by Alison Laverty Montag IBCLC
Do demographic disparities exist in the use of mother’s own milk and banked donor milk in NICUs? Preterm infants who consume breastmilk have lower rates of sepsis and necrotizing enterocolitis. When mother’s own milk is not available, banked donor milk is recommended by the American Academy of Pediatrics.
Black mothers have a greater risk delivering a preterm and/or low birthweight infant, and have lower rates of breastfeeding initiation and duration as compared to white, Asian, and Hispanic mothers.
The authors of “Disparities in Hospital-Reported Breast Milk Use in Neonatal Intensive Care Units – United States, 2015” linked data from the CDC’s 2015 Maternity Practices in Infant Nutrition and Care (mPINC) survey with the 2011-2015 U.S. Census Bureau’s American Community Survey (ACS) to examine the use of breastmilk in NICUs based on the demographic makeup of the hospital’s postal code area.
Hospitals were categorized according to postal codes where the percentage of black residents was greater than or less than the national average of 12.3%.
Based on this article, which statements do you believe are accurate regarding the use of breastmilk (mother’s own milk or donor milk) in NICUs? Choose 1 or more:
- 38% of hospitals in postal codes with higher percentages of black residents reported that no infants in the NICU received donor breastmilk compared to 29.6% of NICU infants in postal codes with lower percentages of black residents.
- Fewer than 25% of the 23 nonprofit, accredited milk banks are located in postal codes with a higher percentage of black residents than the national average (12.3%)
- Across all hospitals, a median of 75% of infants in the NICU received mother’s own milk
- Less than half of hospitals in postal codes with higher percentages of black residents reported that more than 75% of infants in the NICU received mother’s own breastmilk
- Approximately 10% of infants across all NICUs received banked donor human milk
See the Answer
The answers are: A, C, D, E not B
Disparities in Hospital-Reported Breast Milk Use in Neonatal Intensive Care Units — United States, 2015
Ellen O. Boundy, ScD; Cria G. Perrine, PhD; Jennifer M. Nelson, MD; Heather C. Hamner, PhD
Milk Mob Comment by Allison Laverty Montag IBCLC
Mothers with infants in the NICU encounter additional challenges beyond the worry and pain of separation from their infants. When paired with other barriers which may include financial constraints, transportation, etc., the task of building and maintaining a milk supply can be difficult to say the least! Negotiating public transit, walking to the hospital or arranging a ride to visit their baby while recovering from childbirth is certainly a challenge and it takes up precious time Mom needs to express her milk.
Some women may be uncomfortable with the handling of their breasts and breastmilk and may be hesitant to discuss breastfeeding and pumping particularly from an individual with whom they don’t identify. This along with pressure from friends and family to abandon breastfeeding and feed formula and the early return to work has the potential to sabotage the mother’s desire to provide milk for her baby.
Education regarding the importance of early and frequent expression of mother’s own milk can take place bedside during labor and can include teaching manual expression. This along with facilitating milk expression in the early hours after birth will help jumpstart mother’s supply. An emphasis on the importance of any amount of mother’s own milk will help empower the mother.
We can direct our efforts to increase the use of mother’s own milk in hospitals located in areas with higher percentages of black mothers than the national average. The inclusion of breastfeeding supporters of color in healthcare roles as well as peer counselors will help assure equitable access to breastfeeding education and support. Interventions can be targeted to increase the use of breastmilk in NICUs in these areas.
Of the 23 nonprofit milk banks accredited by the Human Milk Banking Association of North America (HMBANA), 10 are located in postal codes with a higher percentage of black residents than the national average. The milk is in the right location for many hospitals. Now let’s get the hospitals using it and work to increase donations to match the demand!