Breast Milk Feeding Research Articles

Issues of infant feeding for postnatal prevention of human T-cell leukemia/lymphoma virus type-1 mother-to-child transmission.

Nationwide antenatal human T-cell leukemia/lymphoma virus type-1 (HTLV-1) antibody screening has been conducted in Japan. The purpose of our study was to clarify the issues related to feeding options to prevent postnatal mother-to-child transmission. Of the pregnant carriers at 92 facilities in Japan between 2012 and 2015, 735 were followed prospectively. Among the children born to them, 313 (42.6%) children were followed up to the age of 3 and tested for HTLV-1 antibodies. The mother-to-child transmission rate was calculated for each feeding option selected before birth. Among the 313 pregnant carriers, 55.0, 35.1, 6.1, and 3.8% selected short-term breast-feeding (≤3months), exclusive formula feeding, frozen-thawed breast-milk feeding, and longer-term breast-feeding, respectively. Despite short-term breast-feeding, 8-18% of the mothers continued breast-feeding for 4-6months. The mother-to-child transmission rate with short-term breast-feeding was 2.3% (4/172), and its risk ratio compared with that of exclusive formula feeding was not significantly different (0.365; 95% CI: 0.116-1.145). Because of the small number of children who were fed by frozen-thawed breast-milk, their mother-to-child transmission rate was not statistically reliable. Pregnant HTLV-1 carriers tended to select short-term breast-feeding in Japan. While short-term breast-feeding was not always easy to wean within 3 months, it may be a viable option for preventing postnatal mother-to-child transmission because the vertical transmission rate with short-term breast-feeding was not significantly higher than that with exclusive formula feeding. Increasing the follow-up rates for children born to pregnant carriers may provide clearer evidence of preventative effects by short-term breast-feeding and frozen-thawed breast-milk feeding.

809 Pregnancy latency among patients with preterm prelabor rupture of membranes attending inpatient centering groups

Outpatient CenteringPregnancy© groups have been shown to reduce rates of preterm birth, specifically in Black mothers, and increase breastfeeding rates, the inpatient use is limited and understudied. We sought to determine the impact of inpatient centering(IC) on latency among women admitted with preterm prelabor rupture of membranes(PPROM). Single institution, retrospective cohort study of women with PPROM participating in at least 1 IC group from 2019-2020 compared to historic controls from 2013-2019. Patients admitted after 33 weeks, age<18, higher order multiples or a latency <24hrs excluded. Primary outcome was pregnancy latency. Secondary outcomes included maternal morbidity, and 6wk post-partum(PP) breastmilk feeding. Analysis stratifying by race performed. Bivariate statistics compared IC cohort to controls. Regression models used to control for confounders. 11 women with PPROM participated in IC compared to 278 controls. IC women had higher rates of HTN, twins and anxiety(Table 1). IC women had longer median latency compared to controls(26 days[IQR:13, 29] vs8 days[3,14] p<0.01), as well as, increased rates of PP breastmilk feeding(91% vs 59% p<0.01)(Table 2). In regression models controlling for confounders, IC was associated with 10.2 day longer latency and 9.4-fold increased odds of PP breastmilk feeding(Table 2). When stratifying by race, Black women who participated in IC had longer median latency than Black controls (27.5vs20 days, p<0.01). This difference did not extend to White women(18vs10 days, p=0.13) or Latinx women(14.5vs7 days, p=0.88). In regression models, IC participation predicted 20.0 days longer latency for Black women, but was not a significant predictor of latency for White or Latinx women (Table 2). No significant differences in PP breastmilk feeding rates seen when stratified by race. This pilot Inpatient Centering study demonstrated longer latency and improved breastfeeding among participants, with more benefit seen among Black women. The adaptation of the CenteringPregnancy model to the antepartum service should be further explored.View Large Image Figure ViewerDownload Hi-res image Download (PPT)

Participación paterna y prácticas de lactancia materna exclusiva.

Este es un estudio cualitativo con objetivo de indagar cómo es el involucramiento de los padres desde el parto y cómo es la participación de los padres durante el postparto, identificando facilitadores de las prácticas de lactancia materna exclusiva. Se escucharon las voces de diez madres en periodo de lactancia, y cuatro padres con hijos menores de seis meses, por medio de entrevistas semiestructuradas. Se utilizó una matriz de análisis, encontrando que todas las mujeres consideran importante la presencia de la pareja desde el parto. Algunas actividades en las que participan los padres son en labores del hogar, alimentación con biberón de leche materna o fórmula, cargar, bañar al bebé y cuidados de hijos mayores.

Sudden Onset of a Unilateral Erythematous Preauricular Mass in a Preterm Infant.

A 71-day-old 24 5/7-week gestation female infant in the NICU presents with right periauricular induration and erythema. ### Prenatal and Birth Histories ### Initial Hospital Course The infant was given endotracheal surfactant and placed on high-frequency jet ventilation. Blood and respiratory culture specimens were obtained and empiric antibiotics initiated. Respiratory culture was positive for Eikenella corrodens and placental pathology demonstrated necrotizing funisitis and chorioamnionitis. Antibiotics were switched to cefepime after sensitivities became available. At 8 days of age, she had an acute cardiopulmonary arrest in the setting of cardiac tamponade because of a hemorrhagic pericardial effusion. A pericardial pigtail catheter was placed and removed on day 12 with echocardiography demonstrating resolution of the effusion. Echocardiography also revealed a small ventricular septal defect and large patent ductus arteriosus, which was treated with 2 courses of indomethacin followed by acetaminophen. Respiratory support was weaned and the infant underwent extubation to continuous positive airway pressure on day 34. Central lines were removed on day 16 following advancement of enteral fortified breast milk feedings. Cranial ultrasonography …

Penyuluhan Pemberian Makanan Pendamping ASI Terhadap Terjadinya Konstipasi Pada Bayi Di Kelurahan Baru Ladang Bambu Kecamatan Medan Tuntungan

Community service on counseling for complementary feeding of breast milk to prevent constipation in infants in Baru Ladang Bambu Village, Medan Tuntungan District, in 2021 aims to provide education and understanding to mothers of infants in the area about the importance of proper complementary feeding patterns to prevent constipation in infants. Through counseling activities, the community service team conducts socialization on the necessary nutrition for infants during growth phases, balanced strategies for complementary feeding of breast milk, as well as signs and prevention of infant constipation. The counseling methods used include lectures, interactive discussions, and distribution of educational materials to mothers of infants. Evaluation is conducted to measure the understanding and behavioral changes of mothers in providing complementary feeding of breast milk. The results of community service show an increase in knowledge and awareness among mothers about the importance of proper complementary feeding patterns to reduce the risk of infant constipation. This community service is expected to provide significant benefits in improving infant health in Baru Ladang Bambu Village.

The minimal invasive surfactant therapy: experience from a low resource setting

Objective To evaluate all cases managed with the Minimal Invasive Surfactant Therapy (MIST) and its effect on outcome. Background Respiratory distress syndrome (RDS), a major cause of morbidity and mortality in preterm new-borns is common in sub-Saharan Africa. Surfactant replacement therapy (SRT) is less practiced and the new MIST is just introduced in Asaba, Nigeria. Methods This descriptive survey recruited new-borns of consenting parents who provided for the surfactant and other commodities. Demographic characteristics were obtained. Intervention included MIST Surfactant, nasal bubble Continuous Positive Airway Pressure (n b-CPAP). Aminophylline or Caffeine, early breast milk feeding and Kangaroo mother care (KMC). Data were collected over a 1-year period and Standard statistical methods were used for data analysis. Results From 1 May 2019 to 30 April 2020, there were 1801 live births, preterm birth rate of 10.72% (193/1801) at the FMC, Asaba. Admissions to the Neonatal Unit (NNU) comprised a total of 731 newborn: 270 preterms. Of these preterm; 52(19.26%) were extreme preterms; 122 (16.15%) very preterm. Of these 731 total admissions there were 104 (14.23%). Their gestational ages (GA) ranged from 24 to 38 weeks and birthweights from 600 to 3400 g. A total of 51 Newborns received surfactant. Their GA ranged from 24 to 38 Weeks; birth weights 600 to 3400 g. These comprised 48 preterm and 3 terms. All 51 infants with RDS who received MIST surfactant included 48 preterms and 3 terms with perinatal Asphyxia and Meconium Aspiration Syndrome. The obstetric management of five mothers of early preterm included two doses of antenatal cortico-steroids prior to delivery. MIST was successful in 47 of 51 (92.2%) cases. Age range at administration was one to 48 h. Duration of n-bCPAP post surfactant: ranged 6 h to 96 h: 4 babies were weaned off CPAP within 24 h; 12 babies at <48 h, another 9 at <72 h; and 20 beyond 96 h. Five babies received a second dose of MIST after 48 h of the first dose. Twelve of 51 (23.5%) babies died; 4 at 48 h, 2 at 72 h, 3at 96 h and 3 beyond 7 days. Prior to the MIST, respiratory distress (RD) and severity rating as indicated by the Silverman Anderson Score (SA) scores in the survivors ranged from 6/10 to 8/10. Conclusions The MIST, at FMC Asaba, improves outcome of the extreme preterm. Financial barriers remain a major constraint to its use.

Parental access to hospitalised children during infectious disease pandemics such as COVID-19.

The COVID-19 pandemic has resulted in many hospitals severely limiting or denying parents access to their hospitalised children. This article provides guidance for hospital managers, healthcare staff, district-level managers and provincial managers on parental access to hospitalised children during a pandemic such as COVID-19. It: (i) summarises legal and ethical issues around parental visitation rights; (ii) highlights four guiding principles; (iii) provides 10 practical recommendations to facilitate safe parental access to hospitalised children; (iv) highlights additional considerations if the mother is COVID-19-positive; and (v) provides considerations for fathers. In summary, it is a child's right to have access to his or her parents during hospitalisation, and parents should have access to their hospitalised children; during an infectious disease pandemic such as COVID-19, there is a responsibility to ensure that parental visitation is implemented in a reasonable and safe manner. Separation should only occur in exceptional circumstances, e.g. if adequate in-hospital facilities do not exist to jointly accommodate the parent/caregiver and the newborn/infant/child. Both parents should be allowed access to hospitalised children, under strict infection prevention and control (IPC) measures and with implementation of non-pharmaceutical interventions (NPIs), including handwashing/sanitisation, face masks and physical distancing. Newborns/infants and their parents/caregivers have a reasonably high likelihood of having similar COVID-19 status, and should be managed as a dyad rather than as individuals. Every hospital should provide lodger/boarder facilities for mothers who are COVID-19-positive, COVID-19-negative or persons under investigation (PUI), separately, with stringent IPC measures and NPIs. If facilities are limited, breastfeeding mothers should be prioritised, in the following order: (i) COVID-19-negative; (ii) COVID-19 PUI; and (iii) COVID-19-positive. Breastfeeding, or breastmilk feeding, should be promoted, supported and protected, and skin-to-skin care of newborns with the mother/caregiver (with IPC measures) should be discussed and practised as far as possible. Surgical masks should be provided to all parents/caregivers and replaced daily throughout the hospital stay. Parents should be referred to social services and local community resources to ensure that multidisciplinary support is provided. Hospitals should develop individual-level policies and share these with staff and parents. Additionally, hospitals should ideally track the effect of parental visitation rights on hospital-based COVID-19 outbreaks, the mental health of hospitalised children, and their rate of recovery.

Assessment of practices of exclusive breast milk feeding, Kangaroo mother care and Non Nutritive sucking among mothers of preterm neonates in PGIMER, Chandigarh, India:A Pilot project

Assessment of practices of exclusive breast milk feeding, Kangaroo mother care and Non Nutritive sucking among mothers of preterm neonates in PGIMER, Chandigarh, India:A Pilot project

Findings of illicit drugs in hair of children at different ages.

Hair is a preferred material to detect exposure or use of illegal drugs in children. In the present study, we investigated a total of 387 hair samples for commonly applied illegal drugs of children up to 16 years. Analysis was by liquid chromatography/mass spectrometry with LOQs of 0.01 ng/mg hair for all analytes except tetrahydrocannabinol carboxylic acid with an LOQ of 0.1 pg/mg hair. Results were firstly compared with our in-house statics on results from adults' hair, and secondly to literature data. We started from the assumption that drug concentrations decrease with increasing age.Results were assigned to 4 different age groups (< 1 year, 1-< 6 years, 6-< 14 years, 14-16 years). As expected, higher results were obtained in age groups 1 and 2. The lowest concentrations were present in age group 3, whereas an increase could be observed in group 4 except heroin. In babies, positive results may be due to in utero exposure, breast milk feeding, and a close physical contact. All drugs under investigation such as cannabinoids, cocaine, amphetamines, and opiates have been detected in breast milk as well as in skin excretions such as sebum, sweat and cutaneous cells. For most drugs, average concentrations in children hair were lower than in adult hair when compared with our in-house statistics. Interestingly, the increase of cannabinoids, cocaine, and amphetamines concentrations in adolescents' hair points to a deliberate use of these drugs possibly in addition to passive exposure. This observation shows that age groups 1 and 4 are most vulnerable if caregivers or parents are drug users, even if the sources of positive drug findings differ.

Becoming a Premature Birth Weight of Less than 1500g under Breastfeeding

Objective: Study the impact of breast feeding on the fate of preterm infants with a birth weight of less than 1500g. Patients and Methods: This was a retrospective, analytical descriptive study carried out over a period of one year (2019) at the neonatal unit of the pediatric department of the Sikasso Hospital. All premature newborns weighing less than 1500g were included. Premature infants over 1500g and term infants were excluded from the study. Chi2 test and odds ratios were used to highlight risk factors for death. The significance threshold adopted was p &lt; 0.05. Results: A total of 50 premature newborns out of 130 admitted. 53.4% female and 45.6% male. 13% of mothers were between 17 and 20 years old with a poor pregnancy in 25.1%; 56.5% were housewives; 11.8% lived in urban areas; 53.4% of premature infants had an entry weight of less than 1200g. The majority of premature babies were fed breast milk through an orogastric tube and / or a teaspoon. Fifty-four (54%) of premature infants acquired food independence between 36 and 38 weeks corrected age. At discharge, 78.8% of premature babies are kept eutrophic; 21.2% acquired ectopic growth retardation. 70% benefited from catching up the weight.

Association of Maternal Confidence and Breastfeeding Practices in Hispanic Women Compared to Non-Hispanic White Women.

Understanding modifiable factors related to breastfeeding initiation and duration is critical to increase breastfeeding rates. Maternal parenting confidence is a modifiable factor whose association with breastfeeding duration has not previously been investigated. In a retrospective cohort of 1023 mother-infant dyads, the association between maternal confidence and breastmilk feeding at 6 and 12 months of age were analyzed. The association of breastmilk frequency categories and maternal confidence score at 6 and 12 months was examined using multinomial logistic regression stratified by race, ethnicity, and adjusted for gestational age. We found that breastmilk feeding frequency at 6 months was negatively associated with the maternal confidence score. After stratification by ethnicity, the association was no longer significant. There was no association between human milk feeding frequency at 12 months and maternal confidence score at 12 months. Our results demonstrate the need for additional research to identify modifiable factors to increase breastfeeding rates.

Awareness about Expressed Breast Milk Storage and Feeding Among Nurses in a Tertiary Care Hospital of Coastal South India

Introduction: Health personnel play a vital role in feeding baby with stored human milk and in educating mothers about expressed breast milk (EBM). Studies assessing nurses’ knowledge about EBM are limited. We aimed to study the awareness about EBM storage and preparation for feeding among pediatric nurses.&#x0D; Methodology: A cross sectional study was carried out in tertiary care hospitals of South India. Participants answered the pretested questionnaire. Mean awareness score percentages of the participants was calculated, and compared for age, years of experience and place of work.&#x0D; Results: Study enrolled 105 paediatric nurses with mean age of 33.13 ±12.05 years. Majority of participants knew the reason for expressing breast milk, how to express breast milk. Regarding the storage temperature of EBM, less than 50 % of the nurses were aware and 34.3% of nurses knew the preparation for feeding. The mean awareness score percentage was 65.71 ±16.64. Age group &gt;40 years, neonatal intensive care unit nurses and work experience &gt;10 years had significant relation to awareness scores.&#x0D; Conclusion: Knowledge of nurses regarding reasons for and technique of expressing breast milk, methods of storing of EBM was good. Knowledge about storage temperatures and preparation for feeding was inadequate. Age group &gt;40 years, neonatal intensive care unit as place of work and more than 10 years’ work experience related to the knowledge.

Does Breastfeeding, milk formula or mixed feeding during maternity stay influence neonatal diet after hospital discharge?

International guidelines recommend exclusive breast milk feeding during the first six months of life and its continued use complemented with other food types until the end of the second year of life. Some studies report that the use of milk formula in maternity wards may influence the nutritional choices of parents regarding their children's future diet. Our aim was to determine if the type of milk used during a newborn maternity ward stay, at our Portuguese Hospital, influences the type of milk used in neonates after hospital discharge. A retrospective analysis was done of the clinical records of babies born at our hospital during 2017. A total of 2505 babies were born and a sample of 491 (19.6%) was included in this study; 50.9% were male and 3.9% were premature. Of these, during maternity ward stay 53.4% were exclusively breastfed, 45.2% had mixed breast and milk formula feeding and 1.4% were exclusively formula-fed. Data recorded at Well Baby Clinic, at around the second, third week of life, regarding baby milk feeding type, as referred by parents, respectively as, 59.7%, 32.6% and 7.7% (p

Assessment of practices of exclusive breast milk feeding, kangaroo mother care and non nutritive sucking among mothers of preterm neonates: A Pilot project

Assessment of practices of exclusive breast milk feeding, kangaroo mother care and non nutritive sucking among mothers of preterm neonates: A Pilot project

Household Food Security, Child Dietary Diversity and Copping Strategies Among Rural Households. The Case of Kole District in Northern Uganda

Household food security, feeding practices, dietary diversity and copping strategies to household food insecurity are largely interconnected. Using a cross sectional study approach involving 162 mothers and care givers in Kole district of Northern Uganda, this study examined the scenarios of household food security status, child feeding practices, dietary diversity and copping strategies. The study revealed that majority of the households (55%) were food secure with an overall observation of low dietary diversity at the household level (72.8%), largely showing dominance of starch-based Cereals, roots and tubers (82%) and limited consumption of other food groups, notably fruits, vegetables, meats and dairy products (18% combined). In terms of feeding practices, majority of the children were fed breast milk for at least 24 months, with mandatory exclusive breastfeeding highly adhered to, but the introduction of complementary foods often delayed and not well planned. Results also showed that a wide range of coping strategies are employed however the major ones were, reliance on less preferred food (54.9%), limiting portions of meals (35.2%), reducing number of melas taken in a day (29%), and gathering wild fruits and harvesting immature crops (29.6%). Generally, it was observed that household food security is a strong determinant of dietary of child dietary diversity, may influence feeding practices and the range of coping strategies applicable to households when they experience food insecurity. It is apparent that nutritional education, household size and livelihood diversity also play a significant role in as far as household food security status, child feeding, diversity and food insecurity copping are concerned within rural households.

Supporting breastfeeding of small, sick and preterm neonates

Breastfeeding is associated with a risk reduction for several acute and chronic diseases in women and their infants. Health benefits of breastfeeding are especially important for small, sick and preterm infants. The objective of this article is to summarize essential steps for healthcare personnel and facilities to improve breastfeeding practices in this vulnerable population. Health facilities can support breastfeeding through the establishment of breastfeeding-supportive policies, staff training and the design of facilities to support rooming-in. Direct support to breastfeeding includes the provision of counseling to mothers at critical time points, skin-to-skin and kangaroo care, and support of responsive (on-demand) breastfeeding. Where direct breastfeeding is not possible, facilities should show mothers how to express their breastmilk and teach mothers alternative feeding modalities. Medically-indicated supplementation of small, sick and preterm may be needed in certain circumstances.

Knowledge effect on postnatal mothers regarding Baby Friendly Hospital Initiative

Breastfeeding is the “Gold standard” for infant feeding. There are several areas of biological superiority of breastfeeding and breast milk over artificial (formula) milk. Exclusive breast milk feeding is the suggested diet for term and untimely children to give ideal baby nourishment, basic immunological and mitigating advantages, and prevention from ailment and illnesses. The Baby-Friendly Hospital Initiative dispatched in1991, is an exertion by UNICEF and WHO to guarantee that all maternities, whether detached or in a medical clinic, become focuses of breastfeeding support. The present study aims to assess knowledge effect on postnatal mothers regarding baby friendly hospital initiative. A one group pretest posttest research design was conducted among 60 postnatal mothers. Convenient sampling technique was used to select samples. Structured knowledge questionnaire was used to assess the effectiveness of information booklet regarding Baby-Friendly Hospital Initiative among postnatal mothers. The present study attempted to evaluate the effectiveness of information booklet on Baby-Friendly Hospital Initiative among postnatal mothers of SMCH and found that 6(10%) had adequate, 9(15%) had moderate adequate knowledge and also 45(75%) had inadequate knowledge in pretest and 42(70%) had adequate, 12(20%) had moderate adequate knowledge and 6(10%) had inadequate knowledge in posttest and concluded that there was a significant improvement after administration of information booklet. Thus, information booklet was effective in improving the knowledge on Baby Friendly Hospital initiative among postnatal mothers.

Kangaroo mother care alters chromogranin A and perfusion index in preterm babies.

While providing various benefits, concerns about the potential risks of kangaroo mother care, or skin-to-skin contact (SSC), between mother and her preterm infant hinder its widespread implementation in some resource- rich countries. In neonates, salivary chromogranin A (s-CgA) is elevated upon exposure to stress, whereas the perfusion index (PI) is associated with hemodynamics and peripheral perfusion. Here, we investigated the effects of SSC on s-CgA and the PI in preterm infants. Twelve infants were enrolled in the study. Factors associated with baseline s-CgA were analyzed. Baseline s-CgA and the level after SSC were compared. Secreted IgA in the saliva was compared as the control. The PI before, throughout, and after SSC were compared. Baseline s-CgA was significantly lower in infants who were supplemented with baby formula milk in addition to breast milk before SSC (n = 2) compared with those fed with their mother's breast milk alone (n = 10, P=0.03). SSC significantly decreased s-CgA in babies who were fed breast milk only before SSC (n = 10, P=0.01) but not in those supplemented with formula milk before SSC (n = 2). Secreted IgA in saliva was not affected by SSC. The PI was significantly elevated during SSC (P=.01). Our data indicate that SSC can reduce s-CgA levels when combined with mother's breast milk and increase the PI in preterm infants, thereby providing additional evidence of the benefit of SSC.

A Comparative Study on Breast Milk Feeding and Formula Milk Feeding in Infants With Congenital Heart Disease After Surgery: A Retrospective Study.

To explore the effects of breast milk feeding and formula milk feeding on infants after cardiac surgery in the cardiac intensive care unit (ICU). Infants who underwent cardiac surgery in our ICU were divided into two groups, according to feeding type. Breast milk feeding and formula milk feeding were separately implemented in the two groups, and the remaining treatment regimens were the same. The related clinical data and feeding effects were recorded and compared. The prealbumin (147.3 ± 15.2 versus 121.5 ± 18.3mg/L) and albumin (46.4 ± 4.2 versus 40.5 ± 5.1 g/L) levels in the breast milk feeding group were better than those in the formula milk feeding group (P < .05). Infants in the breast milk feeding group achieved a better total enteral nutrition time (3.0 ± 1.2 versus 5.2 ± 2.1 d), average daily weight gain (19.0 ± 3.4 versus 14.4 ± 2.3 g/kg·d), length of ICU stay (6.0 ± 2.2 versus 8.1 ± 2.9 d) and length of hospital stay (13.9 ± 4.2 versus 17.8 ± 5.6 d) than those in the formula milk feeding group (P < .05). The incidence of complications such as feeding intolerance, anemia, dyspeptic diarrhea, and nosocomial infection was lower in the breast milk feeding group than in the formula milk feeding group (P < 0.05). Breast milk feeding has a definite nutritional effect on infants after cardiac surgery. It is better than formula milk feeding, making it worthy of popularization and application.

Racial and socioeconomic disparities in breast milk feedings in US neonatal intensive care units.

Very low birth weight (VLBW; <1500 g birth weight) infants are substantially more likely to be born to black than to non-black mothers, predisposing them to potentially preventable morbidities that increase the risk for costly lifelong health problems. Mothers’ own milk (MOM) may be considered the ultimate “personalized medicine” since milk composition and bioactive components vary among mothers and multiple milk constituents provide specific protection based on shared exposures between mother and infant. MOM feedings reduce the risks and associated costs of prematurity-associated morbidities, with the greatest reduction afforded by MOM through to NICU discharge. Although black and non-black mothers have similar lactation goals and initiation rates, black VLBW infants are half as likely to receive MOM at NICU discharge in the United States. Black mothers are significantly more likely to be low-income, single heads of household and have more children in the home, increasing the burden of MOM provision. Although rarely considered, the out-of-pocket and opportunity costs associated with providing MOM for VLBW infants are especially onerous for black mothers. When MOM is not available, the NICU assumes the costs of inferior substitutes for MOM, contributing further to disparate outcomes. Novel strategies to mitigate these disparities are urgently needed.Impact Mother’s own milk exemplifies personalized medicine through its unique biologic activity.Hospital factors and social determinants of health are associated with mother’s own milk feedings for very low-birth-weight infants in the neonatal intensive care unit. Notably, out-of-pocket and opportunity costs associated with providing mother’s own milk are borne by mothers. Conceptualizing mother’s own milk feedings as an integral part of NICU care requires consideration of who bears the costs of MOM provision—the mother or the NICU?