BAP: Testing of a breastfeeding history questionnaire to identify mothers at risk for postpartum formula supplementation

Background: The objective of this study was to test a breastfeeding history questionnaire to predict inhospital formula supplementation. Methods: A breastfeeding questionnaire named BAP, an abbreviation based on three questions, was conceptualized and implemented in clinical practice. Primary outcome was formula supplementation during the postpartum hospital stay. Results: Multiparous women with BAP scores of 1 or less were over four times more likely to use formula during the postpartum hospital stay than women with BAP scores of 2 or greater (RR = 4.35, 95% CI [2.47, 7.65]; p < .001). Additionally, multiparous mothers with BAP scores of 1 or less were more likely to use formula than primiparous mothers (RR = 1.93, 95% CI [1.47, 2.52]; p < .001). The adjusted odds of formula use were eight times greater for women with the lower BAP score (aOR 8.04, 95% CI [3.10, 20.86]; p < .001). Conclusions: The BAP tool can be used to identify multiparous women most at risk for early formula use, thereby allowing targeted referral to breastfeeding support services.