RACIAL DISPARITIES IN BREASTFEEDING RATES FOR PRETERM INFANTS: OPPORTUNITIES FOR CHANGE IN AN ONGOING MOTHER'S OWN MILK QUALITY IMPROVEMENT PROJECT

ABSTRACT

Purpose of Study Breast milk feeding for newborns, especially preterm infants, has been shown to improve numerous health outcomes. Current literature shows that racial and ethnic disparities exist, with non-Hispanic Black women presently exhibiting the lowest breastfeeding rates among all ethnic groups in the US. Our ongoing Mother's Own Milk (MOM) quality improvement project has undergone several plan-do-study-act (PDSA) cycles to improve initiation and sustained breast milk production. We have not thus far investigated whether there are any disparities amongst mothers in our neonatal intensive care unit (NICU). This objective of this study was to determine if there were any differences in the rates of breast milk feeding between White and non-White mothers of premature infants in our level-4 NICU. Methods Used IRB approved retrospective chart review of infants ≤ 32 6/7 weeks gestation at birth, born between 1/1/ 2020 and 12/29/2021, and discharged by 12/31/2021. Type of feeding (MOM vs. formula), number of weeks babies received >50% MOM, length-of-stay, and mother's race were collected. To determine the percentage that >50% MOM was received (number of weeks an infant was given >50% divided by their length-of-stay). Infants who died or whose mothers had a positive urine drug screen (except THC) were excluded. Summary of Results Data from 233 infants was analyzed. There was a significant difference between White and non- White mothers in number of weeks of MOM feeding (p< 0.03) (figure 1). When analyzing these two years individually, no significant difference was seen in 2020 between the two groups. There was also no difference seen when analyzing individual race groups within the non-White group. Conclusions Racial disparities in MOM feeding were seen when analyzing both 2020 and 2021 together but was not seen in 2020 when looking at the years individually. Acknowledging the disparity and identifying the potential barriers to breastfeeding can lessen this gap. The difference seen in 2021 may be attributable to challenges of the ongoing COVID pandemic including hospital staff shortages causing difficulty to meet the needs of lactating mothers, difficulty with transportation to and from the hospital, inability to obtain a breast pump, and family issues causing decreased support for lactation at home. These challenges have disproportionately affected non-White individuals. The next PDSA cycle includes a pump rental program within the NICU (difficulty obtaining a pump was previously identified as a barrier to sustaining milk production) and a MOM website redesign to improve information and education dissemination. (Figure Presented) .