Racial Disparities in Mother's Own Milk Feedings Persist after Discharge from the Neonatal Intensive Care Unit

Objective: 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. Study Design: 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. Results: 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. Conclusions: 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.