Department of Communication Sciences & Disorders, College of Allied Health Sciences, East Carolina University, Greenville, NC, USA.
Cleft Palate Craniofac J. 2023 Jul;60(7):858-864. doi: 10.1177/10556656221087553. Epub 2022 Mar 21.
To evaluate rates of breast milk feeding among infants with cleft lip with or without cleft palate (CL ± P) enrolled in Medicaid compared to Private Insurance/Self-Pay. This was a population-based retrospective cohort study. The 2018 US National Vital Statistics System-Natality component (NVSS-N) was used to examine nationwide birth certificate data. Infants with cleft lip with or without cleft palate and either Medicaid or Private Insurance/Self-Pay were included. Breast milk feeding rates among infants with CL ± P, as a function of insurance status. Chi-square tests of independence revealed that of 896 infants with CL ± P and insured by Medicaid, 527 (58.8%) were breast milk fed at discharge. Of 865 infants with CL ± P and insured by Private Insurance/Self-Pay, 621 (71.8%) were breast milk fed at discharge. Using logistic regression models and controlling for baseline demographic differences, results indicated that infants with CL ± P in the Medicaid group had reduced odds of breast milk feeding compared to the Private Insurance/Self-Pay group (OR = 0.08; 95% CI 0.56, 0.96). Breast milk support services are often necessary for the initiation of breast milk feeding among infants with CL ± P. However, these resources are likely not as readily available for those enrolled in Medicaid. These results suggest that infants with CL ± P, enrolled in Medicaid, may experience reduced breast milk feeding rates due to limited resources to initiate breast milk feeding. Factors that may promote breast milk feeding among this population are discussed.
评估有唇裂和/或腭裂（CL±P）的婴儿在医疗补助计划（Medicaid）和私人保险/自付计划中的母乳喂养率。这是一项基于人群的回顾性队列研究。使用 2018 年美国国家生命统计系统-出生率部分（NVSS-N）检查全国出生证明数据。纳入有唇裂和/或腭裂且有医疗补助或私人保险/自付的婴儿。研究唇裂和/或腭裂婴儿的母乳喂养率，作为保险状况的函数。独立性卡方检验显示，在 896 名有 CL±P 且由 Medicaid 承保的婴儿中，有 527 名（58.8%）在出院时母乳喂养。在 865 名有 CL±P 且由私人保险/自付承保的婴儿中，有 621 名（71.8%）在出院时母乳喂养。使用逻辑回归模型并控制基线人口统计学差异的结果表明，与私人保险/自付组相比， Medicaid 组中唇裂和/或腭裂婴儿母乳喂养的可能性降低（OR=0.08；95%CI 0.56，0.96）。对于有 CL±P 的婴儿来说，通常需要母乳喂养支持服务才能开始母乳喂养。然而，对于参加 Medicaid 的婴儿来说，这些资源可能不太容易获得。这些结果表明，由于启动母乳喂养的资源有限，参加 Medicaid 的唇裂和/或腭裂婴儿可能经历较低的母乳喂养率。讨论了可能促进该人群母乳喂养的因素。
