Racial and ethnic disparities for breastfeeding among very low birthweight infants in an urban, minority-dominated neonatal intensive care unit

Background: The benefits of breast milk for newborns are undeniable and even more important to the health of premature infants. Racial/ethnic disparities in breastfeeding of term newborns have been documented. We sought to examine if these exist amongst VLBW infants enrolled in a NICU-based lactation support (LS) program. Methods: A retrospective cohort study was conducted by using a database of VLBW (401 – 1500 grams) infants admitted to the NICU of University of Miami/Jackson Memorial Hospital (UM/JMH). Chi-square analyses were conducted to examine the association between race/ethnicity and rates of LS program initiation and success through discharge. Success was calculated as percent of participating and surviving VLBW infants discharged home on any breast milk. Results: The sample consisted of 848 VLBW infants (non-Hispanic Black 428, Hispanic 346, non-Hispanic White 74) admitted to UM/JMH NICU, 2006-2009. There was no statistically significant difference between race/ethnicity in mothers of VLBW infants who accepted enrollment in a LS program. However, the breastfeeding success rates differed significantly (p< 0.001), with Hispanics (46.2%) and Whites (48.1%) demonstrating higher success than Blacks (28.7%). Discussion: Despite enrollment in a program providing hospital-grade electric pumps and IBCLC lactation support/education, a lower percentage of black infants receiving breast milk through discharge suggests a need for further investigation of the factors underlying this difference. Possibilities include differences in cultural attitudes towards breastfeeding, family support, or medical conditions precluding breastfeeding. This race/ethnic disparity mirrors that of term infant breastfeeding rates reported by the CDC and suggests a need for culturally-competent lactation support.