Sinai Chicago is first safety net NICU to address health inequity gap by adopting an EHMD

Highest Standard of Nutrition Now Accessible to Illinois' Underserved Premature Infants

CHICAGO, March 24, 2021 -- Sinai Chicago is working to close the health inequity gap for its most fragile patient population: premature infants. Sinai Chicago's neonatal intensive care unit (NICU) has adopted Prolacta Bioscience's nutritional products as part of an Exclusive Human Milk Diet (EHMD) to deliver the high-quality neonatal nutrition to the communities it serves.

Sinai Chicago's implementation of an EHMD is a result of Illinois House Bill 3509, which was passed and signed into law in 2020, which provides that pasteurized donated human breastmilk and breastmilk-based fortifiers shall be covered under health insurance and the medical assistance program under the Illinois Public Aid Code for premature and at-risk infants. Sinai Chicago is the first system in Illinois to implement both an EHMD and these nutritional products since the legislation went into effect.

"As Chicago's largest private safety net health system, we serve a high percentage of low-income, minority patients, many of whom are Black women who would not otherwise have access to this standard of neonatal nutrition that their premature infants need to survive and develop," said Karen Teitelbaum, president and CEO of Sinai Chicago. "We're addressing this problem head-on by making an EHMD accessible to underserved families."

Proven to reduce complications and improve health, Sinai Chicago will be using nutritional fortifiers that are 100% human milk-based as opposed to cow milk-based. Studies have shown cow milk-based fortifiers can trigger feeding intolerance and increase mortality in premature infants due to the risk of severe complications.^1-4

When it comes to preterm birth, there are several racial and socioeconomic disparities that need to be addressed.^5,6 While 1 in 10 babies are born prematurely each year, the preterm birth rate for Black women is 50% higher than for all other women in the U.S., and prematurity is the leading cause of death among Black infants.^7,8 Premature infants are at an increased risk for problems with the lungs, brain, eyes, and other organs, as well as long-term intellectual and developmental disabilities.⁹

"Offering these products as part of an EHMD in our NICU is a monumental step forward for the premature babies born here at Sinai each year," said Brandee Grenda, clinical nutrition manager at Sinai Chicago. "For these vulnerable babies, access to an EHMD may be the difference between life and death. Not only will this give them the best chance to survive prematurity, but also to go on to thrive as healthy infants, children, and adults."

Premature infants require 20% to 40% more calories and protein than a full-term baby to make up for the growth they missed in the third trimester.¹⁰ To provide this extra nutrition, NICUs often add a fortifier to mother's own milk or donor breastmilk. However, clinical studies show a direct correlation between the use of cow milk-based fortifiers and the development of devastating, and potentially terminal complications, including necrotizing enterocolitis (NEC), a disease of the intestines.11

In contrast, preterm infants who receive Prolacta's products as part of an EHMD, which comprises mother's own milk and/or donor milk with Prolacta's 100% human milk-based fortifiers, have fewer complications^1-3 and better growth outcomes,^12-15 which have been linked with healthy neurodevelopment in these fragile infants,16  giving them the best possible chance in life.

"The health disparities in the NICU are based on a variety of factors, including race, ethnicity, and income level, among others, and we are committed to ensuring that all premature infants have access to the highest standard of care available," Teitelbaum said.

Sinai Chicago offers high-quality OB/GYN services — including Level III neonatal intensive care and maternity care recognized by the Illinois Perinatal Collaborative for Excellence as well as Blue Cross Blue Shield's "Blue Distinction" awards — at its north campus located at Mount Sinai Hospital. Its Level III NICU provides the highest level of care available for newborns just steps from the delivery room.

About Sinai Chicago
Sinai Chicagois a Chicago-based private, not-for-profit organization comprising seven member organizations: Mount Sinai Hospital, Holy Cross Hospital, Sinai Children's Hospital, Schwab Rehabilitation Hospital, Sinai Medical Group, Sinai Community Institute, and Sinai Urban Health Institute. The system has over 800 physicians on its hospital medical staffs, 654 licensed beds, 100,000+ annual emergency department patient visits, and eight physician residency training programs. For more information, visit www.sinai.org.

References

1. Sullivan S, Schanler RJ, Kim JH, et al. An exclusively human milk-based diet is associated with a lower rate of necrotizing enterocolitis than a diet of human milk and bovine milk-based products. J Pediatr. 2010;156(4):562-567. e1. doi:10.1016/j.jpeds.2009.10.040
2. Cristofalo EA, Schanler RJ, Blanco CL, et al. Randomized trial of exclusive human milk versus preterm formula diets in extremely premature infants. J Pediatr. 2013;163(6):1592-1595.e1. doi:10.1016/j.jpeds.2013.07.011
3. Abrams SA, Schanler RJ, Lee ML, Rechtman DJ. Greater mortality and morbidity in extremely preterm infants fed a diet containing cow milk protein products. Breastfeed Med. 2014;9(6):281-285. doi:10.1089/bfm.2014.0024
4. Assad M, Elliott MJ, Abraham JH. Decreased cost and improved feeding tolerance in VLBW infants fed an exclusive human milk diet. J Perinatol. 2016;36(3):216-220. doi:10.1038/jp.2015.168.
5. Beck AF, Edwards EM, Horbar JD, Howell EA, McCormick MC, Pursley DM. The color of health: how racism, segregation, and inequality affect the health and well-being of preterm infants and their families. Pediatr Res. 2020;87(2):227-234. doi:10.1038/s41390-019-0513-6
6. Lorch SA. Health equity and quality of care assessment: a continuing challenge. Pediatrics. 2017;140(3):e20172213. doi:10.1542/peds.2017-2213
7. Riddell CA, Harper S, Kaufman JS. Trends in differences in US mortality rates between Black and white infants. JAMA Pediatr. 2017;171(9):911-913. doi:10.1001/jamapediatrics.2017.1365
8. 2020 premature birth report card. March of Dimes. Accessed January 15, 2021. https://www.marchofdimes.org/peristats/tools/reportcard.aspx
9. Long-term health effects of premature birth. March of Dimes. Updated October 2019. Accessed January 15, 2021. https://www.marchofdimes.org/complications/long-term-health-effects-of-premature-birth.aspx
10. Hair AB, Peluso AM, Hawthorne KM, et al. Beyond necrotizing enterocolitis prevention: improving outcomes with an exclusive human milk-based diet. [published correction appears in Breastfeed Med. 2017;12 (10 ):663]. Breastfeed Med. 2016;11(2):70-74. doi:10.1089/bfm.2015.0134.
11. Lucas A, Boscardin J, Abrams SA. Preterm infants fed cow's milk-derived fortifier had adverse outcomes despite a base diet of only mother's own milk. Breastfeed Med. 2020;15(5):297-303. doi:10.1089/bfm.2019.0133
12. Huston R, Lee M, Rider E, Stawarz M, Hedstrom D, Pence M, Chan V, Chambers J, Rogers S, Sager N, Riemann L, Cohen H. Early fortification of enteral feedings for infants <1250 grams birth weight receiving a human milk diet including human milk based fortifier. J Neonatal Perinatal Med. 2020;13(2):215-221. doi: 10.3233/NPM-190300. PMID: 31707377; PMCID: PMC7369034.
13. Hair AB, Hawthorne KM, Chetta KE, et al. Human milk feeding supports adequate growth in infants
14. Huston RK, Markell AM, McCulley EA, Gardiner SK, Sweeney SL. Improving growth for infants ≤1250 grams receiving an exclusive human milk diet. Nutr Clin Pract. 2018;33(5):671-678. doi:10.1002/ncp.10054
15. Visuthranukul C, Abrams SA, Hawthorne KM, Hagan JL, Hair AB. Premature small for gestational age infants fed an exclusive human milk-based diet achieve catch-up growth without metabolic consequences at 2 years of age. Arch Dis Child Fetal Neonatal Ed. 2019;104(3):F242-F247. doi:10.1136/archdischild-2017-314547.
16. Bergner EM, Shypailo R, Visuthranukul C, et al. Growth, body composition, and neurodevelopmental outcomes at 2 years among preterm infants fed an exclusive human milk diet in the neonatal intensive care unit: a pilot study. Breastfeed Med. 2020. 15(5):304-311. doi:10.1089/bfm.2019.0210

Media Contact:
Dan Regan
Vice President – Communications, PR and Marketing
Sinai Chicago
dan.regan@sinai.org
773-257-5228