Work

Midwives’ experiences of formula supplementation for non-medical indications in the Swedish postnatal care context

Year: 2026

Type: article

Abstract: Background: Formula supplementation of breastfed infants for non-medical indications is discouraged in Swedish postnatal care. Still, supplementation rates remain high, with 20%-40% of infants receiving formula in postnatal wards. Early formula supplementation has been associated with reduced breastfeeding exclusivity and duration. Little attention has been given to the perspectives of healthcare professionals involved in supplementation decisions, and there is limited understanding of how midwives experience and navigate situations where formula is requested or considered for non-medical reasons. Aim: To explore midwives' experiences of formula supplementation for non-medical indications in postnatal wards. Methods: This qualitative study used an inductive design with semi-structured interviews. Eleven midwives from three postnatal wards in Southern Sweden participated in individual interviews. The interviews were audio-recorded, transcribed verbatim analyzed using content analysis. Results: Midwives described how workplace culture, guideline adherence, knowledge levels, and interprofessional dialogue influenced supplementation practices. Decisions about supplementation were often negotiated in interactions with parents, where midwives sought to facilitate informed decision-making while supporting breastfeeding. Supplementation for non-medical indications was frequently experienced as professionally challenging and emotionally difficult. Conclusion: Midwives' experiences suggest that formula supplementation practices are shaped by organizational culture, professional alignment within the healthcare team, and interactions with parents. Strengthening breastfeeding-promoting postnatal care may therefore require organizational support, consistent education in breastfeeding support, and structures that enable midwives, who possess the strongest expertise, to actively participate in infant feeding decisions together with the mother.

Source: Frontiers in Global Women s Health

DOI: 10.3389/fgwh.2026.1893484

Authors: Pernilla Ny, Atika Khalaf, Tinde Dowler, Louise Karlsson, Li Thies-Lagergren

Institutions: Lund University, Kristianstad University, Mohammed Bin Rashid University of Medicine and Health Sciences, Skåne University Hospital

Language: English

Topic: Breastfeeding Practices and Influences

Subfield: Epidemiology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $3,077