Author Affiliation: American Speech-Language-Hearing Association, Rockville, Maryland (Mss LaManna and Hatfield); and Independent Researcher, Voorhees, New Jersey (Ms McCann).
Adv Neonatal Care. 2024 Apr 1;24(2):110-118. doi: 10.1097/ANC.0000000000001138. Epub 2024 Jan 19.
Social determinants of health (SDOH) are the nonmedical factors that influence health outcomes. SDOH can be grouped into 5 domains: economic stability, education access and quality, healthcare access and quality, neighborhood and built environment, and social and community context. SDOH impact people's health and quality of life but may also contribute to disparities in access to food, education, and healthcare. SDOH uniquely influence parent feeding practices in the neonatal intensive care unit (NICU) in a variety of ways, ranging from logistical considerations for parent visitation to cultural beliefs such as family perception of human milk feeding.
A hypothetical case example of a preterm infant with a feeding disorder in the NICU is used to connect SDOH that influence prenatal health, parental lived experience, and postnatal medical care to maternal and infant outcomes with implications for feeding practices. Barriers and facilitators to successful feeding practices in the NICU and at discharge are considered for each SDOH domain.
This case example increases awareness of SDOH and how they influence parent feeding practices in the NICU, focusing on the intersection of SDOH, parent stress, and oral feeding outcomes. Examples were provided for how to support applying findings into practice.
By being creating a culture of SDOH awareness, NICU staff can assist families in overcoming barriers by putting supports in place to increase equitable participation in developmentally supportive feeding practices during the NICU stay.
健康的社会决定因素（SDOH）是影响健康结果的非医疗因素。SDOH 可以分为 5 个领域：经济稳定、教育机会和质量、医疗保健机会和质量、邻里和建筑环境以及社会和社区环境。SDOH 影响人们的健康和生活质量，但也可能导致获得食物、教育和医疗保健方面的差距。SDOH 以各种方式独特地影响新生儿重症监护病房（NICU）中父母的喂养行为，从父母探视的后勤考虑到家庭对母乳喂养的文化观念等。
使用 NICU 中患有喂养障碍的早产儿的假设案例示例，将影响产前健康、父母生活经历和产后医疗的 SDOH 与对喂养行为有影响的母婴结局联系起来。考虑了每个 SDOH 领域中 NICU 和出院时成功喂养行为的障碍和促进因素。
这个案例示例提高了对 SDOH 的认识，以及它们如何影响 NICU 中的父母喂养行为，重点是 SDOH、父母压力和口腔喂养结果的交叉点。提供了如何支持将研究结果应用于实践的示例。
通过营造 SDOH 意识的文化，NICU 工作人员可以通过提供支持来帮助家庭克服障碍，在 NICU 期间增加公平参与发展支持性喂养行为的机会。
