Abstract

This study aims to describe the local guidelines for the supplemental feeding of infants of Swedish women’s clinics with maternity wards. Purposeful sampling was used during a four-week data collection time in 2019. Guidelines from 41 of the 43 Swedish women’s clinics with maternity wards were analysed using qualitative and quantitative content analysis. The information provided, and length of the guidelines varied widely in 38 guidelines. Feeding methods were included in 28 guidelines, but 10 provided no information about feeding methods. The most common feeding methods were cup feeding and feeding probes. Suggestions for supplemental feeding included infant formula (32), breast milk (27) and no suggestions (6). The methods to support breastfeeding were skin-to-skin contact (25), breastfeeding freely (22), a caring plan (18), extra supervision (3), optimising the caring environment (2), supplying a breast pump (1) and breastfeeding observation (1). Twenty-two guidelines included information about how long formula should be given and that the feeding should be phased out gradually. We conclude that a national guideline for the supplemental feeding of infants is needed to ensure equal best practice care for infant safety and the support of parents to increase the breastfeeding rate. More national guidelines are needed in general because it is easier to update only one set of guidelines.

Highlights

  • In Sweden, a guideline for hypoglycaemia in neonates [2] focuses on the medical aspects, but there is no national guideline for use in maternity wards on the supplemental feeding of infants

  • There are no privately run maternity clinics in Sweden caring for infants that are in need of supplemental feeding

  • We reviewed the guidelines from 38 clinics, because two had not updated their guidelines and one had none

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Summary

Introduction

In 1991, the WHO and the United Nations Children’s Fund created the Baby-Friendly Hospital Initiative, which includes the global strategy Ten Steps to Successful Breastfeeding [1]. This strategy aims to protect, promote and support breastfeeding and to enhance the conditions for successful breastfeeding worldwide. In Sweden, a guideline for hypoglycaemia in neonates [2] focuses on the medical aspects, but there is no national guideline for use in maternity wards on the supplemental feeding of infants This lack of guidance may cause inequalities in the care of infants and the advice given to parents and may prevent the delivery of best practice and evidence-based care. Providing this knowledge may help to provide better support for parents about breastfeeding and supplemental feeding

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