XL19: Stemming the Tide of Supplementation: What, When, How, and Why

Brian Palmer Lecturer: Marsha Walker
CERPs: 1.0 L CERP
Cost: US$15.00
Access period: One week
Lecture recorded: at GOLD09
Synopsis: Early supplementation of the breastfed infant with infant formula has significant effects on the recipient infant’s gut flora, can provoke sensitivity and allergy to cow’s milk protein and has been identified as an environmental triggering event in the development of diabetes in susceptible families.
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About the lecture: Early supplementation of the breastfed infant with infant formula has significant effects on the recipient infant’s gut flora, can provoke sensitivity and allergy to cow’s milk protein and has been identified as an environmental triggering event in the development of diabetes in susceptible families. In a recent survey in the United States conducted by the Centers for Disease Control and Prevention, 24% of hospitals supplemented more than 50% of their breastfed infants. Supplementation should be undertaken with specific therapeutic goals in mind. However, the vast majority of supplementation in the hospital is done by maternal request based on infant behavior, cultural influences, or due to clinicians’ use of formula to solve breastfeeding problems. Formula supplementation is generally associated with a shorter duration of breastfeeding. Exclusive breastfeeding at hospital discharge is a vanishing entity. This presentation will explore reasons for supplementation, look at true medical indications for supplementation, discuss what to supplement, when to supplement, how to deliver the supplement, how much supplement to give, and how to stem the flow of supplements in the hospital. Some hospitals have successfully helped staff reduce inappropriate supplementation by placing infant formula in a medication distribution system such as Pyxix. Others require infant formula to be logged out to help identify usage and where additional staff education and skill areas need improvement.

About the lecturer: Marsha Walker RN, IBCLC has been assisting breastfeeding families in hospital, clinic, and home settings since 1976. Marsha is the executive director of the National Alliance for Breastfeeding Advocacy: Research, Education, and Legal Branch (NABA REAL). As such, she advocates for breastfeeding at the state and federal levels. She served as a vice president of the International Lactation Consultant Association (ILCA) from 1990-1994 and in 1999 as president of ILCA. She is a board member of the Massachusetts Breastfeeding Coalition and Baby Friendly USA, ILCA's representative to the USDA's Breastfeeding Promotion Consortium, and NABA REAL's representative to the US Breastfeeding Committee. Marsha is an international speaker, and an author of numerous publications including ones on the hazards of infant formula use, Code issues in the US, and Breastfeeding Management for the Clinician: Using the Evidence. Marsha declares that she has occasionally spoken at conferences sponsored by Ameda.