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Peer-reviewedCC BYNutrients

Disparities in Exclusive Human Milk Feeding and Unintended Formula Supplementation Among Infants Discharged Following Birth at an Academic Medical Center

  • Georgette Richardson1
  • Robert D. Roghair2
  • Kelly E. Wood3
  • Aunum Akhter2
  • Jennifer R. Bermick2
  • Emily A. Spellman4
  • Lora B. Albert5
  • Temitope M. Awelewa6
6 affiliations
  1. 1Division of Pediatric Psychology, Department of Pediatrics, Carver College of Medicine, University of Iowa, Iowa City, IA 52242, USA
  2. 2Division of Neonatology, Department of Pediatrics, Carver College of Medicine, University of Iowa, Iowa City, IA 52242, USA
  3. 3Division of Hospital Medicine, Department of Pediatrics, Carver College of Medicine, University of Iowa, Iowa City, IA 52242, USA
  4. 4Nursing, Health Care Stead Family Children’s Hospital, University of Iowa, Iowa City, IA 52242, USA
  5. 5Lactation Services, Health Care Stead Family Children’s Hospital, University of Iowa, Iowa City, IA 52242, USA
  6. 6Division of General Pediatrics and Adolescent Medicine, Department of Pediatrics, Carver College of Medicine, University of Iowa, Iowa City, IA 52242, USA
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Abstract

Background: The mitigation of existing disparities in human milk intake is a shared responsibility. Health systems have emphasized antenatal decision making to increase the proportion of infants that receive Exclusive Human Milk (EHM). However, our recent focus group reported that inadequate communication and other systemic barriers were contributing to unintended formula supplementation. Methods: To explore the influence of sociodemographic factors on EHM intake, we analyzed records for 10,214 newborns discharged from our medical center. Results: While race or ethnicity and prenatal EHM intent were the best predictors of EHM, the lowest rates were seen among infants born to Muslim women or women with non-English language preference (NELP). Even when analysis was restricted to those with a prenatal plan for EHM, unintended formula use exceeded 50% among those that identified as Black, Muslim, or having a NELP. In exploratory analysis, the same predictors were associated with the lowest rates of pasteurized donor human milk (PDHM) utilization. Conclusions: Looking deeper than race and ethnicity, Muslim women and women with NELP have the lowest rates of PDHM utilization and the highest rates of unintended formula use at our institution. These findings can inform culturally responsive interventions focused on education and effective communication.

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Cite

BibTeXRIS
BibTeX
@article{richardson2026disparities,
  title = {{Disparities in Exclusive Human Milk Feeding and Unintended Formula Supplementation Among Infants Discharged Following Birth at an Academic Medical Center}},
  author = {Georgette Richardson and Robert D. Roghair and Kelly E. Wood and Aunum Akhter and Jennifer R. Bermick and Emily A. Spellman and Lora B. Albert and Temitope M. Awelewa},
  journal = {Nutrients},
  year = {2026},
  month = oct,
  doi = {10.3390/nu18193294},
  url = {https://europepmc.org/article/PMC/PMC13667070},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - Disparities in Exclusive Human Milk Feeding and Unintended Formula Supplementation Among Infants Discharged Following Birth at an Academic Medical Center
AU  - Georgette Richardson
AU  - Robert D. Roghair
AU  - Kelly E. Wood
AU  - Aunum Akhter
AU  - Jennifer R. Bermick
AU  - Emily A. Spellman
AU  - Lora B. Albert
AU  - Temitope M. Awelewa
PY  - 2026
DA  - 2026/10/01
JO  - Nutrients
DO  - 10.3390/nu18193294
UR  - https://europepmc.org/article/PMC/PMC13667070
AB  - Background: The mitigation of existing disparities in human milk intake is a shared responsibility. Health systems have emphasized antenatal decision making to increase the proportion of infants that receive Exclusive Human Milk (EHM). However, our recent focus group reported that inadequate communication and other systemic barriers were contributing to unintended formula supplementation. Methods: To explore the influence of sociodemographic factors on EHM intake, we analyzed records for 10,214 newborns discharged from our medical center. Results: While race or ethnicity and prenatal EHM intent were the best predictors of EHM, the lowest rates were seen among infants born to Muslim women or women with non-English language preference (NELP). Even when analysis was restricted to those with a prenatal plan for EHM, unintended formula use exceeded 50% among those that identified as Black, Muslim, or having a NELP. In exploratory analysis, the same predictors were associated with the lowest rates of pasteurized donor human milk (PDHM) utilization. Conclusions: Looking deeper than race and ethnicity, Muslim women and women with NELP have the lowest rates of PDHM utilization and the highest rates of unintended formula use at our institution. These findings can inform culturally responsive interventions focused on education and effective communication.
SN  - 2072-6643
ER  -