Infants of low-income households consume higher amounts of milk formula, according to study

06 May 2019 --- Exclusive breastfeeding is recommended for the first six months of life, by the standards of The World Health Organization (WHO) and American Academy of Pediatrics. However, high rates of early introduction of infant formula and mixed breastfeeding were found among a sample of low-income mothers participating in the Women, Infants and Children (WIC) federal food assistance program, in an analysis conducted by George Mason University’s College of Health and Human Services, in the US.

This study investigated the feeding patterns of 190 low-income mothers who attended two WIC clinics in Loudoun County, Virginia. Food insecurity was found to be high as 81 percent were living below the federal poverty line.

Assistant Professor Sina Gallo, Ph.D., led the study with colleagues from the Loudoun County Health Department and Georgetown University. Published in Public Health Nutrition, the analysis found that 61 percent of infants in their sample received formula in the first few days of life. More than half of the mothers reported use of formula due to perceived insufficient milk supply. Going back to work was also commonly cited as a reason for introducing formula, and some cultural beliefs may have encouraged the use of a mix of both breast milk and formula.

The researchers suggested that most early breastfeeding problems can be addressed with education about how and when to breastfeed, as well as culturally appropriate support from clinicians. “The main reason for introduction of formula was a perceived insufficient milk supply – which is likely a preventable reason – and education on sufficient breast milk in the first few days as well as improved baby-friendly hospital practices such as skin-to-skin and feeding in the first hour can help mitigate this practice,” Dr. Gallo explains.

Mothers who set an exclusive breastfeeding goal were five times more likely to be exclusively breastfeeding at three months post-partum. Those who did not complete high school were four times more likely to be exclusively breastfeeding at three months and six times more likely to be exclusively breastfeeding at six months than those who had completed a high school education or greater.

“The early rates of introduction of formula in the population surveyed is alarming – 17 percent reported giving formula at the first feed and 45 percent before they left the hospital. This is the time when support systems should be in place to help mothers exclusively breastfeed, yet many are choosing formula feeding at this time,” says Dr. Gallo.

The researchers explain that in most cases it is possible for new mothers to adapt to exclusive breastfeeding with education intervention from WIC counsellors, as well as changes in WIC policies to encourage and support breastfeeding.

“Our study aims to inform policymakers of the best way to help minority mothers earning low incomes to adopt exclusive breastfeeding. WIC already provides an expanded food package for exclusively breastfeeding mothers as well as access to lactation counselors,” says Dr. Gallo.

“However an increased focus on intense lactation support in the first weeks, including limiting formula as a part of the WIC package for the first month to special circumstances may further help support mothers to meet breastfeeding recommendations,” she further highlights.

Last month, infant nutrition market leader Nestlé faced severe criticism from Changing Markets Foundation (CMF), which slammed the Swiss multinational food and drink giant for using science as “merely a marketing tool to boost sales of its infant nutrition portfolio.” The environmental and social NGO is calling on Nestlé to step up in the breast milk substitute space following the publication of a report which alleges that so far Nestlé has failed to fulfill its previous commitments on making changes to its infant formula ranges. These include removing sucrose and vanilla compounds from all its products for babies under 12 months and removing contradictory nutritional advice on sucrose and vanilla flavorings.