Association of Primary Language with Provision of Mother's Milk Among Very-Low-Birthweight Infants in Massachusetts

Overview

Journal Breastfeed Med

Publisher Mary Ann Liebert

Specialty Nutritional Sciences

Date 2022 Dec 28

PMID 36576788

Authors

Erika G Cordova-Ramos

Patrice Melvin

Nikita S Kalluri

Michelle-Marie Pena

Mandy B Belfort

Margaret G Parker

Affiliations

Soon will be listed here.

Abstract

Racial/ethnic inequities in mother's milk provision for hospitalized preterm infants persist. The extent to which primary language contributes to these racial/ethnic inequities is unknown. Examine associations of maternal race/ethnicity and primary language with (1) any/exclusive mother's milk at hospital discharge and (2) the time to cessation of mother's milk provision during the hospitalization. We examined 652 mother/very-low-birthweight (VLBW) infant dyads at 9 level 3 neonatal intensive care units in Massachusetts from January 2017 to December 2018. We abstracted maternal race/ethnicity and language from medical records, and examined English and non-English-speaking non-Hispanic White (NHW), non-Hispanic Black (NHB), and Hispanic mothers of any race. We examined associations of race/ethnicity and language with (1) any/exclusive mother's milk at discharge (yes/no) using mixed-effects logistic regression and (2) cessation of mother's milk during the hospitalization using cox proportional hazard models, adjusting for gestational age, birthweight, and accounting for clustering by plurality and hospital. Fifty-three percent were English-speaking NHW, 22% English-speaking NHB, 4% non-English-speaking NHB, 14% English-speaking Hispanic, and 7% non-English-speaking Hispanic. Compared with English-speaking NHW, NHB mothers (English adjusted odds ratio [aOR] 0.28 [0.17, 0.44]; and non-English-speaking aOR 0.55 [0.19, 0.98]), and non-English-speaking Hispanic mothers (aOR 0.29 [0.21, 0.87]) had lower odds of any mother's milk at discharge. In time-to-event analyses, non-English-speaking Hispanic (adjusted hazard ratio [aHR] 4.37 [2.20, 6.02]) and English-speaking NHB mothers (aHR 3.91 [1.41, 7.61] had the earliest cessation of mother's milk provision. In Massachusetts, maternal primary language was associated with inequities in mother's milk provision for VLBW infants with a differential effect for NHB and Hispanic mothers.

Citing Articles

Lactation Support as a Proxy Measure of Family-Centered Care Quality in Neonates with Life-Limiting Conditions-A Comparative Study.

Brito S, Williams A, Fox J, Mohammed T, Chahin N, McCarthy K Children (Basel). 2023; 10(10).

PMID: 37892298 PMC: 10605637. DOI: 10.3390/children10101635.

References

Robinson K, Fial A, Hanson L . Racism, Bias, and Discrimination as Modifiable Barriers to Breastfeeding for African American Women: A Scoping Review of the Literature. J Midwifery Womens Health. 2019; 64(6):734-742. DOI: 10.1111/jmwh.13058. View

Shulman H, DAngelo D, Harrison L, Smith R, Warner L . The Pregnancy Risk Assessment Monitoring System (PRAMS): Overview of Design and Methodology. Am J Public Health. 2018; 108(10):1305-1313. PMC: 6137777. DOI: 10.2105/AJPH.2018.304563. View

Liu J, Parker M, Lu T, Conroy S, Oehlert J, Lee H . Racial and Ethnic Disparities in Human Milk Intake at Neonatal Intensive Care Unit Discharge among Very Low Birth Weight Infants in California. J Pediatr. 2019; 218:49-56.e3. PMC: 7042029. DOI: 10.1016/j.jpeds.2019.11.020. View

Devane-Johnson S, Giscombe C, Williams 2nd R, Fogel C, Thoyre S . A Qualitative Study of Social, Cultural, and Historical Influences on African American Women's Infant-Feeding Practices. J Perinat Educ. 2019; 27(2):71-85. PMC: 6388681. DOI: 10.1891/1058-1243.27.2.71. View

Parker M, Gupta M, Melvin P, Burnham L, Lopera A, Moses J . Racial and Ethnic Disparities in the Use of Mother's Milk Feeding for Very Low Birth Weight Infants in Massachusetts. J Pediatr. 2018; 204:134-141.e1. DOI: 10.1016/j.jpeds.2018.08.036. View

Lee E, Go O . Survival analysis in public health research. Annu Rev Public Health. 1997; 18:105-34. DOI: 10.1146/annurev.publhealth.18.1.105. View

McKinney C, Hahn-Holbrook J, Chase-Lansdale P, Ramey S, Krohn J, Reed-Vance M . Racial and Ethnic Differences in Breastfeeding. Pediatrics. 2016; 138(2). PMC: 4960721. DOI: 10.1542/peds.2015-2388. View

Gould J . The role of regional collaboratives: the California Perinatal Quality Care Collaborative model. Clin Perinatol. 2010; 37(1):71-86. DOI: 10.1016/j.clp.2010.01.004. View

Standish K, Parker M . Social Determinants of Breastfeeding in the United States. Clin Ther. 2021; 44(2):186-192. DOI: 10.1016/j.clinthera.2021.11.010. View

10.

Lechner B, Vohr B . Neurodevelopmental Outcomes of Preterm Infants Fed Human Milk: A Systematic Review. Clin Perinatol. 2017; 44(1):69-83. DOI: 10.1016/j.clp.2016.11.004. View

11.

Johnson T, Patel A, Bigger H, Engstrom J, Meier P . Cost savings of human milk as a strategy to reduce the incidence of necrotizing enterocolitis in very low birth weight infants. Neonatology. 2015; 107(4):271-6. PMC: 4458214. DOI: 10.1159/000370058. View

12.

Cordova-Ramos E, Tripodis Y, Garg A, Kalluri N, Flores G, Parker M . Linguistic Disparities in Child Health and Presence of a Medical Home Among United States Latino Children. Acad Pediatr. 2021; 22(5):736-746. PMC: 8942870. DOI: 10.1016/j.acap.2021.09.011. View

13.

Provini L, Corwin M, Geller N, Heeren T, Moon R, Rybin D . Differences in Infant Care Practices and Smoking among Hispanic Mothers Living in the United States. J Pediatr. 2016; 182:321-326.e1. PMC: 5328962. DOI: 10.1016/j.jpeds.2016.11.053. View

14.

Hoban R, Bigger H, Patel A, Rossman B, Fogg L, Meier P . Goals for Human Milk Feeding in Mothers of Very Low Birth Weight Infants: How Do Goals Change and Are They Achieved During the NICU Hospitalization?. Breastfeed Med. 2015; 10(6):305-11. PMC: 4523097. DOI: 10.1089/bfm.2015.0047. View

15.

Adams S, Davis T, Lechner B . Perspectives on Race and Medicine in the NICU. Pediatrics. 2021; 147(3). DOI: 10.1542/peds.2020-029025. View

16.

Patel A, Johnson T, Engstrom J, Fogg L, Jegier B, Bigger H . Impact of early human milk on sepsis and health-care costs in very low birth weight infants. J Perinatol. 2013; 33(7):514-9. PMC: 3644388. DOI: 10.1038/jp.2013.2. View

17.

Hohl S, Thompson B, Escareno M, Duggan C . Cultural Norms in Conflict: Breastfeeding Among Hispanic Immigrants in Rural Washington State. Matern Child Health J. 2016; 20(7):1549-57. PMC: 5739527. DOI: 10.1007/s10995-016-1954-8. View

18.

Sigurdson K, Morton C, Mitchell B, Profit J . Disparities in NICU quality of care: a qualitative study of family and clinician accounts. J Perinatol. 2018; 38(5):600-607. PMC: 5998372. DOI: 10.1038/s41372-018-0057-3. View

19.

Palau M, Meier M, Brinton J, Hwang S, Roosevelt G, Parker T . The impact of parental primary language on communication in the neonatal intensive care unit. J Perinatol. 2018; 39(2):307-313. DOI: 10.1038/s41372-018-0295-4. View

20.

Parker M, Greenberg L, Edwards E, Ehret D, Belfort M, Horbar J . National Trends in the Provision of Human Milk at Hospital Discharge Among Very Low-Birth-Weight Infants. JAMA Pediatr. 2019; 173(10):961-968. PMC: 6724150. DOI: 10.1001/jamapediatrics.2019.2645. View