Provision of Non-breast Milk Supplements to Healthy Breastfed Newborns in U.S. Hospitals, 2009 to 2013

Breastfed newborns are often given non-breast milk supplements in the hospital, which can negatively impact breastfeeding outcomes. Efforts to improve maternity care practices include reducing supplementation of breastfed newborns. Methods The Maternity Practices in Infant Nutrition and Care (mPINC) survey is administered every 2 years to all hospitals in the United States and territories with registered maternity beds. We examined provision of non-breast milk supplements to healthy, full-term breastfed newborns from 2009 to 2013. Results Hospitals that provided non-breast milk supplements to at least 50 % of breastfed newborns decreased from 31.5 % in 2009 to 23.3 % in 2013. Among hospitals providing any supplements, there was no change in the percent that supplemented with infant formula; whereas, supplementing with water declined from 8.8 % in 2009 to 4.2 % in 2013 and with glucose water from 23.4 % to 12.5 %, respectively. In 2013, 64.9 % of breastfed infants were supplemented with formula for "mother's choice," 25.0 % for "doctor's orders," and 8.7 % for "nurse's recommendation." Discussion Despite improvements in maternity care practices, nearly one-fourth of hospitals are still providing at least 50 % of healthy, full-term breastfed newborns with non-breast milk supplements. While there has been no change in the proportion of hospitals providing infant formula supplements, the proportion supplementing with water and glucose water have declined. Additional education and support of mothers during the early post-partum period and training of physicians may address reasons breastfed infants are supplemented.