Impact of Donor Milk Availability on Breast Milk Use and Necrotizing Enterocolitis Rates

Area of Science:

• Neonatal care
• Human milk banking
• Clinical outcomes research

Background:

• Donor human milk (DHM) is crucial for vulnerable infants when maternal milk is unavailable.
• Understanding DHM accessibility in Neonatal Intensive Care Units (NICUs) is essential for optimizing infant nutrition.
• Previous studies have not fully elucidated the impact of DHM availability on feeding practices and clinical outcomes.

Purpose of the Study:

• To investigate the availability of DHM within a large population-based cohort of very low birth weight infants.
• To determine the association between DHM availability and breast milk feeding rates at NICU discharge.
• To assess the relationship between DHM availability and the incidence of necrotizing enterocolitis (NEC).

Main Methods:

• Utilized clinical data from the California Perinatal Quality Care Collaborative (CPQCC) for very low birth weight infants (2007-2013).
• Linked patient data with hospital-level DHM availability information from the Mothers' Milk Bank of San José.
• Analyzed trends in DHM availability by NICU level and examined changes in feeding and NEC rates in hospitals that introduced DHM.

Main Results:

• DHM availability increased significantly, from 27 to 55 hospitals, across all NICU levels, particularly in regional NICUs.
• By 2013, 81.3% of premature infants in regional NICUs had access to DHM.
• Hospitals transitioning to DHM availability saw a 10% increase in breast milk feeding at discharge and a 2.6% decrease in NEC rates.

Conclusions:

• DHM availability has demonstrably increased in NICUs over the study period.
• Increased DHM access is associated with improved rates of breast milk feeding at NICU discharge.
• The availability of DHM correlates with a reduction in the incidence of necrotizing enterocolitis in high-risk infant populations.