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Individualized Reconstitution of Human Milk Microbiota: A Feasible Approach in Real-World Settings
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Allied health services availability and human milk nutrition among preterm infants

Igbagbosanmi Olatunji1, Jessica Liu2, Jochen Profit3,2

  • 1Department of Pediatrics, Division of Neonatal-Perinatal Medicine, Stanford University School of Medicine and Lucile Packard Children's Hospital at Stanford, Palo Alto, CA, USA. sanmio@stanford.edu.

Pediatric Research
|May 1, 2026
PubMed

Insights

Allied health service availability in neonatal intensive care units (NICUs) did not impact human milk feeding outcomes for very low birth weight infants. Greater availability of these services was unexpectedly linked to lower human milk use at discharge.

Area of Science:

  • Neonatal care
  • Public health
  • Pediatrics

Background:

  • Structural inequities in neonatal care may affect human milk (HM) feeding outcomes.
  • Allied health service (AHS) availability may differ between safety-net (sn) and non-snNICUs, influencing HM use in very low birth weight (VLBW) infants.

Purpose of the Study:

  • To examine differences in AHS availability between sn and non-snNICUs.
  • To assess the association between AHS availability and HM use at discharge among VLBW infants.

Main Methods:

  • Population-based cohort study using California Perinatal Quality Care Collaborative (CPQCC) data (2022-2023).
  • Included infants born <29 weeks' gestation or <1500g birth weight.
  • Multivariable models assessed AHS availability (lactation, therapy, social work, psychology) and HM use, adjusting for covariates.

Main Results:

  • AHS availability did not differ between sn and non-snNICUs.
  • Individual AHS availability was not associated with increased HM use; greater cumulative AHS availability was associated with lower HM use.
  • HM use at discharge was higher in non-snNICUs (70.2% vs. 63.1%).

Conclusions:

  • Cumulative NICU AHS availability was not associated with higher HM use.
  • The structural presence of AHS may not guarantee integration into effective feeding practices.
  • Further evaluation of AHS integration and coordination with family-centered lactation support is needed.
Abstract

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