Marie Tarrant1, Kris Yw Lok1, Daniel Yt Fong1, Irene Ly Lee2, Alice Sham3, Christine Lam4, Kendra M Wu5, Dorothy L Bai1, Ka Lun Wong1, Emmy My Wong6, Noel Pt Chan1, Joan E Dodgson7. 1. 1School of Nursing, Li Ka Shing Faculty of Medicine,The University of Hong Kong,4/F William M.W. Mong Block,21 Sassoon Road,Hong Kong Special Administrative Region (SAR),People's Republic of China. 2. 2Queen Mary Hospital,Hong Kong SAR,People's Republic of China. 3. 3United Christian Hospital,Kowloon,Hong Kong SAR,People's Republic of China. 4. 4Department of Obstetrics and Gynaecology,Queen Elizabeth Hospital,Kowloon,Hong Kong SAR,People's Republic of China. 5. 5School of Public Health,Li Ka Shing Faculty of Medicine,The University of Hong Kong,Hong Kong SAR,People's Republic of China. 6. 6Department of Health and Physical Education,The Hong Kong Institute of Education,New Territories,Hong Kong SAR,People's Republic of China. 7. 7College of Nursing and Healthcare Innovation,Arizona State University,Phoenix,AZ,USA.
Abstract
OBJECTIVE: To investigate the effect of public hospitals in Hong Kong not accepting free infant formula from manufacturers on in-hospital formula supplementation rates and breast-feeding duration. DESIGN: Prospective cohort study. SETTING: In-patient postnatal units of four public hospitals in Hong Kong. SUBJECTS: Two cohorts of breast-feeding mother-infant pairs (n 2560). Cohort 1 (n 1320) was recruited before implementation of the policy to stop accepting free infant formula and cohort 2 (n 1240) was recruited after policy implementation. Participants were followed prospectively for 12 months or until they stopped breast-feeding. RESULTS: The mean number of formula supplements given to infants in the first 24 h was 2·70 (sd 3·11) in cohort 1 and 1·17 (sd 1·94) in cohort 2 (P<0·001). The proportion of infants who were exclusively breast-fed during the hospital stay increased from 17·7 % in cohort 1 to 41·3 % in cohort 2 (P<0·001) and the risk of breast-feeding cessation was significantly lower in cohort 2 (hazard ratio=0·81; 95 % CI 0·73, 0·90). Participants who non-exclusively breast-fed during the hospital stay had a significantly higher risk of stopping any or exclusive breast-feeding. Higher levels of formula supplementation also increased the risk of breast-feeding cessation in a dose-response pattern. CONCLUSIONS: After implementation of a hospital policy to pay market price for infant formula, rates of in-hospital formula supplementation were reduced and the rates of in-hospital exclusive breast-feeding and breast-feeding duration increased.
OBJECTIVE: To investigate the effect of public hospitals in Hong Kong not accepting free infant formula from manufacturers on in-hospital formula supplementation rates and breast-feeding duration. DESIGN: Prospective cohort study. SETTING: In-patient postnatal units of four public hospitals in Hong Kong. SUBJECTS: Two cohorts of breast-feeding mother-infant pairs (n 2560). Cohort 1 (n 1320) was recruited before implementation of the policy to stop accepting free infant formula and cohort 2 (n 1240) was recruited after policy implementation. Participants were followed prospectively for 12 months or until they stopped breast-feeding. RESULTS: The mean number of formula supplements given to infants in the first 24 h was 2·70 (sd 3·11) in cohort 1 and 1·17 (sd 1·94) in cohort 2 (P<0·001). The proportion of infants who were exclusively breast-fed during the hospital stay increased from 17·7 % in cohort 1 to 41·3 % in cohort 2 (P<0·001) and the risk of breast-feeding cessation was significantly lower in cohort 2 (hazard ratio=0·81; 95 % CI 0·73, 0·90). Participants who non-exclusively breast-fed during the hospital stay had a significantly higher risk of stopping any or exclusive breast-feeding. Higher levels of formula supplementation also increased the risk of breast-feeding cessation in a dose-response pattern. CONCLUSIONS: After implementation of a hospital policy to pay market price for infant formula, rates of in-hospital formula supplementation were reduced and the rates of in-hospital exclusive breast-feeding and breast-feeding duration increased.
Entities:
Keywords:
Breast-feeding; Formula supplementation; Hong Kong; Hospital practices; Infant feeding
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