Factors Associated with Inequities in Donor Milk Bank Access Among Different Hospitals.

Donor human milk (DHM) can provide many benefits to neonates. This study examines access to DHM and how structural barriers may exacerbate inequities. The median test and analysis of variance test were used to compare the distribution of maternal race/ethnicity and insurance status variables with DHM access for California neonatal intensive care units (NICUs) in 2021. Across 124 NICUs, those serving a higher percentage of white families were more likely to have access to DHM ( = 0.04). NICUs with a higher percentage of Hispanic families were less likely to have access to DHM ( = 0.03). Hospitals that had higher proportions of uninsured patients were also less likely to have access to DHM ( = 0.015). Inequities in DHM access and use among NICU infants begin at the structural level. Policies that reduce barriers to DHM access may reduce health inequities for Hispanic and uninsured families.