Infant formula use during Rooming-in Care hospitalizations of newborns: a cross-sectional study
DOI:
https://doi.org/10.12957/reuerj.2025.91546Keywords:
Rooming-in Care, Breast Feeding, Infant, Newborn, Infant FormulaAbstract
Objective: to assess factors associated with early and undue use of infant formulas during Rooming-in Care hospitalizations. Method: a cross-sectional study conducted with primiparous women treated between December 2023 and April 2024 in university hospitals from Minais Gerais and Rio de Janeiro. Chi-square and Fisher's exact tests were applied. Prevalence ratios were calculated, as well as Poisson regression with robust variance. Results: a total of 102 dyads were included; 42.2% of the neonates were offered formulas and 22.5% were offered them before breastfeeding initiation. The bivariate analysis pointed to an association with Child-Friendly maternity hospitals (p<0.001), pre-natal guidelines (p=0.007), skin-to-skin contact (p=0.006) and breastfeeding in the first hour of life (p=0.003) as protective factors for breastfeeding. C-sections (p=0.016) emerged as a risk factor. None of the variables was able to explain formula use through the regression analysis. Conclusion: two out of five neonates were offered formulas. However, no factors warranting their early and undue use were found.
References
1. Lyons KE, Ryan CA, Dempsey EM, Ross RP, Stanton C. Breast milk, a source of beneficial microbes and associated benefits for infant health. Nutrients. 2020 [cited 2025 Apr 29]; 12(4):1039. DOI: https://doi.org/10.3390/nu12041039.
2. Victora CG, Bahl R, Barros AJ, França GVA, Horton S, Krasevec J, et al. Breastfeeding in the 21st century: epidemiology, mechanisms, and lifelong effects. Lancet. 2016 [cited 2025 Apr 29]; 387(10017):475-90. DOI: https://doi.org/10.1016/S0140-6736(15)01024-7.
3. Qiu R, Zhong Y, Hu M, Wu B. Breastfeeding and reduced risk of breast cancer: a systematic review and a meta-analysis. Comput Math Methods Med. 2022 [cited 2025 Apr 29]; 2022:8500910. DOI: https://doi.org/10.1155/2022/8500910.
4. World Health Organization. Breastfeeding. Recommendations. Geneva: World Health Organization; 2025 [cited 2025 March 03]. Available from: https://www.who.int/health-topics/breastfeeding#tab=tab_2.
5. World Health Organization. Global breastfeeding scorecard 2023. Rates of breastfeeding increase around the world through improved protection and support. Geneva: World Health Organization; 2023 [cited 2025 Mar 03]. Available from: https://iris.who.int/bitstream/handle/10665/375796/WHO-HEP-NFS-23.17eng.pdf?sequence=1.
6. Universidade Federal do Rio de Janeiro. Aleitamento materno: Aleitamento materno: prevalência e práticas entre crianças brasileiras menores de 2 anos. 4: ENANI – 2019. Rio de Janeiro; 2021 [cited 2025 Mar 03]. Available form: https://enani.nutricao.ufrj.br/wp-content/uploads/2021/11/Relatorio-4_ENANI-2019_Aleitamento-Materno.pdf.
7. Muelbert M, Giugliani ERJ. Factors associated with the maintenance of breastfeeding for 6, 12, and 24 months in adolescent mothers. BMC Public Health. 2018 [cited 2025 Apr 29]; 18:675. DOI: https://doi.org/10.1186/s12889-018-5585-4.
8. Santana GS, Giugliani ERJ, Vieira TO, Vieira GO. Factors associated with breastfeeding maintenance for 12 months or more: a systematic review. J Pediatr. 2018 [cited 2025 Apr 29]; 94(2):104-22. DOI: https://doi.org/10.1016/j.jped.2017.06.013.
9. The Lancet. Unveling the predatory tatics of the formula milk industry. Lancet. 2023 [cited 2025 Apr 29]; 401(10375):409. DOI: https://doi.org/10.1016/s0140-6736(23)00118-6.
10. Rollins N, Piwoz E, Baker P, Kingston G, Mabaso KM, McCoy D, et al. Marketing of commercial milk formula: a system to capture parents, communities, science and policy. Lancet. 2023 [cited 2025 Apr 29]; 401(10375):486-502. DOI: https://doi.org/10.1016/S0140-6736(22)01931-6.
11. Perez-Escamilla R, Tomori C, Hernadez-Cordero S, Baker P, Barros AJD, Bégin F, et al. Breastfeeding: crucially important but increasingly challenge in a market-driven world. Lancet. 2023 [cited 2025 Apr 29]; 401(10375):472-85. DOI: https://doi.org/10.1016/S0140-6736(22)01932-8.
12. Cushiere S. The STROBE guidelines. Saudi J Anaesth. 2019 [cited 2025 Apr 29]; 13(Suppl 1):S31-4. DOI: https://doi.org/10.4103/sja.SJA_543_18.
13. Ruiz MT, Rodrigues EC, da Silva KEPO, de Resende CV, Cavalcanti MC, Santos LM, et al. Effectiveness of individualized counseling on the duration of exclusive breastfeeding: study protocol for a multicenter, randomized, parallel, and open clinical trial. Trials. 2023[cited 2025 Apr 29]; 24(1): 455. DOI: https://doi.org/10.1186/s13063-023-07490-y.
14. Griffin CM, Amorim MH, Almeida FA, Marcacine KO, Goldman RE, Coca KP. LATCH as a systematic tool for assessment of the breastfeeding technique in maternity. Acta Paul Enferm. 2022 [cited 2025 April 29]; 35:eAPE03181. DOI: https://doi.org/10.37689/acta-ape/2022AO03181.
15. von Seehausen MP, Oliveira MIC, Leal MDC, Domingues RMSM, Boccolini CS. Baby-Friendly Hospital Initiative and exclusive breastfeeding during hospital stay. Rev Saude Publica. 2023 [cited 2025 April 29]; 57:28. DOI: https://doi.org/10.11606/s1518-8787.2023057004283.
16. Patterson JA, Keuler NS, Buckingham WR. Differences in exclusive breastfeeding rates in US hospitals according to Baby-Friendly Hospital Initiative designation and area deprivation index category. Breastfeed Med. 2021 [cited 2025 Apr 29]; 16(10):799-806. DOI: https://doi.org/10.1089/bfm.2021.0050.
17. Shing JS, Lok KY, Fong DY, Fan HS, Chow CL, Tarrant M. The influence of the Baby-Friendly Hospital Initiative and maternity care practices on breastfeeding outcomes. J Hum Lact. 2022 [cited 2025 Apr 29]; 38(4):700-10. DOI: https://doi.org/10.1177/08903344221086975.
18. Mäkelä H, Axelin A, Kolari T, Niela-Vilén H. Exclusive breastfeeding, breastfeeding problems, and maternal breastfeeding attitudes before and after the baby-friendly hospital initiative: A quasi-experimental study. Sex Reprod Healthc. 2023 [cited 2025 April 29]; 35:100806. DOI: https://doi.org/10.1016/j.srhc.2022.100806.
19. Lisi C, De Freitas C, Barros H. Maternal country of birth and exclusive breastfeeding during the first in-hospital day in Portugal: The influence of the Baby-Friendly Hospital Initiative. J Hum Lact. 2021 [cited 2025 Apr 29]; 37(1):147-57. DOI: https://doi.org/10.1177/0890334420982248.
20. Kehinde J, O'Donnell C, Grealish A. The effectiveness of prenatal breastfeeding education on breastfeeding uptake postpartum: A systematic review. Midwifery. 2023 [cited 2025 Apr 29]; 118:103579. DOI: https://doi.org/10.1016/j.midw.2022.103579.
21. Oggero MK, Rozmus CL, LoBiondo-Wood G. Effects of prenatal breastfeeding education on breastfeeding duration beyond 12 weeks: a systematic review. Health Educ Behav. 2024 [cited 2025 Apr 29]; 51(5):665-76. DOI: https://doi.org/10.1177/10901981231220668.
22. Li L, Wan W, Zhu C. Breastfeeding after a cesarean section: a literature review. Midwifery. 2021 [cited 2025 Apr 29]; 103:103117. DOI: https://doi.org/10.1016/j.midw.2021.103117.
23. Fan HSL, Wong JYH, Fong DYT, Lok KYW, Tarrant M. Association between intrapartum factors and the time to breastfeeding initiation. Breastfeed Med. 2020 [cited 2025 Apr 29]; 15(6):394-400. DOI: https://doi.org/10.1089/bfm.2019.0166.
24. Branco J, Manuel AR, Completo S, Marques J, Rodrigues Antão R, Pinto Gago C, et al. Prevalence and predictive factors of exclusive breastfeeding in the first six months of life. Acta Med Port. 2023 [cited 2025 Apr 29]; 36(6):416-23. DOI: https://doi.org/10.20344/amp.18692.
25. Gomes MASM, Esteves-Pereira AP, Bittencourt SDA, Augusto LCR, Lamy-Filho F, Lamy ZC, et al. Care for healthy newborns in Brazil: are we making progress in achieving best practices? Cien Saude Colet. 2021 [cited 2025 Apr 29]; 26(3):859-74. DOI: https://doi.org/10.1590/1413-81232021263.26032020.
26. Giang HTN, Duy DTT, Vuong NL, Ngoc NTT, Pham TT, Tuan LQ, et al. Prevalence of early skin-to-skin contact and its impact on exclusive breastfeeding during the maternity hospitalization. BMC Pediatr. 2022 [cited 2025 Apr 29]; 22(1):395. DOI: https://doi.org/10.1186/s12887-022-03455-3.
27. Ballesta-Castillejos A, Rodríguez-Almagro J, Gómez-Salgado J, Martínez-Galiano JM, Romero-Blanco C, Hernández-Martínez A. Preparation and validation of a predictive model of breastfeeding initiation in the first hour of life. Midwifery. 2024 [cited 2025 Apr 29]; 134:104019. DOI: https://doi.org/10.1016/j.midw.2024.104019.
28. Fondo de las Naciones Unidas para la Infancia, Organización Mundial de la Salud. Capturar el momento: Inicio temprano de la lactancia materna: el mejor comienzo para cada recién nacido. 2018 [cited 2025 Mar 03]. Available from: https://www.unicef.org/lac/media/3031/file/PDF%20Capturar%20el%20momento.pdf.
29. Smith ER, Hurt L, Chowdhury R, Sinha B, Fawzi W, Edmond KM, et al. Delayed breastfeeding initiation and infant survival: a systematic review and meta-analysis. PLoS One. 2017 [cited 2025 Apr 29]; 12(7):e0180722. DOI: https://doi.org/10.1371/journal.pone.0180722.
30. Netting MJ, Moumin NA, Knight EJ, Golley RK, Makrides M, Green TJ. The Australian Feeding Infants and Toddler Study (OzFITS 2021): breastfeeding and early feeding practices. Nutrients. 2022 [cited 2025 Apr 29]; 14(1):206. DOI: https://doi.org/10.3390/nu14010206.
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