Does planning to mixed feed undermine breastfeeding?

Michalopoulou, S., Garcia, A. L. , Wolfson, L. and Wright, C. M. (2024) Does planning to mixed feed undermine breastfeeding? Maternal and Child Nutrition, (doi: 10.1111/mcn.13610) (PMID:38093405) (Early Online Publication)

Abstract

Continued breastfeeding is important for infants' health, but it is unclear whether mixed feeding increases the risk of breastfeeding cessation. We aimed to explore associations of mixed feeding and lactation problems with early cessation of breastfeeding. We analysed data from mothers who completed the Scottish National Maternal and Infant Feeding Survey and had previously breastfed their infants. At age 8–12 weeks, mothers (N = 1974) reported their feeding history and intentions, lactation problems and reasons for giving formula milk. The main outcome measure was cessation of breastfeeding before 6–8 weeks and time to cessation. By 6 weeks, 65% had mixed fed at some point, 32% had ceased breastfeeding, 22% were currently mixed feeding and 46% were exclusively breastfeeding. Lactation problems before 2 weeks were common (65%), and strongly associated with stopping breastfeeding (relative risk [RR]: 3.23, 95% confidence interval [CI]: 2.0–5.3) and with mixed feeding (RR: 3.14, 95% CI: 2.5–4.0). However, even after adjustment for breastfeeding problems mothers who planned to mixed feed (RR: 3.39, 95% CI: 2.4–4.9) and those who introduced formula for practicalities (RR: 3.21, 95% CI: 2.3–4.4) were more likely to stop breastfeeding. These variables also predicted later lactation insufficiency (planned mixed feeding RR: 1.39, 95% CI: 1.0–2.0; formula for practicalities RR: 1.76, 95% CI: 1.3–2.3). Mothers who received specialist lactation support were less likely to cease breastfeeding (RR: 0.63, 95% CI: 0.5–0.9) but nonspecialist input was unrelated to risk of cessation (RR: 1.06, 95% CI: 0.2–4.9). In conclusion, choosing to mix feed an infant is strongly associated with stopping breastfeeding, even in the absence of lactation problems.

• Item Type: Articles
• Keywords: Breastfeeding, formula feeding, maternal and infant feeding survey, breastfeeding support.
• Status: Early Online Publication
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Garcia, Dr Ada and Wright, Professor Charlotte
• Authors: Michalopoulou, S., Garcia, A. L., Wolfson, L., and Wright, C. M.
• College/School: College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
• Journal Name: Maternal and Child Nutrition
• Publisher: Wiley
• ISSN: 1740-8695
• ISSN (Online): 1740-8709
• Published Online: 13 December 2023
• Copyright Holders: Copyright © 2023 The Authors
• First Published: First published in Maternal and Child Nutrition 2024
• Publisher Policy: Reproduced under a Creative Commons licence