When I read this I thought that it was odd not to see a follow up completed at discharge to make sure the 'exclusive breastfeeding group' didn't use any formula. It appears that there was only one contact made with them at the hospital when they were recruited and then the next at one week of age. 

There is no comment that any of these mothers during the middle of the night (while still in the hospital) trying to soothe their infant with the tips provided didn't get frustrated and request formula. Just because they signed the contract a nurse is not going to deny them the formula if they asked.  The initial contact happened between 24-36 hours and as LC's that work in the hospital we know about 'Baby's Second Night' which can be very hard on many parents. 


So without follow up or chart audits at the time of discharge it is not known if these 'control' babies received formula. But if they did it would be highly likely that they were provided a 2 ounce bottle. 

Jessica Callahan  RN, IBCLC
USA, NC

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