{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T17:43:35Z","timestamp":1792172615248,"version":"4.4.0"},"reference-count":53,"publisher":"American Academy of Pediatrics (AAP)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,7,1]]},"abstract":"<jats:sec>\n                  <jats:title\/>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>BACKGROUND:<\/jats:title>\n                  <jats:p>In-hospital formula feeding (IHFF) of breastfed infants is associated with shorter duration of breastfeeding. Despite evidence-based guidelines on when IHFF is appropriate, many infants are given formula unnecessarily during the postpartum hospital stay. To account for selection bias inherent in observational data, in this study, we estimate liberal and conservative bounds for the association between hospital formula feeding and duration of breastfeeding.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>METHODS:<\/jats:title>\n                  <jats:p>Infants enrolled in the Minnesota Special Supplemental Nutrition Program for Women, Infants, and Children were selected. Breastfed infants given formula were matched with infants exclusively breastfed (n = 5310) by using propensity scoring methods to adjust for potential confounders. Cox regression of the matched sample was stratified on feeding status. A second, more conservative analysis (n = 4836) was adjusted for medical indications for supplementation.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS:<\/jats:title>\n                  <jats:p>Hazard ratios (HR) for weaning increased across time. In the first analysis, the HR across the first year was 6.1 (95% confidence interval [CI] 4.9\u20137.5), with HRs increasing with age (first month: HR = 4.1 [95% CI 3.5\u20134.7]; 1\u20136 months: HR = 8.2 [95% CI 5.6\u201312.1]; &amp;gt;6 months: HR = 14.6 [95% CI 8.9\u201324.0]). The second, more conservative analysis revealed that infants exposed to IHFF had 2.5 times the hazard of weaning compared with infants who were exclusively breastfed (HR = 2.5; 95% CI 1.9\u20133.4).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS:<\/jats:title>\n                  <jats:p>IHFF was associated with earlier weaning, with infants exposed to IHFF at 2.5 to 6 times higher risk in the first year than infants exclusively breastfed. Strategies to reduce IHFF include prenatal education, peer counseling, hospital staff and physician education, and skin-to-skin contact.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1542\/peds.2019-2946","type":"journal-article","created":{"date-parts":[[2020,6,9]],"date-time":"2020-06-09T12:25:11Z","timestamp":1591705511000},"source":"Crossref","is-referenced-by-count":83,"title":["In-Hospital Formula Feeding and Breastfeeding Duration"],"prefix":"10.1542","volume":"146","author":[{"given":"Marcia Burton","family":"McCoy","sequence":"first","affiliation":[{"name":"Special Supplemental Nutrition Program for Women, Infants, and Children, Division of Child and Family Health, Minnesota Department of Health, St Paul, Minnesota;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pamela","family":"Heggie","sequence":"additional","affiliation":[{"name":"University of Minnesota, Minneapolis, Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2020,7,1]]},"reference":[{"issue":"3","key":"2021120914560931800_B1","doi-asserted-by":"crossref","first-page":"402","DOI":"10.1111\/mcn.12294","article-title":"Impact of the Baby-friendly Hospital Initiative on breastfeeding and child health outcomes: a systematic review","volume":"12","author":"P\u00e9rez-Escamilla","year":"2016","journal-title":"Matern Child Nutr"},{"issue":"1","key":"2021120914560931800_B2","doi-asserted-by":"crossref","DOI":"10.1542\/peds.2008-3256","article-title":"Prolonged and exclusive breastfeeding reduces the risk of infectious diseases in infancy","volume":"126","author":"Duijts","year":"2010","journal-title":"Pediatrics"},{"issue":"467","key":"2021120914560931800_B3","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1111\/apa.13147","article-title":"Optimal breastfeeding practices and infant and child mortality: a systematic review and meta-analysis","volume":"104","author":"Sankar","year":"2015","journal-title":"Acta Paediatr"},{"issue":"1","key":"2021120914560931800_B4","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1542\/peds.2010-3000","article-title":"Breastfeeding and reduced risk of sudden infant death syndrome: a meta-analysis","volume":"128","author":"Hauck","year":"2011","journal-title":"Pediatrics"},{"issue":"7","key":"2021120914560931800_B5","doi-asserted-by":"crossref","first-page":"e181161","DOI":"10.1001\/jamapediatrics.2018.1161","article-title":"Association of exposure to formula in the hospital and subsequent infant feeding practices with gut microbiota and risk of overweight in the first year of life [published correction appears in JAMA Pediatr. 2018;172(7):704]","volume":"172","author":"Forbes","year":"2018","journal-title":"JAMA Pediatr"},{"issue":"12","key":"2021120914560931800_B6","doi-asserted-by":"crossref","first-page":"1137","DOI":"10.1001\/jamapediatrics.2019.3544","article-title":"Primary prevention of cow\u2019s milk sensitization and food allergy by avoiding supplementation with cow\u2019s milk formula at birth: a randomized clinical trial","volume":"173","author":"Urashima","year":"2019","journal-title":"JAMA Pediatr"},{"issue":"3","key":"2021120914560931800_B7","doi-asserted-by":"crossref","first-page":"274","DOI":"10.1177\/0890334410362222","article-title":"Maternal hospital experiences associated with breastfeeding at 6 months in a northern California county","volume":"26","author":"Dabritz","year":"2010","journal-title":"J Hum Lact"},{"issue":"1","key":"2021120914560931800_B8","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1542\/peds.2011-3633","article-title":"Baby-Friendly hospital practices and meeting exclusive breastfeeding intention","volume":"130","author":"Perrine","year":"2012","journal-title":"Pediatrics"},{"issue":"6","key":"2021120914560931800_B9","doi-asserted-by":"crossref","first-page":"1339","DOI":"10.1016\/j.jpeds.2013.12.035","article-title":"In-hospital formula use increases early breastfeeding cessation among first-time mothers intending to exclusively breastfeed","volume":"164","author":"Chantry","year":"2014","journal-title":"J Pediatr"},{"issue":"4","key":"2021120914560931800_B10","doi-asserted-by":"crossref","first-page":"397","DOI":"10.1177\/0890334405280835","article-title":"In-hospital formula supplementation of healthy breastfeeding newborns","volume":"21","author":"Gagnon","year":"2005","journal-title":"J Hum Lact"},{"issue":"2","key":"2021120914560931800_B11","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1111\/j.0730-7659.2005.00349.x","article-title":"Comparing sociodemographic and hospital influences on breastfeeding initiation","volume":"32","author":"Kruse","year":"2005","journal-title":"Birth"},{"issue":"3 pt 1","key":"2021120914560931800_B12","doi-asserted-by":"crossref","first-page":"607","DOI":"10.1542\/peds.112.3.607","article-title":"Risk factors for suboptimal infant breastfeeding behavior, delayed onset of lactation, and excess neonatal weight loss","volume":"112","author":"Dewey","year":"2003","journal-title":"Pediatrics"},{"issue":"2","key":"2021120914560931800_B13","doi-asserted-by":"crossref","first-page":"238","DOI":"10.1177\/0890334415599399","article-title":"Effect on Baby-Friendly Hospital steps when hospitals implement a policy to pay for infant formula","volume":"32","author":"Tarrant","year":"2016","journal-title":"J Hum Lact"},{"issue":"5","key":"2021120914560931800_B14","doi-asserted-by":"crossref","first-page":"929","DOI":"10.2105\/AJPH.2008.135236","article-title":"Hospital practices and women\u2019s likelihood of fulfilling their intention to exclusively breastfeed","volume":"99","author":"Declercq","year":"2009","journal-title":"Am J Public Health"},{"issue":"6","key":"2021120914560931800_B15","doi-asserted-by":"crossref","first-page":"593","DOI":"10.1016\/j.jogn.2019.09.004","article-title":"Systematic review of expected weight changes after birth for full-term, breastfed newborns","volume":"48","author":"DiTomasso","year":"2019","journal-title":"J Obstet Gynecol Neonatal Nurs"},{"issue":"1","key":"2021120914560931800_B16","doi-asserted-by":"crossref","DOI":"10.1542\/peds.2014-1532","article-title":"Early weight loss nomograms for exclusively breastfed newborns","volume":"135","author":"Flaherman","year":"2015","journal-title":"Pediatrics"},{"key":"2021120914560931800_B17","doi-asserted-by":"crossref","first-page":"188","DOI":"10.1089\/bfm.2017.29038.ajk","article-title":"ABM clinical protocol# 3: supplementary feedings in the healthy term breastfed neonate, revised 2017","volume":"12","author":"Kellams","year":"2017","journal-title":"Breastfeed Med"},{"issue":"3","key":"2021120914560931800_B18","doi-asserted-by":"crossref","first-page":"178","DOI":"10.1089\/bfm.2006.1.178","article-title":"ABM clinical protocol #1: guidelines for glucose monitoring and treatment of hypoglycemia in breastfed neonates","volume":"1","author":"Wight","year":"2006","journal-title":"Breastfeed Med"},{"issue":"5","key":"2021120914560931800_B19","doi-asserted-by":"crossref","first-page":"250","DOI":"10.1089\/bfm.2017.29042.vjf","article-title":"ABM clinical protocol #22: guidelines for management of jaundice in the breastfeeding infant 35 weeks or more of gestation-revised 2017","volume":"12","author":"Flaherman","year":"2017","journal-title":"Breastfeed Med"},{"issue":"3","key":"2021120914560931800_B20","doi-asserted-by":"crossref","first-page":"399","DOI":"10.1080\/00273171.2011.568786","article-title":"An introduction to propensity score methods for reducing the effects of confounding in observational studies","volume":"46","author":"Austin","year":"2011","journal-title":"Multivariate Behav Res"},{"issue":"7","key":"2021120914560931800_B21","doi-asserted-by":"crossref","first-page":"1242","DOI":"10.1002\/sim.5984","article-title":"The use of propensity score methods with survival or time-to-event outcomes: reporting measures of effect similar to those used in randomized experiments","volume":"33","author":"Austin","year":"2014","journal-title":"Stat Med"},{"issue":"8","key":"2021120914560931800_B22","doi-asserted-by":"crossref","first-page":"1033","DOI":"10.1079\/PHN2004640","article-title":"Motherhood meets epidemiology: measuring risk factors for breast-feeding cessation","volume":"7","author":"Peat","year":"2004","journal-title":"Public Health Nutr"},{"key":"2021120914560931800_B23","unstructured":"Baby-Friendly USA. Baby-friendly facilities a-z and by state. Available at: https:\/\/www.babyfriendlyusa.org\/for-parents\/baby-friendly-facilities-by-state\/. Accessed February 11, 2020"},{"key":"2021120914560931800_B24","doi-asserted-by":"crossref","unstructured":"Xie\u2008Z\n          . Minnesota\u2019s progress towards Baby Friendly Hospital designation: 2019 minnesota infant feeding practices survey. In: Minnesota Breastfeeding Coalition 12th Annual Statewide Workshop and Conference; October 24\u201325, 2019; Rochester, Minnesota. Available at: https:\/\/mnbfc.files.wordpress.com\/2019\/10\/bfsurveyresults_zxie_mbcconf2019.pdf. Accessed February 10, 2020","DOI":"10.1215\/00265667-7328954"},{"issue":"7","key":"2021120914560931800_B25","doi-asserted-by":"crossref","first-page":"851","DOI":"10.1007\/s10995-009-0544-4","article-title":"Reliability and validity of birth certificate prepregnancy weight and height among women enrolled in prenatal WIC program: Florida, 2005","volume":"15","author":"Park","year":"2011","journal-title":"Matern Child Health J"},{"issue":"3","key":"2021120914560931800_B26","doi-asserted-by":"crossref","first-page":"286","DOI":"10.1038\/pr.2011.37","article-title":"Validity of child anthropometric measurements in the Special Supplemental Nutrition Program for Women, Infants, and Children","volume":"71","author":"Crespi","year":"2012","journal-title":"Pediatr Res"},{"issue":"1","key":"2021120914560931800_B27","doi-asserted-by":"crossref","first-page":"259","DOI":"10.1007\/s13524-016-0544-0","article-title":"America\u2019s churning races: race and ethnicity response changes between census 2000 and the 2010 census","volume":"54","author":"Liebler","year":"2017","journal-title":"Demography"},{"issue":"6","key":"2021120914560931800_B28","doi-asserted-by":"crossref","first-page":"1057","DOI":"10.1002\/sim.6004","article-title":"A comparison of 12 algorithms for matching on the propensity score","volume":"33","author":"Austin","year":"2014","journal-title":"Stat Med"},{"issue":"1","key":"2021120914560931800_B29","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1111\/j.1523-536X.1990.tb00007.x","article-title":"The influence of breast surgery, breast appearance, and pregnancy-induced breast changes on lactation sufficiency as measured by infant weight gain","volume":"17","author":"Neifert","year":"1990","journal-title":"Birth"},{"key":"2021120914560931800_B30","volume-title":"Propensity Score Analysis: Statistical Methods and Applications","author":"Guo","year":"2015","edition":"2nd ed"},{"issue":"1","key":"2021120914560931800_B31","doi-asserted-by":"crossref","first-page":"1267","DOI":"10.1186\/1471-2458-14-1267","article-title":"The association between breastfeeding and childhood obesity: a meta-analysis","volume":"14","author":"Yan","year":"2014","journal-title":"BMC Public Health"},{"issue":"1","key":"2021120914560931800_B32","first-page":"255","article-title":"Neuroendocrine regulation of lactation and milk production","volume":"5","author":"Crowley","year":"2015","journal-title":"Compr Physiol"},{"issue":"6","key":"2021120914560931800_B33","doi-asserted-by":"crossref","first-page":"931","DOI":"10.1093\/advances\/nmz039","article-title":"Perspective: should exclusive breastfeeding still be recommended for 6 months?","volume":"10","author":"P\u00e9rez-Escamilla","year":"2019","journal-title":"Adv Nutr"},{"issue":"2","key":"2021120914560931800_B34","doi-asserted-by":"crossref","first-page":"401","DOI":"10.1079\/PNS19950009","article-title":"Breast-feeding: matching supply with demand in human lactation","volume":"54","author":"Wilde","year":"1995","journal-title":"Proc Nutr Soc"},{"issue":"10","key":"2021120914560931800_B35","doi-asserted-by":"crossref","first-page":"451","DOI":"10.1089\/bfm.2015.29016.ros","article-title":"ABM clinical protocol# 19: breastfeeding promotion in the prenatal setting, revision 2015","volume":"10","author":"Rosen-Carole","year":"2015","journal-title":"Breastfeed Med"},{"issue":"5","key":"2021120914560931800_B36","doi-asserted-by":"crossref","first-page":"e20170647","DOI":"10.1542\/peds.2017-0647","article-title":"The breastfeeding-friendly pediatric office practice","volume":"139","author":"Meek","year":"2017","journal-title":"Pediatrics"},{"issue":"5","key":"2021120914560931800_B37","doi-asserted-by":"crossref","first-page":"942","DOI":"10.1542\/peds.2012-1310","article-title":"Evaluation of an office protocol to increase exclusivity of breastfeeding","volume":"131","author":"Corriveau","year":"2013","journal-title":"Pediatrics"},{"issue":"2","key":"2021120914560931800_B38","first-page":"296","article-title":"Office prenatal formula advertising and its effect on breast-feeding patterns","volume":"95","author":"Howard","year":"2000","journal-title":"Obstet Gynecol"},{"issue":"11","key":"2021120914560931800_B39","doi-asserted-by":"crossref","first-page":"2228","DOI":"10.1007\/s10995-016-2095-9","article-title":"Provision of non-breast milk supplements to healthy breastfed newborns in U.S. hospitals, 2009 to 2013","volume":"20","author":"Nelson","year":"2016","journal-title":"Matern Child Health J"},{"issue":"1","key":"2021120914560931800_B40","doi-asserted-by":"crossref","first-page":"e20170142","DOI":"10.1542\/peds.2017-0142","article-title":"Variation in formula supplementation of breastfed newborn infants in New York hospitals","volume":"140","author":"Nguyen","year":"2017","journal-title":"Pediatrics"},{"issue":"1","key":"2021120914560931800_B41","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1177\/0890334408325821","article-title":"Reasons for in-hospital formula supplementation of breastfed infants from low-income families","volume":"25","author":"Tender","year":"2009","journal-title":"J Hum Lact"},{"key":"2021120914560931800_B42","unstructured":"World Health Organization. Ten steps to successful breastfeeding. Available at: https:\/\/www.who.int\/activities\/promoting-baby-friendly-hospitals\/ten-steps-to-successful-breastfeeding. Accessed March 5, 2020"},{"issue":"2","key":"2021120914560931800_B43","doi-asserted-by":"crossref","first-page":"128","DOI":"10.1089\/bfm.2017.0124","article-title":"Using 24-hour weight as reference for weight loss calculation reduces supplementation and promotes exclusive breastfeeding in infants born by cesarean section","volume":"13","author":"Deng","year":"2018","journal-title":"Breastfeed Med"},{"issue":"1","key":"2021120914560931800_B44","doi-asserted-by":"crossref","first-page":"e12670","DOI":"10.1111\/mcn.12670","article-title":"The effect of maternity practices on exclusive breastfeeding rates in U.S. hospitals","volume":"15","author":"Patterson","year":"2019","journal-title":"Matern Child Nutr"},{"key":"2021120914560931800_B45","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1016\/j.jpeds.2019.09.069","article-title":"Trends in breastfeeding interventions, skin-to-skin care, and sudden infant death in the first 6 days after birth","volume":"218","author":"Bartick","year":"2020","journal-title":"J Pediatr"},{"issue":"11","key":"2021120914560931800_B46","first-page":"CD003519","article-title":"Early skin-to-skin contact for mothers and their healthy newborn infants","author":"Moore","year":"2016","journal-title":"Cochrane Database Syst Rev"},{"issue":"10085","key":"2021120914560931800_B47","doi-asserted-by":"crossref","first-page":"2204","DOI":"10.1016\/S0140-6736(17)31373-9","article-title":"Advising women with diabetes in pregnancy to express breastmilk in late pregnancy (Diabetes and Antenatal Milk Expressing [DAME]): a multicentre, unblinded, randomised controlled trial","volume":"389","author":"Forster","year":"2017","journal-title":"Lancet"},{"issue":"2","key":"2021120914560931800_B48","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1016\/S0377-1237(09)80125-1","article-title":"Effect of antenatal expression of breast milk at term in reducing breast feeding failures","volume":"65","author":"Singh","year":"2009","journal-title":"Med J Armed Forces India"},{"issue":"2","key":"2021120914560931800_B49","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1515\/jpm-2012-0196","article-title":"Presence of human milk bank is associated with elevated rate of exclusive breastfeeding in VLBW infants","volume":"41","author":"Arslanoglu","year":"2013","journal-title":"J Perinat Med"},{"issue":"3","key":"2021120914560931800_B50","doi-asserted-by":"crossref","first-page":"e20153123","DOI":"10.1542\/peds.2015-3123","article-title":"Impact of donor milk availability on breast milk use and necrotizing enterocolitis rates [published correction appears in Pediatrics. 2016;137(6):e20160784]","volume":"137","author":"Kantorowska","year":"2016","journal-title":"Pediatrics"},{"issue":"2","key":"2021120914560931800_B51","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1177\/089033449701300212","article-title":"Prenatal breastfeeding education: its effect on breastfeeding among WIC participants","volume":"13","author":"Reifsnider","year":"1997","journal-title":"J Hum Lact"},{"issue":"1","key":"2021120914560931800_B52","doi-asserted-by":"crossref","first-page":"136","DOI":"10.1007\/s10995-014-1504-1","article-title":"Maternal WIC participation improves breastfeeding rates: a statewide analysis of WIC participants","volume":"19","author":"Metallinos-Katsaras","year":"2015","journal-title":"Matern Child Health J"},{"issue":"10","key":"2021120914560931800_B53","doi-asserted-by":"crossref","first-page":"724","DOI":"10.1089\/bfm.2019.0053","article-title":"Assessing the feasibility and effectiveness of two prenatal breastfeeding intervention apps in promoting postpartum in-hospital exclusive breastfeeding","volume":"14","author":"Farr","year":"2019","journal-title":"Breastfeed Med"}],"container-title":["Pediatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/doi\/10.1542\/peds.2019-2946\/1080023\/peds_20192946.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/doi\/10.1542\/peds.2019-2946\/1080023\/peds_20192946.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,12,10]],"date-time":"2021-12-10T03:59:56Z","timestamp":1639108796000},"score":1,"resource":{"primary":{"URL":"https:\/\/publications.aap.org\/pediatrics\/article\/146\/1\/e20192946\/77021\/In-Hospital-Formula-Feeding-and-Breastfeeding"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,7,1]]},"references-count":53,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2020,7,1]]},"published-print":{"date-parts":[[2020,7,1]]}},"URL":"https:\/\/doi.org\/10.1542\/peds.2019-2946","relation":{},"ISSN":["0031-4005","1098-4275"],"issn-type":[{"value":"0031-4005","type":"print"},{"value":"1098-4275","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,7,1]]},"article-number":"e20192946"}}