breastfeedingBreastfeeding is the healthiest option for most infants. Mothers who want to breastfeed are often advised to start breastfeeding from birth in the hospital and to avoid using commercial infant formulas at all costs to prevent confusion. Researchers from US San Francisco suggest a different tactic, especially for infants who lose weight quickly immediately following birth. Early limited formula (ELF) may increase the duration of breastfeeding. The study results were published in Pediatrics.

Researchers enrolled infants born full term who lost a minimum of 5% body weight within the first 48 hours of delivery. Forty infants were eventually enrolled. Infants were randomly assigned to the control or active group of the study. The mothers of infants in the control group breastfed eight to 12 times daily without supplemental infant formula. The mothers of infants in the active group were allowed to breastfeed like normal, but infants were given a small amount of infant formula via syringe by mouth immediately after breastfeeding. Researchers chose to use a syringe instead of a bottle to prevent the possibility of nipple confusion. When the mother’s first milk developed into mature milk the supplementation program was ceased.

Mothers and infants were followed and assessed for three months. All mothers were breastfeeding one week after delivery. About 10% of infants in the active (ELF) group were still receiving some infant formula, compared to 47% of infants in the control group. By the three-month mark, 79% of the active group was still exclusively breastfeeding with 95% of infants consuming some form of breast milk daily. The control group did not maintain comparable breastfeeding numbers – only 42% were exclusively breastfeeding at three months with 68% consuming some breast milk during the day.

Though the study results clearly point to a positive correlation between limited early use of infant formula as a supplement to breast milk and breastfeeding exclusivity and duration, additional research is needed according to Dr. James Taylor of the University of Washington Newborn Nursery. “The results of this study are provocative and challenge conventional wisdom. It is crucial that we have more randomized controlled trials on interventions to increase breastfeeding rather than relying on heavily confounded observational studies or biased expert opinion.”

Source: Valerie J. Flaherman, Janelle Aby, Anthony E. Burgos, Kathryn A. Lee, Michael D. Cabana, and Thomas B. Newman. Effect of Early Limited Formula on Duration and Exclusivity of Breastfeeding in At-Risk Infants: An RCT. Pediatrics, May 13, 2013 DOI: 10.1542/peds.2012-2809