Fostering Breastfeeding Equity in the Neonatal Intensive Care Unit

Area of Science:

• Human lactation and infant nutrition
• Public health and disparities in infant feeding
• Neonatal intensive care unit (NICU) support systems

Background:

• Mother's milk provides extensive benefits for both term and preterm infants.
• Despite policy advancements supporting breastfeeding, sustained human milk provision remains a challenge.
• Significant racial, ethnic, and age-related disparities exist in breastfeeding rates and human milk consumption.

Purpose of the Study:

• To explore the underlying drivers of breastfeeding inequities within neonatal intensive care units (NICUs).
• To analyze the individual and institutional factors impacting mother's milk provision.
• To understand the inherent costs associated with breastfeeding and human milk provision.

Main Methods:

• Case reviews were conducted to examine breastfeeding experiences.
• Analysis focused on identifying factors contributing to inequities in human milk provision.
• Exploration of individual and institutional-level influences on breastfeeding duration and exclusivity.

Main Results:

• Breastfeeding initiation rates are high, but sustained provision declines significantly by 6 months and 1 year postpartum.
• Non-Hispanic Black infants and younger mothers (20-29 years) show lower rates of ever breastfeeding.
• Marginalized racial and ethnic groups, including non-Hispanic Black and Native American very low birth weight infants, exhibit lower human milk prevalence at discharge.

Conclusions:

• Sustained breastfeeding beyond the early postpartum period is challenging, necessitating targeted interventions.
• Addressing disparities in human milk provision requires understanding and mitigating individual and institutional barriers.
• Further research into the costs and systemic factors influencing breastfeeding is essential for promoting equitable access to mother's milk.