Donor Milk Research Articles

Good practice in lactation counseling for Ukrainian refugee mothers to ensure the health and mental benefits of breastfeeding - an observational study.

The study presents a cross-sectional analysis of the population of Ukrainian women who received maternity care in 11 Polish hospitals. Multidirectional lactation counseling was implemented from March to November 2023 by the Human Milk Bank Foundation in cooperation with UNICEF Refugee Response Office in Poland. Medical data were collected using questionnaires prepared for the study. When the mother indicated that she had mental problems or the health care personnel spotted problems, she was she referred to a psychologist for diagnostics, who used questionnaires appropriate to the patient's situation such as: Patient Health Questionnaire-9 for depression assessment and Generalized Anxiety Disorder Questionnaire-7 for anxiety assessment. In total, 1203 consultations were carried out, of which 542 were lactation counseling, 305 - were physiotherapy, 227 - were psychological, and 129 - were with speech-language pathologists. Two hours of skin-to-skin contact (SSC) and latching on the breast within the 1st hour postpartum occurred in more than half of the participants. In the rest of the population, shortened or lack of SSC was associated with breastfeeding delayed by at least one day. 53% of the population required lactation counseling, of which 242 were one-time visits. Continued support was 98% effective in achieving breastfeeding goals. 167 mothers required psychological support, of which only 53 women continued treatment beyond one-time counseling. Only about 1% of women experienced mental disorders based on a psychological interview. The use of lactation counseling more often than psychological counseling by refugee mothers could be related to the beneficial effects of breastfeeding on maternal well-being through hormonal self-regulation and empowerment as a mother. However, focused research is needed on the impact of breastfeeding on the mental health of refugee women.

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.

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.

Neurodevelopmental Outcomes of Extremely Preterm Infants Fed Donor Milk or Preterm Infant Formula: A Randomized Clinical Trial

(JAMA. 2024;331(7):582–591. doi: 10.1001/jama.2023.27693) A large, nationwide, randomized clinical trial examining how donor milk and preterm infant formula affect neurodevelopment in premature infants has found that outcomes in both groups were similar. The double-blinded trial was conducted with 483 participants at 15 academic medical centers in the United States that are part of a National Institute of Child Health Neonatal Research Network. Previous studies have shown that preterm infants fed with maternal milk while hospitalized have better neurodevelopment outcomes.

Vitamin B12 concentrations vary greatly in milk donated to a large provincial milk bank, and are influenced by supplementation and parity

Feeding parent's milk with supplemental donor milk (DM) is the optimal way to feed very low birth weight (VLBW) infants instead of formula; however, suboptimal neurodevelopment persists. This is believed due, in part, to suboptimal nutrition. Given vitamin B12's role in neurodevelopment and increased adoption of plant-based diets among females of child-bearing age, we aimed to determine the adequacy of vitamin B12 in DM (n=380 donors) and associated donor characteristics. Vitamin B12 was measured in consecutive raw DM donations received at the milk bank from March 2020-2021 using a validated competitive chemiluminescent enzyme immunoassay (IMMULITE 2000, Siemens). Donor characteristics were obtained from screening records and associations with milk vitamin B12 concentrations explored using a generalized additive model. Donors were 32±4 years old (mean±SD), and DM was expressed 98±85 days postpartum. Vitamin B12 concentrations in DM had a median (25th, 75th percentile) of 232 (149, 373) pmol/L; 64% had concentrations <310pmol/L (common cut-off for inadequacy in healthy term-born infants). In a multivariable analysis, donors consuming a vitamin B12-containing supplement had higher DM vitamin B12 (β±SE: 80.3±25.4pmol/L; p=0.020) compared to those not taking a supplement. Primiparous donors had higher DM vitamin B12 than multiparous donors (36.7±18.2pmol/L greater; p=0.044). No associations were observed for other donor characteristics. Milk donated to a large human milk bank showed evidence of suboptimal vitamin B12; levels were associated with both donor vitamin B12-containing supplement use and parity. Further research as to whether and when milk bank donors are recommended to consume a supplement and the benefits and risks of routine vitamin B12 supplementation of DM-fed infants is warranted.

Composition of Breast Milk in Women with Obesity.

Background/Objectives: Among US breastfeeding women, those with obesity have significantly increased breast milk fat and caloric content from foremilk to hindmilk, with a 4-fold increase in fat content from the first to last milk sample. In view of different dietary norms and nutritional standards, we sought to evaluate the relationship between maternal BMI with breast milk fat and calorie content in women from Brazil, a low-middle-income country. Methods: Women who delivered singleton-term neonates were recruited from the Ana Abrao Breastfeeding Center (AABC) and Human Milk Bank at the Federal University of Sao Paulo, Brazil. These women were then studied at 7-8 weeks postpartum. Women were grouped by BMI categories of nonobese (NonOB; BMI 18.5-29.9) and obese (OB; BMI ≥ 30). A breast pump was applied, and milk samples were obtained continuously in 10 mL aliquots from foremilk to hindmilk; samples were analyzed for macronutrients and lipids, and maternal blood was analyzed for serum lipids and glucose. Results: As compared to NonOB women, those with OB had significantly higher milk fat in the mid (4.9 ± 0.3 vs. 3.9 ± 0.2) and last hindmilk (6.6 ± 0.4 vs. 5.5 ± 0.3) samples, though not in the first foremilk sample, as compared to NonOB women. In both NonOB and OB subjects, milk caloric and fat content increased 1.5 to 2-fold from foremilk to hindmilk, with the average milk caloric value being 11% greater in OB women. Protein content was significantly increased in all three milk samples (first, middle, and last) in women with OB. Conclusions: Although the value of breastfeeding remains clear, these findings may have significant implications for infant nutrition and excessive infant weight gain in women with OB.

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.

Macronutrient concentrations in human milk beyond the first half year of lactation: a cohort study

ObjectiveHuman milk composition is dynamic. While extensive research has focused on its macronutrient concentrations during the first 6 months of lactation, limited research exists for extended lactation periods. This study...

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.

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.

A descriptive study to assess the knowledge on breast milk bank among postnatal mother's in postnatal ward at Thoothukudi Medical College and Hospital , Thoothukudi.

A quantitative and descriptive research design was chosen to assess the knowledge on breast milk banking among postnatal mother. The study was conducted in postnatal ward at Thoothukudi medical college and hospital, Thoothukudi.The sample comprises of 60 between the age group of 18-45 years of postnatal mother's. The samples were selected by convenient sampling techniques. Knowledge on breast milk bank was assessed by using a self structure questionnaire method

Breast milk sharing practices in emergency settings

Abstract Background In emergencies, breast milk sharing becomes essential to sustain infant nutrition when access to maternal breastfeeding is disrupted. This study examines donor motivations and assesses the impact of such initiatives on infant health outcomes during wartime. Methods This qualitative study investigated a community of breast milk donors on a Facebook platform for the month following the start of the war on October 7, 2023. We investigated two main groups participating in breast milk sharing through reflective thematic analysis of social media messages. Results A count of posts one month before and after October 7 revealed a doubling in post frequency post-7/10, emphasizing the surge in war-related posts. Two main themes emerged concerning the war: 1. Infant needs: Posts addressed various infant needs, including general necessities and those specific to war-related situations. Requests for milk sharing emerged from the second day of the war, particularly for infants whose mothers were missing or injured. Government information from the National Human Milk Bank was shared within these Facebook groups, encouraging donations for these infants. 2. Donor Motivation: Posts reflected both non-war-related and war-related motivations, with a notable emphasis on the latter. Authors, including both women and men, actively promoted the donation of human milk to conflict-affected areas. Suggestions included pumping milk specifically for war-affected infants or offering frozen human milk. Some posts also offered to collect and deliver human milk to needy infants within the affected regions. Conclusions Post frequency doubled in both Facebook groups compared to the previous month, mainly focusing on war-related topics, indicating an increased drive to share human milk with those affected by the conflict. Key messages • Breast milk sharing, crucial in emergencies, analyzed via social media, sheds light on donor motivations and impacts on infant health during conflicts. • This qualitative study investigated a community of breast milk donors on a Facebook platform for the month following the start of the war on October 7, 2023.

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.

Interventions to prevent Neonatal Healthcare-associated Infection: a systematic review of RCT

Abstract Background Healthcare-acquired infections (HAI) in neonatal intensive care unit (NICU) specifically refer to infections that occur in newborn infants within the healthcare environment. Preterm infants, often more vulnerable to infections, in the NICU may be exposed to various medical interventions, devices, and environments that can increase the risk of infections. This systematic review aims to evaluate the effectiveness of interventions proposed to prevent neonatal healthcare-associated infections. Methods PubMed, Scopus and Web of Science databases were searched to identify any RCT study coming from high income countries, published from 2004, that investigated the efficacy of any intervention to prevent HAI in NICU. All type of HAI were considered. Results A total of seven studies were included (2 from USA, 5 from UE). Three studies focused on: administration of donor milk; probiotic Bifidobacterium breve; intravenous Staphylococcus aureus immune globulin; all failed to demonstrate any protective action. Of the four remaining studies that investigate different aspect of the vascular catheterization process only two lead a a statistical significant reduction of HAI. Garland et al. demonstrate in 85 neonates how vancomycin-heparin lock solution is capable to reduce catheter related blood stream infection (CRBSI) 8/43 neonates (18.6%) in the control group vs 0/42 in the vancomycin-heparin-lock group (P = 0.006). Bertini et al. demonstrate in 86 preterm infants how utilization of AgION catheter in Umbelical vein catheterization (UVC) lead to CRBSI rate reduction (2 vs. 22%; p = 0.005), shorter hospital stay (p = 0.04), lower case fatality rate due to Blood stream infection (p = 0.01). Conclusions Among the proposed methodology only the one acting on the catheterization process provide a statistical significant reduction of HAI onset. Widespread observation of proposed protocol may results in reduction of HAI in NICU. Key messages • Modfiication on the catheterization process provide a statistical significant reduction of HAI onset. • Knowing these measures assure reduction of HAI.

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.

Survey on the State, Potential, and Obstacles of the Digital Transformation in Human Milk Banks

Digitalization of human milk banking was examined in a survey among participants of the largest German-speaking symposium for human milk banks. Of the 100 participants, 47% were nurses, 23% were physicians, and 3% were midwives. The overwhelming majority (96%) desired more digitalization in their milk bank. The best-digitized processes were clinical results from donors, milk labeling, and milk orders. At the same time, a discrepancy between the maximum conceivable potential and the current implementation of digital transformation became evident. The survey revealed most participants use in-house digital solutions. Potential main advantages of digitalization were cited as efficiency gains, while implementation efforts and security concerns, particularly power outages and cyberattacks, were seen as disadvantages. Financial restraints, personnel shortage, resistance from local IT departments, and legal concerns were perceived as the biggest barriers. Despite these challenges and a critical examination of the disadvantages, the participants expressed strong optimism and a desire for further digitalization in the human milk bank sector.

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.