Online Program

282149
Impact of the cessation of free infant formula in public hospitals on hospital practices and the duration and exclusivity of breastfeeding


Wednesday, November 6, 2013 : 9:24 a.m. - 9:42 a.m.

Marie Tarrant, RN MPH PhD, School of Nursing, University of Hong Kong, Hong Kong, Hong Kong
Daniel Yee Tak Fong, PhD, School of Nursing, University of Hong Kong, Hong Kong, Hong Kong
Irene Lee, RN RM MHA MPHC, Queen Mary Hospital, Hong Kong, Hong Kong
Emmy Wong, RN MN PhD, Faculty of Health Studies, Hong Kong Institute of Education, Hong Kong
Alice Sham, RN RM MSc MBA, Kwong Wah Hospital & TWGHs Wong Tai Sin Hospital, Hong Kong
Christine Lam, RN RM MMW IBCLC, Dept. of Obstetrics and Gynaecology, Queen Elizabeth Hospital, Hong Kong, Hong Kong
Dorothy Li Bai, MBBS, School of Nursing, University of Hong Kong, Hong Kong, Hong Kong
Kendra M. Wu, MSE MMedSc, School of Public Health, University of Hong Kong, Hong Kong, Hong Kong
Joan E. Dodgson, PhD MPH, RN, College of Nursing and Health Innovation, Arizona State University, Phoeniz, AZ
In April 2010, all public obstetric hospitals in Hong Kong stopped accepting free infant formula from manufacturers and began paying market price for infant formula products. The aim of the study was to assess the impact of adopting a policy of paying market price for infant formula in public hospitals on in-hospital infant formula supplementation rates, baby-friendly hospital practices and breastfeeding duration and exclusivity. This study employed a quasi-experimental design. Two prospective cohorts of mother-infant pairs were recruited from the post-natal obstetric units of four public hospitals in Hong Kong. The first cohort (n=1417) was recruited prior to the policy implementation in 2006-07 and the second cohort (n=1287) was recruited after the policy implementation in 2011-12. The proportion of participants who exclusively breastfed during the first 24 and 48 hours after birth increased from 28.5% to 61.8% and from 17.1% to 41.5%, respectively. In 2011-12, 45.0% of participants initiated breastfeeding within the first hour after birth, compared with only 28.5% in 2006-07. The median duration of any breastfeeding increased from 8 weeks to 11 weeks while the median duration of exclusive breastfeeding remained unchanged at 2 weeks. The overall risk of weaning was significantly reduced after the policy change (HR=0.76; 95% CI 0.68 – 0.84). Stopping the acceptance of free infant formula in hospitals appears to improve in-hospital exclusive breastfeeding rates, increases compliance with baby-friendly practices such as the early initiation of breastfeeding and prolongs the duration of breastfeeding.

Learning Areas:

Epidemiology
Provision of health care to the public
Public health or related public policy

Learning Objectives:
Identify the impact of removing free infant formula from hospitals on in-hospital formula supplementation rates and on baby-friendly hospital practices. Identify the impact of removing free infant formula from hospitals on the duration of any and exclusive breastfeeding.

Keyword(s): Breastfeeding, Maternal and Child Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I was the Principal Investigator on the study and responsible for all of the findings. I am an Associate Professor in the Dept. of Nursing studies at The University of Hong Kong, and my research focuses on maternal and child health, specifically as related to pregnancy and infant feeding. In particular, I have investigated factors that increase the exclusivity and duration of breastfeeding in Hong Kong, including hospital-related factors to be described in this presentation.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.