Elizabeth A Brownell1,2,3, Kelsey C Smith1,2, Erin L Cornell1,2, Patricia A Esposito1,4, Catherine C Wiley3,5, Zhu Wang2,3, Abigail W Bushley2, Mary M Lussier1, James I Hagadorn1,3. 1. 1 Connecticut Human Milk Research Center, Division of Neonatology, Connecticut Children's Medical Center , Hartford, Connecticut. 2. 2 Department of Research, Connecticut Children's Medical Center , Hartford, Connecticut. 3. 3 Department of Pediatrics, University of Connecticut School of Medicine , Farmington, Connecticut. 4. 4 Department of Clinical Nutrition, Connecticut Children's Medical Center , Hartford, Connecticut. 5. 5 Primary Care Center, Connecticut Children's Medical Center , Hartford, Connecticut.
Abstract
OBJECTIVE: To identify independent maternal and infant factors associated with donor milk nonconsent and to examine secular trends in nonconsent rates. MATERIALS AND METHODS: Mothers of infants eligible to receive donor milk (≤32 weeks of gestation or ≤1,800 g) born between August 2010 and 2015 were included. Multivariable logistic regression modeled odds of nonconsent. RESULTS: Of the 486 mother/infant dyads from the first 5 years of the donor milk program, nonwhite race (adjusted odds ratio [aOR] 1.69; 95% confidence interval [CI] 1.04-2.76) and increasing gestational age (aOR 1.11; 95% CI 1.03-1.21) independently predicted nonconsent. Each year the program existed, there was a 48% reduction in odds of nonconsent (aOR 0.52; 95% CI 0.43-0.62). The most common reason given for nonconsent was "it's someone else's milk." CONCLUSION: Program duration was associated with reduced nonconsent rates and may reflect increased exposure to information and acceptance of donor milk use among neonatal intensive care unit staff and parents. Despite overall improvements in consent rates, race-specific disparities in rates of nonconsent for donor milk persisted after 5 years of this donor milk program. Further research is warranted to clarify the basis for race-based disparities in donor milk nonconsent rates, with the goal of designing interventions to reduce donor milk refusal among minority mothers.
OBJECTIVE: To identify independent maternal and infant factors associated with donor milk nonconsent and to examine secular trends in nonconsent rates. MATERIALS AND METHODS: Mothers of infants eligible to receive donor milk (≤32 weeks of gestation or ≤1,800 g) born between August 2010 and 2015 were included. Multivariable logistic regression modeled odds of nonconsent. RESULTS: Of the 486 mother/infant dyads from the first 5 years of the donor milk program, nonwhite race (adjusted odds ratio [aOR] 1.69; 95% confidence interval [CI] 1.04-2.76) and increasing gestational age (aOR 1.11; 95% CI 1.03-1.21) independently predicted nonconsent. Each year the program existed, there was a 48% reduction in odds of nonconsent (aOR 0.52; 95% CI 0.43-0.62). The most common reason given for nonconsent was "it's someone else's milk." CONCLUSION: Program duration was associated with reduced nonconsent rates and may reflect increased exposure to information and acceptance of donor milk use among neonatal intensive care unit staff and parents. Despite overall improvements in consent rates, race-specific disparities in rates of nonconsent for donor milk persisted after 5 years of this donor milk program. Further research is warranted to clarify the basis for race-based disparities in donor milk nonconsent rates, with the goal of designing interventions to reduce donor milk refusal among minority mothers.
Authors: Laura R Kair; Nichole L Nidey; Jessie E Marks; Kirsten Hanrahan; Lorraine Femino; Erik Fernandez Y Garcia; Kelli Ryckman; Kelly E Wood Journal: J Hum Lact Date: 2019-11-26 Impact factor: 2.219