National Prevalence of Donor Milk Use Among Level 1 Nurseries

Parker, Margaret G.; Burnham, Laura; Kerr, Stephen M.; Belfort, Mandy B.; Perrin, Maryanne T.; Corwin, Michael J.; Heeren, Timothy

doi:10.1542/hpeds.2020-001396

Cited by 10 publications

(5 citation statements)

References 34 publications

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“…Although extensive evidence supports the use of DHM in VLBW infants, availability of DHM is a healthcare disparity. DHM use varies by level of care, ranging from 18% of level 1 nurseries to 66% of level 3 and 74% of level 4 units which typically care for post-surgical neonates [ 20 , 24 – 27 ]. Safety-net hospitals (≥75% Medicaid) and hospitals with a high proportion of Black or Hispanic patients are less likely to use DHM compared to non-safety-net hospitals [ 24 , 26 , 28 ].…”

Section: Barriers To Donor Human Milk Access and Usementioning

confidence: 99%

US state policies for Medicaid coverage of donor human milk

et al. 2022

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Donor human milk is recommended by the American Academy of Pediatrics for high-risk infants when mother’s own milk is absent or insufficient in quantity. Several factors may contribute to the inequitable use of or access to donor human milk, including a limited knowledge of its effects, cost, reimbursement, and regulatory barriers. The American Academy of Pediatrics and the United States Surgeon General have called for investigating barriers that prevent use of donor human milk for high-risk infants and for changes to public policy known to improve availability and affordability. We review the current legislative, regulatory, and economic landscape surrounding donor human milk use in the United States, as well as suggest state- and federal-level solutions to increase access to donor human milk.

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Section: Barriers To Donor Human Milk Access and Usementioning

confidence: 99%

US state policies for Medicaid coverage of donor human milk

et al. 2022

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“…The importance that was placed on human milk by having DHM available may also have strengthened participants’ resolve to breastfeed despite ongoing challenges. Given that a substantial number of nurseries are now making DHM available for well-newborn supplementation (Parker et al, 2020), further study of the benefit of DHM on breastfeeding outcomes is important, as hospitals consider resource allocation and population health.…”

Section: Discussionmentioning

confidence: 99%

The Association Between Type of Supplementation in the Newborn Nursery and Breastfeeding Outcomes at 2 and 6 Months of Age

et al. 2022

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Background: Supplementation in the newborn nursery has been associated with shorter breastfeeding duration. However, supplementation may at times be necessary. Research Aim: To determine the association between type of supplementation in the newborn nursery (mother’s own milk, formula, donor human milk) and breastfeeding outcomes at 2 and 6 months of age. Methods: This was a prospective, longitudinal, observational multi-group cohort study. In total, 2,343 surveys were sent to parents who, prior to delivery, indicated intent to exclusively breastfeed. Participants were grouped by type of nursery supplementation. Surveys asked about breastfeeding outcomes when infants were 2 and 6 months old. Our final analytic sample included data from 1,111 healthy newborns ≥ 35 weeks. We used multiple logistic regression to compare future breastfeeding outcomes for infants who were exclusively directly breastfed or who received supplementation during their birth hospitalization. Results: Both the donor human milk and formula groups had decreased breastfeeding at 2 and 6 months compared to the exclusively directly breastfed group. Notably, for infants who received formula compared to donor human milk, the odds of breastfeeding at 2 and 6 months were 74% and 58% lower, respectively ( OR = 0.26, 95% CI [0.12, 0.56] at 2 months; OR = 0.42, 95% CI [0.19, 0.94] at 6 months). The donor human milk group had lower odds of breastfeeding at both follow up times compared to the mother’s own milk group. Conclusion: Among those who intend to breastfeed, supplementation with donor human milk instead of formula in the newborn nursery may support longer breastfeeding.

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“…Among these women, 59% identified as Hispanic, and 65.1% identified as non-Hispanic Black (Martin et al, 2021). Furthermore, hospitals with greater than 75% Medicaid patients were less likely to offer DHM (Parker et al, 2020); therefore, women of color have lower access to DHM. For this reason, when supporting legislation regarding DHM coverage, Medicaid reform is needed to lessen racial disparities related to the receipt of human milk.…”

Section: Implications For Practice and Policymentioning

confidence: 99%