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Racial and Ethnic Disparities in Human Milk Intake at Neonatal Intensive Care Unit Discharge among Very Low Birth Weight Infants in California.

CPQCC Publication
TitleRacial and Ethnic Disparities in Human Milk Intake at Neonatal Intensive Care Unit Discharge among Very Low Birth Weight Infants in California.
Publication TypeJournal Article
Year of Publication2020
AuthorsLiu J, Parker MG, Lu T, Conroy SM, Oehlert J, Lee HC, Gomez SLin, Shariff-Marco S, Profit J
JournalJ Pediatr
Volume218
Pagination49-56.e3
Date Published2020 03
ISSN1097-6833
KeywordsAdult, Breast Feeding, California, Continental Population Groups, Ethnic Groups, Female, Humans, Infant, Newborn, Infant, Very Low Birth Weight, Intensive Care Units, Neonatal, Male, Milk, Human, Patient Discharge, Pregnancy, Retrospective Studies
Abstract

OBJECTIVES: To examine how infant and maternal factors, hospital factors, and neighborhood-level factors impact or modify racial/ethnic disparities in human milk intake at hospital discharge among very low birth weight infants.

STUDY DESIGN: We studied 14 422 infants from 119 California Perinatal Quality Care Collaborative neonatal intensive care units born from 2008 to 2011. Maternal addresses were linked to 2010 census tract data, representing neighborhoods. We tested for associations with receiving no human milk at discharge, using multilevel cross-classified models.

RESULTS: Compared with non-Hispanic whites, the adjusted odds of no human milk at discharge was higher among non-Hispanic blacks (aOR 1.33 [1.16-1.53]) and lower among Hispanics (aOR 0.83 [0.74-0.93]). Compared with infants of more educated white mothers, infants of less educated white, black, and Asian mothers had higher odds of no human milk at discharge, and infants of Hispanic mothers of all educational levels had similar odds as infants of more educated white mothers. Country of birth and neighborhood socioeconomic was also associated with disparities in human milk intake at discharge.

CONCLUSIONS: Non-Hispanic blacks had the highest and Hispanic infants the lowest odds of no human milk at discharge. Maternal education and country of birth were the biggest drivers of disparities in human milk intake, suggesting the need for targeted approaches of breastfeeding support.

DOI10.1016/j.jpeds.2019.11.020
Alternate JournalJ Pediatr
PubMed ID31843218
PubMed Central IDPMC7042029
Grant ListR01 HD084667 / HD / NICHD NIH HHS / United States
R01 HD095060 / HD / NICHD NIH HHS / United States