Determinant factors in formula supplementation following delivery in a baby-friendly hospital.

Abstract

Objectives: Although exclusive breastfeeding is recommended for the first 6 months of life, in-hospital formula supplementation is widespread all around the world and has been demonstrated to be a strong determinant of shorter exclusive and any breastfeeding. The aim of the study is to assess the reasons in which in-hospital formula supplementation occurs in a baby-friendly hospital.

Methods: This retrospective cohort study was conducted among 503 mother-infant pairs from January to December 2018. Data collected from mother-infant files were analysed to identify factors associated with in-hospital supplementation.

Results: During hospital stay 14.5% of the infants were received formula. The most common reasons for supplementation were lack of human-milk  (78%) and hypoglycemia (15%). The most common way for supplemantation was cup-feeding (91.78%).  Lower gestational week (GW) and birth weight of the infant, cesarean delivery (C/S), in vitro fertilisation (IVF) pregnancy, shorter breastfeeding duration of the siblings were significantly higher in formula-supplemented group. The factors associated with in-hospital formula supplementation in univariant analysis were assessed with Logistic regression; lower birth weight, IVF pregnancy and C/S delivery were still significant in formula-supplemented group.

Conclusion: Our results identified several factors that enhance supplementation in hospital. Healthcare profesional recommandations and support before and after delivery may reduce the adverse effects of lower GW and birth weight and IVF pregnancy. Special care is needed for mothers delivering by C/S to enable to initiate and maintain breastfeeding.

Keywords

• breastfeeding,human-milk,in-hospital formula supplementation,infant formula

Bebek dostu bir hastanede doğumu takiben formül süt desteği verilmesinde belirleyici faktörler

Öz

Amaç: Hayatın ilk 6 ayında sadece anne sütü önerilmesine rağmen, tüm dünyada hastanede formül süt desteği oldukça yaygındır. Bu durumun anne sütü ile beslenme süresinin daha kısa olmasındaki en güçlü belirleyici faktör olduğu farklı çalışmalarda gösterildi. Çalışmamızda bebek-dostu hastanemizde doğum sonrası hastane takiplerinde formül süt desteği gereksiniminin nedenlerini belirlemeyi amaçladık.

Gereç ve Yöntemler: Bu retrospektif kohort çalışmaya Ocak – Aralık 2018 tarihleri arasında doğum yapan 503 anne ve onların bebekleri dahil edildi. Anne – bebek dosyalarından toplanan bilgiler hastanede formül süt desteği ilişkili faktörleri belirlemek için analiz edildi.

Bulgular: Hastanede yenidoğanları %14,5’u formül süt desteği aldı. En sık nedenler anne sütü eksikliği (%78) ve hipoglisemiydi (%15). Formül süt en sık kadeh (%91,78) ile verildi. Düşük gestasyon haftası (GH) ve doğum ağırlığı (DA), sezeryan doğum (C/S), in vitro fertilizasyon (IVF) gebelik ve kardeşlerin emzirme süresinin daha kısa olması hastanede formül süt desteği alanlarda anlamlı yüksekti. Univariate analizlerde hastanede formül süt desteği ile ilişkili bulunan faktörler lojistik regresyon analizi ile değerlendirildiğinde düşük DA, C/S doğum ve IVF gebeliğin anlamlılığını sürdürdüğü görüldü.

Sonuç: Çalışmamızda hastanede formül süt destek gereksinimini arttıran nedenler düşük DA, C/S ve IVF gebelik olarak belirlendi. Doğum öncesi ve sonrasında sağlık profesyonellerinin öneri ve desteği, kurumun yazılı emzirme politikası olması doğum sonrası hastane takipleri sırasında tıbbi endikasyon dışında formül süt desteği verilmemesi düşük DA ve GH ile IVF gebeliğin olumsuz etkilerini azaltabilir C/S ile doğum yapan annelerin emzirmeye başlaması ve devamlılığının sağlanması için daha fazla destek gerekir.

Anahtar Kelimeler

• Emzirme,anne sütü,hastanede formül süt desteği,formül süt

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