Midwives’ experiences of formula supplementation for non-medical indications in the Swedish postnatal care context
- 1Department of Health Sciences, Midwifery Research, Reproductive, Perinatal and Sexual Health, Faculty of Medicine, Lund University , ,
- 2The PRO-CARE Group, Faculty of Health Science, Kristianstad University , ,
- 3Department of Obstetrics and Gynaecology, Skåne University Hospital ,
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: Three categories were identified: Workplace culture is crucial, Negotiating infant feeding decisions and Moral and professional tensions. 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.
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BibTeX
@article{ny2026midwives,
title = {{Midwives’ experiences of formula supplementation for non-medical indications in the Swedish postnatal care context}},
author = {Pernilla Ny and Atika Khalaf and Tinde Dowler and Louise Karlsson and Li Thies-Lagergren},
journal = {Frontiers in global women's health},
year = {2026},
month = oct,
doi = {10.3389/fgwh.2026.1893484},
url = {https://europepmc.org/article/PMC/PMC13719545},
note = {CC BY},
}
RIS
TY - JOUR
TI - Midwives’ experiences of formula supplementation for non-medical indications in the Swedish postnatal care context
AU - Pernilla Ny
AU - Atika Khalaf
AU - Tinde Dowler
AU - Louise Karlsson
AU - Li Thies-Lagergren
PY - 2026
DA - 2026/10/16
JO - Frontiers in global women's health
DO - 10.3389/fgwh.2026.1893484
UR - https://europepmc.org/article/PMC/PMC13719545
AB - 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: Three categories were identified: Workplace culture is crucial, Negotiating infant feeding decisions and Moral and professional tensions. 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.
SN - 2673-5059
ER -