Factors Associated with Inequities in Donor Milk Bank Access Among Different Hospitals

<b><i>Objective:</i></b> Donor human milk (DHM) can provide many benefits to neonates. This study examines access to DHM and how structural barriers may exacerbate inequities. <b><i>Study Design:</i></b> The median test and analysis of variance test were used to compare the distribution of maternal race/ethnicity and insurance status variables with DHM access for California neonatal intensive care units (NICUs) in 2021. <b><i>Results:</i></b> Across 124 NICUs, those serving a higher percentage of white families were more likely to have access to DHM (<i>p</i> = 0.04). NICUs with a higher percentage of Hispanic families were less likely to have access to DHM (<i>p</i> = 0.03). Hospitals that had higher proportions of uninsured patients were also less likely to have access to DHM (<i>p</i> = 0.015). <b><i>Conclusion:</i></b> Inequities in DHM access and use among NICU infants begin at the structural level. Policies that reduce barriers to DHM access may reduce health inequities for Hispanic and uninsured families.