Variation in Formula Supplementation of Breastfed Newborn Infants in New York Hospitals
Abstract
Objectives We examined the variation between 126 New York hospitals in formula supplementation among breastfed infants after adjusting for socioeconomic, maternal, and infant factors and stratifying by level of perinatal care. Methods We used 2014 birth certificate data for 160 911 breastfed infants to calculate hospital-specific formula supplementation percentages by using multivariable hierarchical logistic regression models. Results Formula supplementation percentages varied widely among hospitals, from 2.3% to 98.3%, and was lower among level 1 hospitals (18.2%) than higher-level hospitals (50.6%-57.0%). Significant disparities in supplementation were noted for race and ethnicity (adjusted odds ratios [aORs] were 1.54-2.05 for African Americans, 1.85-2.74 for Asian Americans, and 1.25-2.16 for Hispanics, compared with whites), maternal education (aORs were 2.01-2.95 for ≤12th grade, 1.74-1.85 for high school or general education development, and 1.18-1.28 for some college or a college degree, compared with a Master's degree), and insurance coverage (aOR was 1.27-1.60 for Medicaid insurance versus other). Formula supplementation was higher among mothers who smoked, had a cesarean delivery, or diabetes. At all 4 levels of perinatal care, there were exemplar hospitals that met the HealthyPeople 2020 supplementation goal of ≤14.2%. After adjusting for individual risk factors, the hospital-specific, risk-adjusted supplemental formula percentages still revealed a wide variation…
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In New York City, Asian American mothers were the group most likely to supplement with formula.
“Researchers have found that in New York City, Asian American mothers were most likely to supplement with formula, and Asian American mothers of Chinese ethnicity were least likely to breastfeed (Lau et al., 2021; Nguyen et al., 2017).”
From Infant Feeding Practices and Social Support Networks Among Immigrant Chinese American Mothers With Economic Disadvantage in New York City (2023) · cites this paper as Nguyen et al., 2017
In New York City, Asian American mothers of Chinese ethnicity were the least likely to breastfeed.
“Researchers have found that in New York City, Asian American mothers were most likely to supplement with formula, and Asian American mothers of Chinese ethnicity were least likely to breastfeed (Lau et al., 2021; Nguyen et al., 2017).”
From Infant Feeding Practices and Social Support Networks Among Immigrant Chinese American Mothers With Economic Disadvantage in New York City (2023) · cites this paper as Nguyen et al., 2017
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References 51 · Cited by 28
- Authors
- Nguyen, T., Dennison, B. A., Fan, W., Xu, C., & Birkhead, G. S.
- Affiliations
- New York State Department of Health (US)
- University at Albany, State University of New York (US)
- Corresponding author
- Nguyen, Trang
- Venue
- Pediatrics
- Publisher
- American Academy of Pediatrics (AAP)
- Published
- 2017-07-01
- Volume
- 140
- Issue
- 1
- ISSN
- 0031-4005 (ISSN-L)
- 1098-4275
- OpenAlex
- W2697114391
- Cited by
- 28
- References
- 51
- Citations by year
- 2026: 2 · 2025: 4 · 2023: 5 · 2022: 2 · 2021: 2 · 2020: 2 · 2019: 5 · 2018: 5 · 2017: 1
- FWCI
- 2.80
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- PEDIATRICS (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Epidemiology › Breastfeeding Practices and Influences
- Health Sciences › Nursing › Nutrition and Dietetics › Infant Nutrition and Health
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Infant Development and Preterm Care
- Keywords
- formula supplementation, breastfeeding, neonates, hospital variation, racial and ethnic disparities, maternal education, Medicaid, maternal smoking, cesarean section, maternal diabetes, exclusive breastfeeding, Healthy People 2020, maternity care practices
- MeSH terms
- Adolescent, Adult, Breast Feeding, Humans, Infant, Newborn, New York, Socioeconomic Factors, Dietary Supplements, Infant Formula, Young Adult
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