375 - Disparities in Breastmilk Feeding Rates in Preterm Infants After Discharge from the Neonatal Intensive Care Unit (NICU)

Poster Number: 375
Publication Number: 375.102

Nicole E. Larsen, Rush Medical College of Rush University Medical Center, Chicago, IL, United States; Tricia J. Johnson, Rush University, Chicago, IL, United States; Paula Meier, Rush Medical College of Rush University Medical Center, Oak Park, IL, United States; Kayla J. Dobies, Rush Medical College of Rush University Medical Center, Macomb, MI, United States; Mary C. Dyrland, Rush Medical College of Rush University Medical Center, Chicago, IL, United States; Charlie Fischer, Rush Medical College of Rush University Medical Center, Chicago, IL, United States; Aloka L. Patel, Rush Medical College of Rush University Medical Center, Chicago, IL, United States; Suhagi Kadakia, Rush Medical College of Rush University Medical Center, elmhurst, IL, United States

Background: There are limited data about post-NICU discharge breastmilk (BM) feeding rates in preterm (PT) infants, despite multiple initiatives to improve in-hospital rates of BM feeding for this population. 

Objective: 1) To determine BM feeding rates in PT infants in the first year of life. 2) To evaluate whether differences in BM feeding rates exist by race/ethnicity in PT infants in the first year of life. 

Design/Methods: Retrospective study of PT infants (gestational age (GA) < 37 weeks) discharged from the NICU that sought care at a pediatric clinic within the academic medical center. Infant demographic characteristics and feeding at NICU discharge were extracted from the medical record. Feeding history was extracted from healthcare maintenance visits at newborn, and 2, 4, 6, 9 and 12 months for PT infants born between January 1- May 15, 2018, as part of a larger ongoing study. Exclusion criteria included: having a contraindication to BM feeding or insufficient feeding documentation. 

Results: Of 150 infants discharged during the study period, 42 infants met eligibility criteria, with mean birth GA 33±3 weeks (Table 1). At NICU discharge, 62% were receiving any BM (exclusive or combined with formula). At the newborn visit, 37% were receiving exclusive BM and 16% mixed feedings (BM+formula), yielding 53% receiving any BM (Figure 1). Receipt of any BM decreased over the first year. Racial/ethnic differences were observed, most notably at the newborn visit with 100% of Non-Hispanic White/Asian/Other infants receiving any BM compared to 56% of Hispanic infants and 37% of Non-Hispanic Black infants (Figure 2). Exclusive formula feeding rates for Non-Hispanic Black infants increased 1.7-fold from 46% to 78% over the first 2 months. Although Hispanic and Non-Hispanic Black infants had similar rates of exclusive BM feeding, receipt of any BM was higher in Hispanic infants due to greater rates of combined feedings.  

Conclusion(s): BM feeding rates in the first year progressively decreased for all PT infants, with a sharp decline by 2 months. Disparities previously described during NICU hospitalization persist after discharge, with higher rates of exclusive formula feeding in Non-Hispanic Black infants at all time points. These disparities highlight opportunities for research to understand factors that result in the rapid decline in BM feedings in order to develop interventions to support continued BM feedings for former PT infants.