Larsen Nicole, Johnson Tricia J, Patel Aloka L, Dyrland Mary, Fischer Charlie, Dobies Kayla, Meier Paula P, Kadakia Suhagi
Department of Pediatrics, Rush University Medical Center, Chicago, Illinois, USA.
Division of Neonatal Perinatal Medicine, University of Michigan, Ann Arbor, Michigan, USA.
Breastfeed Med. 2025 Mar;20(3):187-193. doi: 10.1089/bfm.2024.0293. Epub 2025 Feb 5.
To investigate mother's own milk (MOM) feeding rates in the first year of life after neonatal intensive care unit (NICU) discharge for infants born <37 weeks gestational age and compare rates by race and ethnicity. This was a retrospective study of preterm infants discharged from the NICU who sought care at a primary care clinic within our academic health system. Infant demographic characteristics and feeding at NICU discharge were extracted from the medical record. Post-discharge feeding history was extracted from health care maintenance (HCM) visit records at 2, 4, 6, 9, and 12 months for infants born between January 2018 and December 2019. Exclusion criteria included having a contraindication to MOM feeding or insufficient feeding documentation. Of the 314 infants meeting inclusion criteria, 57% received any MOM and 24% received exclusive MOM at NICU discharge. At the 6-month HCM visit, MOM feeding rates decreased to 25% for any MOM and 12% for exclusive MOM. Statistically significant racial and ethnic differences in MOM feeding rates were observed at all HCM visits, with White infants having the highest and Black infants having the lowest MOM feeding rates. MOM feeding rates decreased from NICU discharge to the 12-month HCM visit. Disparities observed during the birth hospitalization persisted after discharge, with Black infants having consistently lower MOM feeding rates compared with Hispanic and White infants. These disparities highlight research opportunities to pinpoint factors contributing to the decline in MOM feedings and develop targeted interventions to address these disparities.
调查孕周小于37周的婴儿在新生儿重症监护病房(NICU)出院后第一年的母乳喂养率,并按种族和族裔比较母乳喂养率。这是一项对从NICU出院后在我们学术健康系统内的初级保健诊所寻求护理的早产儿的回顾性研究。从病历中提取婴儿的人口统计学特征和NICU出院时的喂养情况。从2018年1月至2019年12月出生的婴儿在2、4、6、9和12个月的医疗保健维护(HCM)就诊记录中提取出院后的喂养史。排除标准包括有母乳喂养的禁忌症或喂养记录不足。在符合纳入标准的314名婴儿中,57%在NICU出院时接受了任何母乳,24%接受了纯母乳喂养。在6个月的HCM就诊时,任何母乳喂养率降至25%,纯母乳喂养率降至12%。在所有HCM就诊中均观察到母乳喂养率存在统计学上显著的种族和族裔差异,白人婴儿的母乳喂养率最高,黑人婴儿的母乳喂养率最低。母乳喂养率从NICU出院到12个月的HCM就诊时有所下降。出生住院期间观察到的差异在出院后仍然存在,与西班牙裔和白人婴儿相比,黑人婴儿的母乳喂养率一直较低。这些差异突出了研究机会,以确定导致母乳喂养下降的因素,并制定有针对性的干预措施来解决这些差异。