Association between maternal sociodemographic characteristics and exclusive mother's own milk feeding in preterm infants: a cohort study using data from the National Neonatal Research Database.

Objective: To ascertain the sociodemographic and geographical determinants of exclusive and no mother's own milk (MOM) feeding for infants <34 weeks' gestational age (GA) in England and Wales.

Study design: Retrospective cohort study using the National Neonatal Research Database (2016-2022). We calculated unadjusted and mutually adjusted ORs for exclusive and no MOM feeding throughout an infant's neonatal stay, by maternal age group, ethnicity and deprivation quintile. Neonatal Operational Delivery Network and unit were included as random effects, and the adjusted models included other potential confounders such as gestational age and mode of delivery.

Results: Among the 90 730 infants, 11 962 (13.2%) were exclusively MOM fed, while 9018 (9.9%) never received MOM. The odds of exclusive MOM feeding increased with decreasing maternal social deprivation (OR for least deprived vs most deprived quintile 2.16, 95% CI 2.01 to 2.33), while the odds of no MOM decreased (OR 0.33, 95% CI 0.30 to 0.36). The odds of exclusive MOM feeding were lower for Asian/Asian-British mothers compared with white mothers (OR 0.88, 95% CI 0.82 to 0.95). The odds of never receiving MOM were lower for Black, Asian and mixed ethnicities compared with white mothers. Infants of mothers aged 26-35 years had the highest odds of exclusive MOM feeding. There was a geographical variation in feeding practices with a north-south divide in the prevalence of never receiving MOM. There was a significant variation in feeding practices between neonatal units.

Conclusion: Provision of MOM to preterm infants in England and Wales is associated with maternal sociodemographic characteristics.