Program Evaluation of a Breastfeeding History Questionnaire and Screening Program for the Risk of In-Hospital Formula Supplementation at an Academic Medical Center

BACKGROUND: Early formula supplementation disrupts the natural course of breastmilk production making it difficult for mothers who supplement to return to an exclusively breastfeeding state. In-hospital formula use leads to increased risk of early breastfeeding cessation when compared to infants who are exclusively breastfed in-hospital.
PURPOSE: This project evaluated the use and impact of a breastfeeding history questionnaire and screening tool (BAP Breastfeeding History Questionnaire and Screening tool) during hospital stay.
METHODS: A retrospective review of 490 couplet charts was completed to evaluate use of the BAP Questionnaire and Screening tool and the effect of lactation support provided to couplets based on their calculated risk.
RESULTS: For this project, 282 couplets met inclusion criteria. Of those, 230 couplets were identified as high risk for in-hospital formula supplementation. Six percent of high-risk couplets did not receive lactation support. Of the couplets identified as high risk and who did not receive lactation support, 36% used formula in-hospital.
CONCLUSION: Utilizing the BAP Breastfeeding History Questionnaire and Screening Tool prenatally can assist with identifying couplets at risk for in-hospital formula supplementation. Recognizing this risk allows lactation resources to be focused on high-risk couplets to decrease non-medically indicated formula use and promote long term breastfeeding success.