679 - Breast Milk Feeding for Early Preterm Black Infants: Identifying Predictors and Barriers in an Urban Neonatal Intensive Care Unit

Poster Number: 679
Publication Number: 679.232

Megan Chang, LAC+USC/USC Keck School of Medicine, Los Angeles, CA, United States; Sarra Bae, University of Maryland Children's Hospital, Baltimore, MD, United States; Sarah-Therese Curtis, University of Maryland School of Medicine, baltimore, MD, United States; Natalie Davis, University of Maryland School of Medicine, BALTIMORE, MD, United States

Background: Mother’s milk (MM) feeds are associated with improved outcomes for preterm infants, however socioeconomic status (SES), mental health, and racial disparities exist in the provision of MM in this country. Our urban Level IV neonatal intensive care unit (NICU) serves a predominantly underserved, low SES patient population, allowing us to better study this important demographic in order to identify modifiable barriers to MM provision to early preterm Black infants.

Objective: To evaluate incidence and barriers to provision of MM to early preterm Black infants.

Design/Methods: We performed a retrospective medical record review of early preterm Black infants born < 34 weeks gestational age (GA) between 2014-2020 and admitted to our urban Level IV NICU. We performed bivariate analyses of clinical and demographic variables comparing: 1) characteristics of mothers who did vs. did not provide MM during NICU admission and 2) neonatal characteristics based on exposure to any MM vs. none. Analyses performed using SAS 9.4.

Results: We identified 527 infants of whom 79% (n=426) received MM during NICU admission. We found no difference in maternal age, ethnicity, or maternal hypertension between the 2 groups. [Table 1] Those who did not provide MM received less prenatal care, had higher incidence of tobacco use and of bipolar diagnosis. Infants who did not receive MM were born less prematurely, had higher birth weights, and were less likely to require delivery room resuscitation. Interestingly, mother's who did not provide MM had significantly higher gravidity and parity, were more likely to have living infants born at term, and to have delivered vaginally. In addition, there was a significant difference in documentation of lactation consultation (LC), with women who did not provide MM rarely undergoing LC.

Conclusion(s): Identifying barriers to MM provision for early preterm Black infants will allow us to focus educational and supportive interventions and reduce disparities in healthcare for this population. Lower incidence of MM provision was associated with less PNC as well as higher maternal gravidity and parity. It is possible that transportation issues and childcare/home responsibilities may limit these mothers' ability to obtain adequate PNC as well as pump and bring MM to the NICU. Disparities in lactation consultation existed and this was strongly associated with MM provision. Infants not receiving MM were also less premature, and perhaps perceived as less vulnerable by mothers. These findings help to identify potentially modifiable barriers to Black infants receiving MM in the NICU.
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