Donor Human Milk Research Articles

Understanding modifiable barriers to human milk donation in the United Kingdom.

When premature infants cannot receive their own mother's milk, donor human milk (DHM) is the first-line recommended option, with growing demand for DHM use outside of neonatal units. To meet the potential need, we need to consider whether DHM supply can increase. This study aimed to explore the reasons that prevent women who wish to donate their milk in the United Kingdom from doing so to understand which barriers may be modifiable. Women who wanted to donate their milk but did not do so completed an online survey. Open and closed questions examined the response they received, their reasons for not donating and what they did with any milk that they had already stored. Out of 732 mothers, 391 (53.4%) did not enquire as they did not think it was possible for them, 218 (29.8%) enquired but were told that they could not donate, 59 (8.1%) enquired but decided not to proceed and 64 (8.7%) received no response. Reasons for being told they could not donate included the use of certain medications, infant age, inadequate staffing, geographic barriers and incorrect storage. Process aspects (e.g., blood tests, practicalities) and lifestyle limitations led mothers to decide not to donate. Although some women will be prevented from donating due to medication or health issues, investment in milk banking staffing and infrastructure and awareness campaigns could increase DHM supply, enabling guidelines to extend eligibility criteria for receiving DHM such as for late preterm infants, gestational diabetes or to support low maternal milk supply.

Construction and Initial Validation of Measures Regarding Human Milk Donation: An Application of the Theory of Planned Behavior

Objective: to construct and validate measures related to human milk donation (HMD), based on the theory of planned behavior (TPB). Theoretical framework: it is assumed that TPB can be used to explain and predict HMD behavior and the construction of these measures should consider reflective and formative measures. Method: a questionnaire was developed with 12 direct reflective measures and 30 indirect formative measures and applied to a sample of postpartum women eligible to donate. The reliability of the direct measures was verified by the internal consistency criterion, using Cronbach's alpha and composite reliability. The reliability of the indirect measures was verified by the temporal stability criterion, using the test-retest technique and the intraclass correlation coefficient. The construct validity of the direct measures was established through the convergent and discriminant validity of these measures. The construct validity of the indirect formative measures was established through convergent validity, the assessment of collinearity problems and the assessment of the significance and relevance of the formative measures. Results and conclusion: the reliability and validity of the direct reflective and indirect formative measures indicated that they are reliable and acceptable. Research implications: this questionnaire can be used to predict HMD behavior, which in turn can improve donor recruitment management in human milk banks. Originality/value: a questionnaire with direct and indirect measures of the TPB on HMD is unprecedented.

Greater and Earlier Exposure of Mother's Own Milk Compared to Donor Human Milk Moderates Risk and Severity of Bronchopulmonary Dysplasia.

Background: Bronchopulmonary dysplasia (BPD) is a common complication of preterm very low birth weight (VLBW) infants. Mother's own milk (MOM) may mitigate the severity of BPD. Pasteurized donor human milk (PDHM) is often used as an alternative when MOM is unavailable with limited information on the influence of PDHM on BPD risk and severity. Objective: To compare the influence of MOM to PDHM on risk and severity of BPD in preterm VLBW infants. Design/Methods: A retrospective chart review of preterm (<34 weeks) and VLBW (<1,500 g) infants born at the Children's Hospital of Richmond from 2019 to 2021 was performed. The analysis included demographics, type and timing of nutrition received (MOM, PDHM, Formula), and incidence/severity of BPD based on National Institute of Child Health & Human Development (NICHD) definition. Data analysis used chi-square, linear regression, and a multinomial logistic regression test. Results: A total of 200 infants met inclusion criteria, of which 116 (58%) had no BPD, 34 (17%) had mild BPD, 32 (16%) had moderate BPD, and 18 (9%) had severe BPD. Infants exposed to MOM within the first 3 days and within the first 7 days of life had lower incidence of moderate to severe BPD when compared to those with no MOM exposure (p = 0.02, p = 0.04). The percent of MOM received throughout hospitalization moderated the incidence of BPD (p = 0.01, 95% Confidence Interval (CI) [-0.14, -0.02]), such that as the percent of MOM received increased, the effect of gestational age on severity of BPD decreased. In contrast, the percent of PDHM received throughout hospitalization did not moderate BPD incidence (p = 0.61, 95% CI [2.28, 3.43]). Conclusion: These results identify that earlier and greater total exposure to MOM, but not PDHM, was associated with decreased moderate to severe BPD in <34-week preterm VLBW infants.

Donor Human Milk Fat Content Is Associated with Maternal Body Mass Index.

Introduction: Donor human milk is increasingly being utilized for both preterm and term infants when mother's milk is unavailable. With the rising prevalence of maternal overweight and obesity, it is crucial to evaluate the relationship between maternal body mass index and the fat and energy content of donor human milk. Objectives: To assess the impact of maternal body mass index on human milk fat content. Methods: A cross-sectional study was carried out using retrospective data from women who made their first human milk donation at ≥15 days postpartum at a human milk bank in São Paulo, Brazil, from January 2018 to December 2020. Data of sociodemographic, obstetric, health, and anthropometric measures were collected by the human milk bank staff. Milk fat and energy content were determined using the crematocrit test. Analysis of variance and multiple linear regression were used to compare means of crematocrit and fat. We determined the p-values using a test of heterogeneity and linear trend and presented the one with the lower p-value. Results: Most donors were between 25 and 35 years old, had higher education, were employed, and lived with a partner. At the time of milk donation, 40.9% of women were overweight or obese. The fat (1.09 g/dL) and energy (9.83 kcal/dL) content of human milk were higher in obese donor compared with eutrophic donors. Conclusions: The fat and energy content of human milk were associated with maternal body mass index, suggesting the potential value for selective use of high fat and high calorie donor milk for very low birthweight or premature infants.

Efficacy of exclusive human milk diet in preterm infants weighing ≤1500 g: a single-center COHORT study

Efficacy of exclusive human milk diet in preterm infants weighing ≤1500 g: a single-center COHORT study

Impact of changing donor human milk feeding guideline for extremely preterm infants on the use of infant formula and cost of donor human milk purchase.

Impact of changing donor human milk feeding guideline for extremely preterm infants on the use of infant formula and cost of donor human milk purchase.

CHALLENGES TO THE BRAZILIAN NETWORK OF HUMAN MILK BANKS: INTERFACE BETWEEN PRIMARY AND TERTIARY CARE

This study analyzed the interface between a family health unit and the human milk bank of a maternity hospital in Rio de Janeiro. Through interviews, key actors pointed out problems related to the Health Care Network and strategies for overcoming them. Matus's categories supported the analysis of the interviews. The link between primary and tertiary care, between health teams and the community, and the involvement of the actors in this process configured a network work recognized and multiplied by the Municipal Health Department, which articulated a network of Human Milk Receiving Stations. The experience contributed to increasing the collection of breast milk by milk banks. The study showed that local actions contribute to a more effective capillarization of human milk donation with the effective participation of the units that operate in the Family Health Strategy. The institutionalization of actions at the local level is an important strategy to reinforce national breastfeeding policies, in a network logic that goes beyond the traditional reference and counter-reference models.

Freeze-drying donor human milk allows compositional stability for 12 months at ambient temperatures

Breastfeeding, which is recognised as the optimum nutrition for infants, offers numerous benefits. However, circumstances can arise when infants are unable to be breastfed from birth. In such cases, the World Health Organisation (WHO) recommends donor human milk (DHM) as the safest alternative. Current practices freeze DHM and transport it under a cold supply chain, which can create logistical challenges. Here, we investigated the efficacy of freeze-drying as a method for determining the compositional stability of DHM. The samples were freeze-dried and stored at −20°C, 4°C and ambient temperature, with sampling at 1, 3, 6, 9, and 12 months. The macronutrient composition was assessed before and after freeze-drying, protein and lipid profiles were studied using MALDI-TOF MS, and the metabolite profile was analysed through LA-REIMS. The findings revealed that freeze-drying did not significantly alter the macronutrient composition and that microbiological safety was preserved. Lipid, protein, and metabolite fingerprints remained consistent across storage conditions over 12 months. This work provides a broad insight into the compositional stability of DHM after freeze-drying. It suggests the applicability of freeze-drying for long-term preservation without a cold supply chain. The use of freeze-dried DHM may broaden its use in emergency situations and resource-limited settings.

Beliefs About Donating Human Milk to a Milk Bank: A Theory-Based Salient Belief Elicitation.

Pasteurized donor human milk provides a safe and desirable alternative when a parent's own milk is insufficient or unavailable. Currently, the demand for donor human milk exceeds the available supply. Little is known about the beliefs breastfeeding individuals have about milk bank donation. The aims of this exploratory study were to (a) provide a preliminary estimate of how well intention can be predicted, and to suggest which of the global constructs of the Reasoned Action Approach has the most influence on intention; and (b) identify the salient, top-of-the-mind beliefs underlying the intention to donate some of the milk an individual is currently producing to a milk bank. An exploratory, cross-sectional study design, based on the Reasoned Action Approach, was used to measure the theory's global constructs and elicit beliefs underlying the intention to donate milk of lactating individuals (N = 118) living in Indiana, Illinois, Missouri, and Kentucky. Thematic and frequency analyses and multiple regression were performed. Quantitative analyses found that injunctive norm and the autonomy component of perceived behavioral control were independently associated with intention. Qualitative analyses identified the advantages (e.g., help and save babies, won't waste milk), referents who support (e.g., husband, family), and facilitators (e.g., having a convenient, close location, having more knowledge and information) of donating milk. This research provides insight into how milk banks might recruit and retain donors. Additional quantitative research with a larger sample is necessary to confirm the preliminary findings of this study.

Quality improvement initiative to achieve early enteral feeds in preterm infants at a level IV neonatal intensive care unit.

We report the results of a quality improvement initiative to reduce the time to full enteral feeds and number of central line and parenteral nutrition days in premature infants in a level IV neonatal intensive care unit (NICU) by 20%. In 2020, a multidisciplinary team at our NICU initiated a quality improvement project to improve enteral feeding in infants with a birthweight <1800 g. The key drivers were early donor human milk consent, trophic feeds initiation, and modification of the enteral feeding guidelines. The interventions included prenatal donor human milk consents, mandatory staff education, and NICU newsletter reminders. Retrospective baseline data were collected May 1, 2020, to November 23, 2020, and prospective data were collected November 24, 2020, to September 30, 2022. Special cause variation was detected for time to achieve full enteral feeds, central line days, and parenteral nutrition days with 30%, 44%, and 42% improvements, respectively. There was no increase in feeding intolerance or necrotizing enterocolitis. Small changes in feeding guideline processes improved enteral feedings in preterm infants without increase in morbidities. Our process measures are practical and easy to implement in most NICU settings.

New latex agglutination assay for the determination of lactoferrin in human milk

BackgroundLactoferrin (LF) in human milk has various biological properties and contributes to the prevention of preterm birth complications. Enzyme-linked immunosorbent assay (ELISA) is one of the most commonly used methods to measure LF in human milk, but this method is time-consuming and laborious. In Japanese human milk banks, the concentration of LF in donor human milk (DHM) is measured routinely. Here, we reported a rapid, simple, and accurate method for determining LF in human milk using a new reagent based on a latex agglutination assay.MethodsWe obtained 208 human milk pools from 148 mothers, and samples were collected before and after Holder pasteurization. Milk samples were diluted 100- or 200-fold and LF concentrations were measured by a latex agglutination assay using an automated analyzer. The reagent was validated in terms of repeatability, linearity, detection limit, recovery, and comparison with ELISA.ResultsThe coefficient of variation (CV) for intra-assay precision ranged from 0.6 to 5.0% in human milk with high, medium, and low LF concentrations. The linearity was also tested by serial sample dilution and was confirmed up to 16 µg/mL with a detection limit of 0.2 µg/mL. The recovery rates in a spiked recovery test were ranged from 90 to 120% at high, medium, and low concentrations of LF. Furthermore, a strong correlation was observed between LF levels determined by the latex agglutination assay and ELISA (r = 0.978, p < 0.001, n = 255). The regression equation was y = 0.991x + 0.545 (r2 = 0.974, p < 0.001). Compared with ELISA, the latex agglutination assay reduces the measurement time by 160 min and the cost by 55%.ConclusionsThe latex agglutination assay used to determine LF in human milk is rapid, simple, and accurate enough to be used routinely. Its use may contribute to the quick and easy provision of appropriate DHM to preterm infants.

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

Objective: Donor human milk (DHM) can provide many benefits to neonates. This study examines access to DHM and how structural barriers may exacerbate inequities. Study Design: 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. Results: Across 124 NICUs, those serving a higher percentage of white families were more likely to have access to DHM (p = 0.04). NICUs with a higher percentage of Hispanic families were less likely to have access to DHM (p = 0.03). Hospitals that had higher proportions of uninsured patients were also less likely to have access to DHM (p = 0.015). Conclusion: 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.

Stakeholder perspectives on supplemental milk for infants under six months with growth faltering

Abstract Background Growth faltering is a significant public health issue among infants aged &amp;lt;6 months (m). Supplemental milk is commonly used for infants with growth faltering, with variations in type and duration. We synthesized qualitative evidence on stakeholder perspectives about equity, feasibility, and acceptability of the type and duration of supplemental milk for infants aged &amp;lt;6m with growth faltering. Methods We conducted a comprehensive search of six electronic databases in addition to manual searches to identify all qualitative studies published during January 2000-June 2022. Identified articles were screened in two stages against an inclusion criteria with titles and abstract screened first followed by full-text screening. Included studies were quality appraised using the Critical Appraisal Skills Programme checklist. The primary outcome was equity, feasibility, and acceptability of various supplemental milk for infants &amp;lt;6mwith growth faltering. Results Eighteen studies, reporting perspectives of mothers, fathers, grandmothers and healthcare providers were included. Studies were conducted in North America (9), Africa (5) and Asia (3) and South Australia (1). Donor human milk (DHM) (13) and infant formula(9) were the main supplementary milk reported followed by cow/goat milk (2). Key sub-themes derived were: education/awareness, socio-economic status (SES), race and religion, practicality, availability of resources, sustainability, cost, affective attitude, perceived effectiveness and ethicality. Maternal/caregiver SES was a key sub-theme across all three supplemental milk feeds, acting either as a barrier or facilitator for uptake. Conclusions DHM and infant formula were the most commonly reported supplemental feed for infants aged &amp;lt;6m with growth faltering. Maternal/care giver factors were perceived as key to ensure equity, feasibility, and acceptability with respect to type and duration of supplemental milk for infants aged &amp;lt;6m with growth faltering. Key messages • Stakeholders perceived donor human milk and infant formula as main supplemental milk for infants aged &amp;lt;6 months with growth faltering. • Maternal/care giver factors are key to ensure equity, feasibility, and acceptability of supplemental milk for infants aged &amp;lt;6 months with growth faltering.

Impact of maternal health and stress on steroid hormone profiles in human milk: Implications for infant development

Steroid hormones are biologically active factors in human milk (HM) that influence the physical and mental development of infants. Critically, maternal psychosocial stress has been associated with changes in HM steroid composition. This work aimed to characterize the steroid hormone profile of HM and pasteurized donor human milk (DHM) and assess the interplay between maternal physical and psychosocial status, the HM steroid profile, and infant outcomes. A targeted ultra-performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS) method was developed to quantify sixteen steroid hormones in HM samples. HM samples from mothers of term infants (N = 42) and preterm infants (N = 35) were collected at (i) recovery of birth weight or achievement of complete enteral nutrition, respectively, and (ii) 6 months later as well as DHM samples (N = 19) from 11 donors. The physical and psychosocial status of mothers and infant neurodevelopment and temperament were assessed through structured interviews and validated questionnaires. Fourteen steroids were detected in HM/DHM samples, with cortisol, 20β-dihydrocortisol, dehydroepiandrosterone, pregnenolone, and cortisone being present in > 48% of samples. Pregnenolone, 17α-OH-progesterone, and dehydroepiandrosterone are reported for the first time in HM. Whereas milk cortisol levels were not directly related to maternal physical and psychosocial status nor with infant development, cortisone, and pregnenolone correlated positively with maternal weight gain during pregnancy and were associated with maternal well-being and infant growth. The pasteurization process may have a detrimental effect on the steroid hormone levels in HM, which might influence the development of receptors.

41 Neonatal outcomes with exclusive breast milk in infants with gastroschisis: A systematic review and meta-analysis

Abstract Background Infants with gastroschisis may experience prolonged stays in hospital as they transition from parenteral nutrition to enteral feeds. Some studies suggest that patients who receive exclusive breast milk experience better outcomes than those who receive supplemental or exclusive formula. These findings are inconsistent and the evidence for exclusive breast milk remains uncertain. Objectives To systematically review and meta-analyze the effectiveness of exclusive breast milk in infants with gastroschisis. Design/Methods We searched Medline, Embase, and Cochrane without language restriction from inception until June 2023. Manual searches of trial registries and reference lists of relevant articles were also performed. We included studies that assessed the effectiveness of exclusive breast milk compared to formula among infants with gastroschisis. Title, abstract, full-text screening, and data extraction were completed by two independent reviewers. The Newcastle-Ottawa Scale was used to assess the risk of bias. Our outcomes of interest were time to full enteral feeds, days of parenteral nutrition, length of stay, necrotizing enterocolitis (NEC), cholestasis, and mortality. RevMan was used to meta-analyze treatment effects using a random effects model whenever possible. Summary statistics were reported as relative risk (RR) with 95% confidence intervals (95% CI). Results We identified 130 studies of which six were selected for review. All included studies were observational and retrospective. Only 3 studies (n=3211 participants) reported outcome data that were amenable to meta-analysis. All participants received exclusive breast milk (n=1009) or supplemental or exclusive formula (n=2202). Exposure to exclusive breast milk was associated with a lower risk of mortality compared to those who received formula (unadjusted RR=0.36; 95% CI: 0.13-0.96, 2 studies, n=3157, I2=0%). Exposure to exclusive breast milk was not associated with a decrease in NEC (unadjusted RR=0.20; 95% CI: 0.03-1.14; 3 studies, n=3211, I2=0%). The primary source of bias among included studies was lack of adjustment for confounders. We identified one randomized controlled trial comparing exclusive breast milk to formula. This study was stopped due to low recruitment. Conclusion The use of exclusive breast milk among infants with gastroschisis may be associated with a reduction in mortality; however, this estimate is based on small numbers from observational studies. Estimates may change as more data become available. Further research is needed to establish best feeding practices, including the role of human donor milk.

Sociodemographic and Psychological Factors Influencing Human Milk Donation: A Cross-Sectional Study of 420 Lactating Mothers in Vijayapura.

Background Breastfeeding is crucial for infant health, but not all mothers can breastfeed due to various constraints. Making human milk banks (HMBs) isessential for providing donor milk to preterm and sick infants. Methods This is a cross-sectional study at Shri BM Patil Medical College Hospital and Research Centre in Vijayapura involving 420 lactating mothers. Convenience sampling and semi-standardized interviews were used to assess socio-demographics, maternal factors, and attitudes toward milk donation. Results Among the 420 lactating mothers surveyed, urban mothers were significantly more likely to have received breastfeeding counseling (56.7% vs. 41.4%) and were more aware of milk bank donations (20.0% vs. 11.4%) than rural mothers. Logistic regression analysis revealed that urban residence, higher education, and prior knowledge of milk donation were significant predictors of willingness to donate breast milk. Conclusion The findings emphasize the importance of education and awareness, particularly in rural areas, to promote milk donation. Addressing socio-economic disparities and sharing personal experiences can also encourage donations. Targeted educational programs are crucial for enhancing donation rates and improving newborn health outcomes, making milk donation a vital area for public health initiatives.

Microbiological analysis of donor human milk over seven years from the Hearts Milk Bank (United Kingdom)

When maternal milk is unavailable, donor human milk (DHM) from human milk banks (HMBs) is the optimal alternative, as recommended by the World Health Organisation. The microbiota of DHM could contain opportunistic pathogens, which means rigorous microbiological screening for DHM, prior to pasteurisation, is recommended to safeguard recipients. Here, an analysis of 6863 DHM samples from 1419 donors at the Hearts Milk Bank between 2017 and 2023 showed approximately 70.1% of samples exhibited a total viable count (TVC) between 10³-10⁵ CFU/mL, while 18.3% yielded no growth; 11.5% of samples exceeded the 10⁵ CFU/mL threshold. Staphylococcus was the most prevalent genus, with S. epidermidis found in 61.5% of samples. A significant (p < 0.05) negative co-occurrence was observed between S. epidermidis and Gram-negative opportunistic pathogens. Overall, 16.8% of DHM samples failed to meet UK microbiological screening criteria, with 68.3% of these failures due to exceeding TVC thresholds. S. epidermidis accounted for approximately 10.2% of the total failed samples. The majority of DHM samples met the current microbiological criteria specified in the National Institute for Health and Care Excellence (NICE) clinical guidance (CG93), “Donor milk banks: service operation”. The core species in DHM reflects microorganisms typically found on the skin. These findings highlight that the current UK thresholds and criteria could potentially be modified to increase the available supply of DHM without increasing microbiological risk.

Early human milk feeding: Relationship to intestinal barrier maturation and postnatal growth.

Early exposure to mother's own milk (MOM) promotes intestinal barrier maturation in preterm infants. We hypothesized (1) donor human milk (DHM) supplementation reduces intestinal permeability (IP) similar to exclusive MOM and (2) early HM exposure and low IP at 7-10 days postnatal age (PNA) are associated with improved growth outcomes. IP was measured by the standard sugar absorption test (SAT) in infants <33 weeks gestation between 7-10 days PNA. Nutritional and anthropometric data were recorded. Postnatal growth failure (PNGF) was defined as a decrease in weight z-score >1 from birth to discharge to home. Of 158 preterm infants, the mean (SD) gestational age was 29.9(2.3) weeks and birthweight 1388(424) g. Diet prior to SAT was exclusive MOM [N = 55(35%)], DHM ± MOM [N = 52(33%)], or preterm formula±MOM [N = 51(32%)]. The mean Lactulose(La)/Rhamnose(Rh) ratio was lower in the exclusive MOM [0.06(0.07)] and DBM ± MOM [0.05(0.07)] groups compared to the preterm formula±MOM group [0.11(0.11)], p < 0.01). Cumulative intake >150 ml/kg MOM ± DHM, but not preterm formula within 7-10 days PNA was associated with early intestinal barrier maturation. Low IP was not associated with lower risk of PNGF at discharge. Low IP is associated with cumulative intake of MOM alone or supplemented with DHM > 150 ml/kg within 7-10 days PNA. Clinicaltrials.gov NCT01756040 ; web link to study on registry: https://clinicaltrials.gov/study/NCT01756040 . Key message Early intestinal barrier maturation is associated with cumulative intake of exclusive MOM alone or supplemented with DHM > 150 ml/kg within 7-10 days after birth, but is not associated with lower risk of PNGF at time of discharge. What it adds to existing literature? This observational study is the first study to demonstrate that supplemental DHM promotes intestinal barrier maturation similar to MOM alone. What is the impact? The findings underscore the importance of early introduction of human milk feeds as MOM or MOM supplemented with DHM in sufficient volume to promote early intestinal barrier maturation.

Peer-to-Peer Human Milk Sharing Through Social Media Groups: The Experiences of Women Donors and Recipients in Hong Kong.

To explore the lived experience of donors and recipients involved in peer-to-peer human milk donation. An exploratory descriptive qualitative study. Semi-structured interviews were conducted between November 2022 and April 2023. A total of 50 women consisting of 34 donors and 16 recipients were recruited using purposive sampling from specific social media groups in Hong Kong that focus on breast milk donation and sharing. Data were analysed based on thematic analysis. Five key themes were identified in this study: Motivation; Milk sharing as a social act; Not a Norm; Recommendation to formal milk banks; and Formal donation as the preferred route. The findings indicate informal milk sharing is seen as an inferior alternative to formal milk donation systems. The establishment of formal milk banks is viewed as a way to address the shortcomings of informal sharing. The findings have implications for the healthcare field, particularly in improving the experiences of those involved in informal milk sharing. The insights gained from the experiences of informal milk sharers can directly inform and enhance the services provided by formal milk banks. Given the growing prevalence of online informal milk sharing, healthcare professionals should enhance their understanding of this practice. However, the practice has remained understudied, particularly in Asian region. This study brings together the experiences of both milk donors and recipients, providing a comprehensive view on the phenomenon. The Standards for Reporting Qualitative Research (SRQR). No patient or public contribution.

Perspectives of healthcare workers on the acceptability of donor human milk banking in Southwest Nigeria

BackgroundThe World Health Organization prioritizes Mother’s Own Milk (MOM) or donor human milk (DHM) when MOM is unavailable or insufficient. It is also important for healthcare workers (HCWs) to provide adequate support, information, and education to mothers to help improve their milk production and breastfeeding experience. DHM is scarce in developing countries, prompting a need for understanding health workers’ perspectives.MethodsThis cross-sectional study, conducted in 2021 in Ekiti State, Nigeria, examined the knowledge and attitudes of HCWs regarding human milk banking. A sample of 321 participants from government-owned hospitals completed a self-administered questionnaire.ResultsOf the 321 participants (84.7% response rate), the majority were females (69.2%), aged 30–39 (32.1%), Christian (91.9%), and employed in tertiary hospitals (91.9%). About 65% of the HCWs believe that HMB is a safe practice and 42% believe that the DHM has the same quantity of immunological factors as fresh human milk. While 80.4% displayed good DHM knowledge, attitudes varied. The HCWs profession influenced their attitudes and a higher proportion of all female HCWs (71%), except for health assistants (65.4%), expressed willingness to donate their breast milk if needed. Among males HCWs, the majority of those who were doctors (82.8%) and pharmacists (62.5%) expressed willingness to support their spouses to donate breast milk, and they also had higher acceptance of DHM for their infants. In all, more than 80% of the HCWs will encourage mothers to donate their milk and feed babies under their care with DHM, but only 47% would accept DHM to feed their own children. Health assistants had less favourable views, and negative perceptions were linked to the internet and media sources.ConclusionsThe study highlights health workers’ awareness of DHM but indicates a reluctance to fully embrace it, especially among health assistants. The need for targeted education programs, to address knowledge gaps and negative perceptions, is crucial for the successful implementation of human milk banks in Nigeria. Overcoming challenges, such as safety concerns and sociocultural influences, requires focused efforts from policymakers and healthcare institutions.