For very low-birth-weight (VLBW) infants, defined as 1500 g or less, human milk provides substantial health benefits. The degree to which the use of human milk has changed over time and the variables impacting its use, however, are less understood. This cohort study of 346,248 VLBW infants across 802 U.S. hospitals (2008 to 2017) aimed to characterize the extent of enteral human milk use and its provision across various racial and/or ethnic groups. Researchers found that the provision of human milk to infants at discharge increased from 44% to 52% between 2008 and 2017. Compared to Southern states, human milk provision was higher in Western states among single births (prevalence ratio (PR) 1.32, 95% CI 1.25 to 1.39) and multiple births (PR 1.28, 95% CI 1.21 to 1.35), as well as the Northeast states among single births (PR 1.11, 95% CI 1.04 to 1.19) and multiple births (PR 1.11, 95% CI 1.04 to 1.19). Compared to non-Hispanic white mothers, human milk provision was higher among Asian mothers for single births (PR 1.21, 95% CI 1.18 to 1.25) and multiple births (PR 1.12, 95% CI 1.09 to 1.15). Conversely, compared to non-Hispanic white mothers, human milk provision was lower among Native Americans for single births (PR 0.64, 95% CI 0.59 to 0.70) and multiple births (PR 0.59, 95% CI 0.50 to 0.69), Hispanic single births (PR 0.98, 95% CI 0.96 to 1.01) and multiple births (PR 0.88, 95% CI 0.86 to 0.91), and non-Hispanic black mothers for single births (PR 0.67, 95% CI 0.65 to 0.70) and multiple births (PR 0.57, 95% CI 0.54 to 0.60). These significant findings suggest that, in spite of an increase in human milk provision over the past decade, notable disparities by ethnicity and U.S. region exist.
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