Content area
Full Text
(ProQuest: ... denotes non-US-ASCII text omitted.)
Research Papers
Public policies
The recommendation for exclusive breast-feeding for the first 6 months of life is based on the nutritional and immunological importance of breast-feeding for optimal health, growth and development(1,2)and the well-documented risks of infant formula feeding(3,4). Although breast-feeding initiation rates have increased substantially in most developed countries over the past several decades, early breast-feeding cessation is common and rates of exclusive breast-feeding remain low(5,6). Many healthy breast-feeding newborns are supplemented with infant formula before leaving hospital, with rates ranging from 23 % to 82 %(7-13). Supplements are often given for non-medical reasons(14)such as maternal fatigue, instrumental or operative deliveries, and perceived insufficient milk(7,8,11). Early infant formula supplementation disrupts the establishment of breast-feeding by reducing the frequency of breast-feeding and the amount of breast milk removed from the breasts, which often necessitates further supplementation(15).
Excessive marketing and promotion of infant formula, including the provision of free or heavily discounted products to hospitals and medical providers, may contribute to the high rates of in-hospital formula supplementation and the subsequent reduced rates of exclusive breast-feeding(16). In 1989, the WHO and UNICEF developed a set of guidelines for maternity care facilities to protect, promote and support breast-feeding(17). The WHO later launched the Baby Friendly Hospital Initiative (BFHI), which outlined minimum global criteria for accreditation as a Baby-Friendly Hospital. The BFHI stipulates that hospitals should not accept free or heavily discounted infant formula products from manufacturers and must pay market price for all breast-milk substitutes(18). Despite this BFHI guideline, financial incentives mean many hospitals that are not BFHI accredited continue to accept infant formula products from the manufacturers(16). Research has highlighted that early infant formula supplementation is one of the strongest predictors of early breast-feeding cessation(8,11,19-21). Providing mothers with infant formula samples upon hospital discharge has also been shown to shorten breast-feeding duration(22