Top 5 Takeaways

  1. Significant Proportion of Hospitals Lack Donor Milk: 13.0% of U.S. hospitals with level III or IV neonatal intensive care units reported that donor milk was not available for infants with very low birthweight (VLBW).
  2. Disparities in Donor Milk Availability: Availability was higher among hospitals with a level IV unit, those with higher annual birth volumes, and those located in the Midwest and Southwest regions, as well as nonprofit and teaching hospitals, and those designated Baby-Friendly.
  3. Benefits of Human Milk for VLBW Infants: Human milk reduces risks for necrotizing enterocolitis, late-onset sepsis, chronic lung disease, retinopathy of prematurity, and neurodevelopmental impairment in VLBW infants.
  4. Variation by Hospital Characteristics: Donor milk availability varied significantly by hospital type, with nonprofit hospitals more likely to have donor milk available compared to for-profit and government or military hospitals.
  5. Public Health Implications: Addressing barriers to the provision of donor milk could ensure that VLBW infants receive necessary nutrition, potentially decreasing associated morbidity and mortality.

Original Article Author and Citation

Corresponding Author

Ellen O. Boundy,, 770-488-4438.

Suggested Citation

Boundy EO, Anstey EH, Nelson JM. Donor Human Milk Use in Advanced Neonatal Care Units — United States, 2020. MMWR Morb Mortal Wkly Rep 2022;71:1037–1041. DOI:


The CDC’s 2020 Maternity Practices in Infant Nutrition and Care survey revealed that 13% of hospitals with advanced neonatal care units lacked donor milk availability for infants with VLBW, emphasizing the need to identify and address barriers to its provision.


The survey assessed practices for donor milk use across U.S. hospitals providing maternity care, focusing on those with level III or IV neonatal care units and analyzing availability by various hospital characteristics and regions.


The analysis highlights the critical role of donor milk for VLBW infants and the disparities in availability across hospitals. Efforts to improve donor milk availability could significantly impact infant health outcomes.


Enhancing donor milk availability in hospitals, particularly those with advanced neonatal care units, is imperative to support the health and development of VLBW infants, with potential long-term public health benefits.


This has been your booster shot of MMWR Info! Please check back for more MMWR, Public Health, and Programming Tutorial content daily.

Leave a Reply

Your email address will not be published. Required fields are marked *

You may use these HTML tags and attributes:

<a href="" title=""> <abbr title=""> <acronym title=""> <b> <blockquote cite=""> <cite> <code> <del datetime=""> <em> <i> <q cite=""> <s> <strike> <strong>