94.1%接受补充喂养的婴儿中，健康的新生儿被给予了人工奶，其中5.9%的母亲未被告知。补充喂养最常见的母亲原因是“缺奶”（49.8%）、“婴儿哭闹”（35.5%）、“剖宫产”（11.5%）、新生儿体重减轻（10.6%）和乳头疼痛（10.1%）。在所有给出的原因中，24.6%被归类为医学上可接受。初产妇在医院补充喂养的可能性是经产妇的1.3倍，而经产妇纯母乳喂养的可能性是初产妇的1.3倍。
在我们的研究中，健康足月儿补充配方奶的大多数原因并非标准的可接受医学原因，这表明需要加强对母亲的支持、修订医院政策以及培训医院工作人员。
