Influence of Race and Ethnicity on Meeting Intention to Exclusively Breast Milk Feed at Postpartum Hospital Discharge

<b><i>Background:</i></b> Racial/Ethnic disparities in breastfeeding practices exist despite strong evidence for significant health benefits of breastfeeding for the mother-newborn dyad. Breastfeeding intentions are known to predict breastfeeding practices at hospital discharge and breastfeeding retention in the long term. Interventions during postpartum hospitalization can help mothers achieve breastfeeding intentions and reduce racial/ethnic gaps in breastfeeding on discharge. This study aims to identify racial/ethnic disparities in meeting intentions to exclusively breast milk feed (EBMF) on hospital discharge. <b><i>Methods:</i></b> This was a retrospective cohort study of mothers who intended to EBMF and their newborns delivered at term at a single academic medical center during 2022. The primary outcome was EBMF at discharge. <b><i>Results:</i></b> Participants included non-Hispanic Black (NHB) (<i>n</i> = 96), Hispanic (<i>n</i> = 97), and non-Hispanic White (NHW) (<i>n</i> = 955) mothers who intended to EBMF. Mothers who identified as NHB (40.6%) or Hispanic (64.9%) were significantly less likely to EBMF compared with NHW (87.5%) mothers (odds ratio [OR] = 0.14, 95%CI [0.08, 0.23] and OR = 0.37, 95%CI [0.22, 0.61], respectively) at newborn hospital discharge. Rurality, insurance type, gravidity, parity, gestational diabetes, and birth weight were not associated with breast feeding choice/practices at discharge, but increasing age was associated with an increased likelihood of EBMF (OR = 1.07, 95%CI [1.03, 1.11]), as was neonatal intensive care unit admission (OR = 2.93, 95%CI [1.18, 7.31]). Cesarean birth was associated with decreased likelihood of EBMF (OR = 0.57, 95%CI [0.38, 0.85]). <b><i>Conclusion:</i></b> Significant racial/ethnic disparities in EBMF at hospital discharge exist among those who intended to EBMF, which are not explained by differences in other examined covariates.