Resources for Health Professionals
As healthcare providers, you play a pivotal role in guiding and supporting families through their parenting journey, especially when it comes to infant nutrition and care.
Human milk banking offers a unique and invaluable solution for infants in need, and your understanding and advocacy can make a significant difference in the lives of these vulnerable little ones.
Resources for Health Professionals Database
If there is a resource that you think should be on this page, please let us know.
Table of Contents
We recognise the importance of having accurate and up-to-date information to assist your patients effectively, and these resources are intended to be your go-to reference on this crucial topic.
Within this compilation, you will find a wealth of information on the science and research behind human milk banking, the strict protocols for donor screening and milk collection, and the distribution and utilisation of donated breastmilk.
Thank you for your commitment to improving your patients’ lives and engaging with this essential aspect of infant care.
Let these resources guide your journey to champion the cause of human milk donors and milk banking, contributing to healthier and happier outcomes for the little ones under your care.
HUMAN MILK BANKING ▼
Human Milk Banking
Abstract
It is universally accepted that breast milk is the optimum exclusive source of nutrition for the first six months of life, and may remain part of the healthy infant diet for the first two years of life and beyond.
Despite advances in infant formulas, human breast milk provides a bioactive matrix of benefits that cannot be replicated by any other source of nutrition. When the mother’s own milk is unavailable for the sick, hospitalized newborn, pasteurized human donor breast milk should be made available as an alternative feeding choice followed by commercial formula.
There is a limited supply of donor breast milk in Canada and it should be prioritized to sick, hospitalized neonates who are the most vulnerable and most likely to benefit from exclusive human milk feeding.
Reference
Human milk banking. Kim J, Unger S. Paediatr Child Health. 2010 Nov;15(9):595-602. PMID: 22043143; PMCID: PMC3009567.
Author Information:
Correspondence: Canadian Paediatric Society, 2305 St Laurent Boulevard, Ottawa, Ontario K1G 4J8. Telephone 613-526-9397, fax 613-526-3332, websites
www.cps.ca, www.caringforkids.cps.ca
Copyright © 2010 Canadian Paediatric Society. All rights reserved
IMPORTANCE OF HUMAN MILK
Long-term effects of Breastfeeding – A systematic review
Overview
In 2007, WHO carried out a systematic review and meta-analysis on the long-term consequences of breastfeeding.
The Department of Maternal, Newborn, Child and Adolescent Health of the WHO has now commissioned an update of this review.
The following long-term outcomes were reviewed: blood pressure, type-2 diabetes, serum cholesterol, overweight and obesity, and intellectual performance.
These outcomes are of great interest to researchers, as made evident by the number of publications identified: 60 new publications were identified since 2006. This report describes the methods, results and conclusions of this updated review.
Reference
Long-term effects of Breastfeeding – A systematic review, Horta, BL., Victoria, CG.
Author Information:
Emergencies Preparedness, Maternal Health, Maternal, Newborn, Child & Adolescent Health & Ageing
Copyright © World Health Organization – All rights reserved
In-hospital formula use increases early breastfeeding cessation among first-time mothers intending to exclusively breastfeed
Objective
To evaluate in-hospital formula supplementation among first-time mothers who intended to exclusively breastfeed and determined if in-hospital formula supplementation shortens breastfeeding duration after adjusting for breastfeeding intention.
Study design
We assessed strength of breastfeeding intentions prenatally in a diverse cohort of expectant primiparae and followed infant feeding practices through day 60. Among mothers planning to exclusively breastfeed their healthy term infants for ≥1 week, we determined predictors, reasons, and characteristics of in-hospital formula supplementation, and calculated the intention-adjusted relative risk (ARR) of not fully breastfeeding days 30-60 and breastfeeding cessation by day 60 with in-hospital formula supplementation (n = 393).
Results
Two hundred ten (53%) infants were exclusively breastfed during the maternity stay and 183 (47%) received in-hospital formula supplementation. The most prevalent reasons mothers cited for in-hospital formula supplementation were: perceived insufficient milk supply (18%), signs of inadequate intake (16%), and poor latch or breastfeeding (14%). Prevalence of not fully breastfeeding days 30-60 was 67.8% vs 36.7%, ARR 1.8 (95% CI, 1.4-2.3), in-hospital formula supplementation vs exclusively breastfed groups, respectively, and breastfeeding cessation by day 60 was 32.8% vs 10.5%, ARR 2.7 (95% CI, 1.7-4.5). Odds of both adverse outcomes increased with more in-hospital formula supplementation feeds (not fully breastfeeding days 30-60, P = .003 and breastfeeding cessation, P = .011).
Conclusions
Among women intending to exclusively breastfeed, in-hospital formula supplementation was associated with a nearly 2-fold greater risk of not fully breastfeeding days 30-60 and a nearly 3-fold risk of breastfeeding cessation by day 60, even after adjusting for strength of breastfeeding intentions. Strategies should be sought to avoid unnecessary in-hospital formula supplementation and to support breastfeeding when in-hospital formula supplementation is unavoidable.
Reference
In-hospital formula use increases early breastfeeding cessation among first-time mothers intending to exclusively breastfeed. Chantry, C. J., Dewey, K. G., Peerson, J. M., Wagner, E. A., & Nommsen-Rivers, L. A. (2014). The Journal of Pediatrics, 164(6), 1339– 1345.e1335.
Author Information:
Caroline J. Chantry, MD ,
Kathryn G. Dewey, PhD,
Janet M. Peerson, MS,
Erin A. Wagner, MS,
Laurie A. Nommsen-Rivers, PhD
Copyright © 2014 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
Antiviral Properties of Human Milk
Abstract
Humans have always coexisted with viruses, with both positive and negative consequences. Evolutionary pressure on mammals has selected intrinsic properties of lactation and milk to support the relatively immunocompromised neonate from environmental pathogens, as well as support the normal development of diverse immune responses.
Human milk supports both adaptive and innate immunity, with specific constituents that drive immune learning and maturation, and direct protection against microorganisms.
Viruses constitute one of the most ancient pressures on human evolution, and yet there is a lack of awareness by both public and healthcare professionals of the complexity of human milk as an adaptive response beyond the production of maternal antibodies.
This review identifies and describes the specific antiviral properties of human milk and describes how maternal support of infants through lactation is protective beyond antibodies.
Reference
Antiviral Properties of Human Milk. Wedekind SIS, Shenker NS., Microorganisms. 2021 Mar 31;9(4):715. PMID: 33807146; PMCID: PMC8066736.
Author Information:
by Sophie I. S. Wedekind 1 & Natalie S. Shenker 1,2,*
Copyright © 2014 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
USING DONOR MILK
Receiving screened donor human milk for their infant supports parental wellbeing: a mixed-methods study
Abstract
Background
Access to donor human milk (DHM) has primarily been based on the health and development outcomes of premature infants but there has been little examination of the broader impact of an infant receiving it upon parental mental health. Breastfeeding and mental health are closely tied with women who experience breastfeeding difficulties or are unable to meet their own breastfeeding goals often experiencing feelings of guilt, sadness and anger, alongside an increased risk of postnatal depression. The aim of the current study was to explore how experience of receiving DHM for their baby affected the wellbeing of parents.
Methods
UK parents of infants aged 0 – 12 months who had received screened DHM from a milk bank (typically on the neonatal unit or in some cases in the community) completed an online questionnaire exploring their experiences. The questionnaire included Likert scale items examining perceived impact upon infant health, own wellbeing and family functioning alongside open-ended questions exploring perceptions of how receiving DHM affected wellbeing.
Results
Almost all of the 107 participants (women = 102) agreed that receiving DHM had a positive impact upon infant health and development, their own mental and physical health, and their family’s wellbeing. Parents felt relieved that their infant was receiving DHM for health reasons but also due to the experience of being listened to, supported and having their infant feeding decisions facilitated. Receiving DHM helped mothers to process some of their emotions at not being able to breastfeed, in part because knowing their baby was being fed gave them the space to focus on recovery and bonding with their baby. Some parents did experience challenges, feeling guilty at receiving DHM, insecure that another woman was able to feed their baby when they could not, or negative reactions from family. Although the impact of receiving DHM upon breastfeeding was not measured, some women who were working to build their own milk supply noted that it helped motivate them to continue.
Conclusions
DHM may play an important role not only in protecting infant health and development but in supporting the mental health and wellbeing of mothers for whom their infant receiving human milk is important.
Reference
Receiving screened donor human milk for their infant supports parental wellbeing: a mixed-methods study. Brown, A., Shenker, N. BMC Pregnancy Childbirth 22, 455 (2022).
Author Information:
Copyright Open Access This article is licensed under a Creative Commons Attribution 4.0 International License.
Use of donor human milk in nonhospitalized infants: An infant growth study
Abstract
When mother’s own milk (MOM) is unavailable or insufficient, donor human milk (DHM) is recommended as the next best alternative for low birthweight infants. DHM use for healthy, term infants is increasing, but evidence for growth and tolerability is limited.
This retrospective study evaluated growth in term infants in the community who received DHM from a UK milk bank. Mothers of infants receiving DHM between 2017 and 2019 were contacted (n = 49), and 31 (63.2%) agreed to participate. Fourteen infants received DHM as a supplement to other feeds (MOM and/or infant formula) and 17 were exclusively fed DHM where breastfeeding was impossible (range: 3–6 weeks).
Growth was assessed by deriving z-scores using the WHO standard for infant growth and compared with 200 exclusively breastfed infants. Multivariate regression analysis revealed no feeding method-specific association between z-score and age, nor between weight and age, suggesting that z-scores and growth velocity were not affected by feeding exclusive MOM, supplemental DHM or exclusive DHM. DHM was well-tolerated with no adverse events that led to early cessation. After receiving supplemental DHM group, 63% of infants whose mothers had no physical barrier to breastfeeding (5/8 infants) were exclusively breastfed.
This novel study reports adequate growth outcomes of healthy nonhospitalized infants receiving DHM, either as the sole milk source or supplement. Prospective studies are needed to confirm whether DHM is a suitable feeding alternative for term infants in the community, optimal durations, as well as the impact of DHM availability on breastfeeding rates and maternal mental health.
Reference
Use of donor human milk in nonhospitalized infants: An infant growth study. Bramer, S., Boyle, R., Weaver, G., Shenker, N., First published: 06 January 2021
Author Information:
Solange Bramer, Robert Boyle, Gillian Weaver, Natalie Shenker
Copyright Open Access This article is licensed under a Creative Commons Attribution 4.0 International License.
A Case Study of Human Milk Banking with Focus on the Role of IoT Sensor Technology
Abstract
Human milk is the biological norm for newborn nutrition, with breast milk from the mother being recognized as the best source of nutrition for infant health. When the mother’s milk is unavailable, donor human milk is the best alternative for infants with low birthweights. Growing recognition of the benefits of donor human milk has led to increasing global interest in monitoring and controlling human milk’s quality to fulfil the need for donor human milk. In response to this need, the REAMIT project proposed to adapt and apply existing innovative technology to continuously monitor and record human milk quality and signal potential milk quality issues. IoT sensors and big data technology have been used to monitor conditions that may increase spoilage (such as temperature and humidity) in the transportation stage. The sensors were installed in the insulated bags used to transport the milk from the donor’s home or hospital to the human milk bank and vice versa. The temperature and humidity were collected every 30 min, whilst the GPS locator sent data every 2 min. The data are collected in the cloud using GPRS/CAT-M1 technology. An algorithm was designed to send alerts when the milk temperature is above the prespecified threshold specified by the organisation, i.e., above −20 °C. The experience showed evidence that IoT sensors can efficiently be used to monitor and maintain quality in supply chains of high-quality human milk. This rare product needs a high level of quality control, which is possible with the support of smart technologies. The IoT technology used can help the human milk supply chain in five different aspects, namely by reducing waste, assuring quality, improving availability, reducing cost and improving sustainability. This system could be extended to various supply chains of rare and precious commodities, including further medical supplies such as human blood and organs, to completely avoid waste and ensure total quality in supply chains.
Reference
A Case Study of Human Milk Banking with Focus on the Role of IoT Sensor Technology. Ramanathan, U.; Pelc, K.; Costa, T.P.d.; Ramanathan, R.; Shenker, N., Sustainability 2023, 15, 243.
Author Information:
by Usha Ramanathan 1,*,, Katarzyna Pelc 2, Tamíris Pacheco da Costa 3, Ramakrishnan Ramanathan 4 and Natalie Shenker 5,6
Copyright 2022 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
SAFETY OF PASTEURISED DONOR MILK
The risk of infectious pathogens in breast-feeding, donated human milk and breast milk substitutes
Abstract
Objective
This review collates the published reports that focus on microbial and viral illnesses that can be transmitted by breast milk, donor milk and powdered infant formula (PIF). In this context, we attempt to define a risk framework encompassing those hazards, exposure scenarios, vulnerability and protective factors.
Design
A literature search was performed for reported cases of morbidity and mortality associated with different infant feeding modes.
Setting
Exclusive breast-feeding is the recommended for infant feeding under 6 months, or failing that, provision of donated human milk. However, the use of PIF remains high despite its intrinsic and extrinsic risk of microbial contamination, as well as the potential for adverse physiological effects, including infant gut dysbiosis.
Results
Viable pathogen transmission via breast-feeding or donor milk (pasteurised and unpasteurised) is rare. However, transmission of HIV and human T-cell lymphotropic virus-1 is a concern for breast-feeding mothers, particularly for mothers undertaking a mixed feeding mode (PIF and breast-feeding). In PIF, intrinsic and extrinsic microbial contamination, such as Cronobacter and Salmonella, remain significant identifiable causes of infant morbidity and mortality.
Conclusions
Disease transmission through breast-feeding or donor human milk is rare, most likely owing to its complex intrinsically protective composition of human milk and protection of the infant gut lining. Contamination of PIF and the morbidity associated with this is likely underappreciated in terms of community risk. A better system of safe donor milk sharing that also establishes security of supply for non-hospitalised healthy infants in need of breast milk would reduce the reliance on PIF.
Reference
The risk of infectious pathogens in breast-feeding, donated human milk and breast milk substitutes, Blackshaw, K., Valtchev, P., Koolaji, N., Berry, N., Schindeler, A., Dehghani, F., Banati, R. (2020). Public Health Nutrition. 24. 1-16.
Author Information:
Copyright © The Authors 2020
Safety of donor milk: a brief report
Abstract
Objective
To review the standard processing and testing of human donors and donor milk and to report the frequency of detected markers of potential harm.
Study Design
This was a retrospective analysis of the data gathered by a donor and human milk screening and monitoring process over a period of 3 years.
Results
Screening results from 2011 to the end of 2015 demonstrated that careful history taking resulted in rejection or hold of 29.7% of willing donor candidates. Individual infection screening tests rejected an additional 0.3–2.9 per 1000 donations. DNA fingerprinting of donations eliminated 2 out of 13 491. Drug testing rejected 42 out of 12 408 and dilution or adulteration eliminated 73 out of 4935 donations. Only the dilution rejection rate was significantly higher in the remunerated donors. The details of these results are presented.
Conclusions
There are significant risks involved in the collection, processing and distribution of donor milk-based products. The behaviors of the donors, biochemical and genetic screening and milk processing are critical to mitigation of these recognized risks. Testing at this level of rigor appears to be justified.
Reference
Safety of donor milk: a brief report. Bloom, B., J Perinatol 36, 392–393 (2016)
Author Information:
Barry T Bloom
Copyright Open Access This article is licensed under a Creative Commons Attribution 4.0 International License.
EFFECTS OF PASTEURISATION ON HUMAN MILK
Effects of Holder pasteurization on human milk oligosaccharides
Abstract
The benefits of human milk have been confirmed for preterm infants, due to its nutritional aspects and to its biologically active compounds.
Oligosaccharides play an emerging leading role among these compounds.
Mother’s milk can sometimes be lacking for preterm infants; pasteurized donor milk represents therefore an important alternative.
The aim of this study is to evaluate the effects of Holder pasteurization on the concentration and pattern of oligosaccharides in preterm human milk.
Our results indicate that pasteurization does not affect the concentration or pattern of analyzed oligosaccharides.
Reference
Effects of Holder Pasteurization on Human Milk Oligosaccharides. Bertino E, Coppa GV, Giuliani F, et al. International Journal of Immunopathology and Pharmacology. 2008;21(2):381-385. doi:10.1177/039463200802100216
Author Information:
Bertino E, Coppa GV, Giuliani F, et al.Copyright Open Access This article is licensed under a Creative Commons Attribution 4.0 International License.
Quality study of Holder pasteurization of donor human milk in a neonatal personalized nutrition unit
Abstract
Objective
Holder pasteurization is the technique used most frequently in milk banks to minimize the risk of transmission of infectious agents. Different pasteurization devices have been described that generally use hot water or air as heat sources. In our study, we analysed the quality of pasteurization achieved with a new automated water-free pasteurizer in a neonatal personalized nutrition unit in which donated milk from mothers of infants delivered at different gestational ages and of different postnatal ages is pasteurized.
Material and methods
We analysed the temperatures of different phases of pasteurization with 8 external probes distributed evenly throughout the pasteurizer. We applied the optimal range criteria established by the European Milk Bank Association (EMBA) to assess the quality of pasteurization. We also analysed the macronutrient composition of 8 samples of donor human milk of different volumes before and after automated pasteurization.
Results
We did not find significant differences in the following parameters under study: time from 58 °C to 62.5 °C, duration of plateau, highest temperature during plateau and length of exposure to temperatures over 58 °C. The macronutrient analysis showed significant changes in fat content but not in protein or lactose content.
Conclusions
Holder pasteurization of human milk with a water-free pasteurizer met the quality standards recommended by the European Milk Bank Association independently of the quantity of milk pasteurized in each bottle and with significant changes in the fat content but not in the protein or lactose content.
Reference
Quality study of Holder pasteurization of donor human milk in a neonatal personalized nutrition unit, Caballero Martín, S., Sánchez Gomez de Orgaz, M.C., Sánchez Luna, M., Anales de Pediatría, Volume 96, Issue 4, April 2022, Pages 294-299
Author Information:
Sylvia Caballero Martín, M. Carmen Sánchez Gomez de Orgaz, Manuel Sánchez Luna
Copyright Open Access This article is licensed under a Creative Commons Attribution 4.0 International License.
Human milk composition and the effects of pasteurisation on the activity of its components
Abstract
Background
Human milk is the ideal source of nutrition for infants, especially during the first six months of life. Milk components can protect against inflammation and infection, and stimulate immune maturation. In cases where mothers are unable to express breastmilk, pasteurised donor milk is a preferred option. Distributed from human milk banks, donor milk is particularly important to preterm infants. Born with an immature gut, these infants are at risk of developing diseases such as necrotising enterocolitis and sepsis. While Holder pasteurisation of breastmilk is recommended, this and other heat treatment processes can lead to the inactivation of bioactive components and change the composition and content of the major milk components.
Scope and approach
This review examines previous studies on the impact of pasteurisation of human milk on the bioactivity of proteins, content and composition of oligosaccharides and lipids. More recent studies investigated the effect of pasteurisation on the enzymatic properties of bile salt-stimulated lipase, which naturally occurs in human milk and contributes to lipid digestion and absorption. These studies highlight the potential consequence of pasteurised donor milk on the growth and development of an infant.
Key findings and conclusion
The bioactivity of proteins is reduced due to pasteurisation thereby hindering their ability to exert their immunological properties. However, the content and composition of oligosaccharides and lipids still remain the same following heat treatments. Despite this, the decrease in activity of lipases would impair the digestion and absorption of lipids. It is thus critical to ensure that conditions such as the temperature and heating time are chosen carefully when pasteurising donor human milk.
Reference
Human milk composition and the effects of pasteurisation on the activity of its components. Binte Abu Bakar, S.Y., Salim, M., Clulow, A.J., Nicholas, K.R., Boyd, B.J., Trends in Food Science & Technology, Volume 111, May 2021, Pages 166-174
Author Information:
Syaza Y. Binte Abu Bakar, Malinda Salim, Andrew J. Clulow, Kevin R. Nicholas, Ben J. Boyd
Copyright © 2021 Elsevier Ltd. All rights reserved.
STORAGE AND DISPENSING OF PASTEURISED DONOR HUMAN MILK
Storing expressed breastmilk
Breastfeeding: expressing and storing breastmilk covers all aspects of expressing and storage of breastmilk including hand/pump expressing, when to hire/buy a pump, long term milk expression, and correct storage and handling of breastmilk.
It contains
- Reasons why you may want to express breastmilk
- Details on the let-down reflex and why it is important
- Tips on how often and how much to express
Instructions for hand expressing - Details on the different breast pumps available and which pumps suit different situations
Benefits and costs associated with hiring or buying a breast pump - Information on exclusive expressing and expressing long term
- Instructions for safely storing and handling your breastmilk
- Tips for feeding breastmilk to your baby.
Reference
Australian Breastfeeding Association website, https://www.breastfeeding.asn.au/resources/storing-ebm
Copyright
Australian Breastfeeding Association
PO Box 33221
Melbourne VIC 3044
Email: info@breastfeeding.asn.au
USE OF DONOR MILK OUTSIDE THE HOSPITAL
Use of Donor Human Milk and Maternal Breastfeeding Rates: A Systematic Review
Abstract
The number of human milk banks is growing worldwide. The introduction of donor human milk (DHM) to neonatal units has been advocated as a strategy to promote maternal breastfeeding.
However, concern has been raised that the introduction of DHM may actually lead to a decrease in maternal breastfeeding. To address this question, we conducted a systematic literature review of studies that assessed maternal breastfeeding rates before and after the introduction of DHM.
We searched 7 electronic databases, carried out citation tracking, and contacted experts in the field. Where data for breastfeeding rates before and after the introduction of DHM were directly comparable, a relative risk was calculated.
Our search identified 286 studies, of which 10 met the inclusion criteria. Definitions of patient populations and study outcomes varied, limiting meaningful comparison.
Where possible, relative risks (RR) were calculated on aggregated data. The introduction of DHM had a significant positive impact on any breastfeeding on discharge (RR, 1.19; 95% confidence interval [CI], 1.06-1.35; P = .005) but none on exclusive maternal breastfeeding on discharge (RR, 1.12; 95% CI, 0.91-1.40; P = .27) or on exclusive administration of own mother’s milk (OMM) days 1 to 28 of life (RR, 1.08; 95% CI, 0.78-1.49; P = .65).
A single-center study demonstrated a significant decrease in the percentage of feeds that were OMM after the introduction of DHM.
In conclusion, the available data demonstrate some evidence of positive and negative effects on measures of maternal breastfeeding when DHM is introduced to a neonatal unit.
Reference
Use of Donor Human Milk and Maternal Breastfeeding Rates: A Systematic Review. Williams, T., Nair, H., Simpson, J., Embleton, N. (2016). Journal of human lactation: official journal of International Lactation Consultant Association. 32.
Author Information:
Thomas Williams, MRCPCH, Harish Nair, MD, PhD, Judith Simpson, MD, & Nicholas Embleton, MD
Copyright © The Author(s) 2016.
Use of donor human milk in nonhospitalized infants: An infant growth study
Abstract
When mother’s own milk (MOM) is unavailable or insufficient, donor human milk (DHM) is recommended as the next best alternative for low birthweight infants. DHM use for healthy, term infants is increasing, but evidence for growth and tolerability is limited.
This retrospective study evaluated growth in term infants in the community who received DHM from a UK milk bank. Mothers of infants receiving DHM between 2017 and 2019 were contacted (n = 49), and 31 (63.2%) agreed to participate. Fourteen infants received DHM as a supplement to other feeds (MOM and/or infant formula) and 17 were exclusively fed DHM where breastfeeding was impossible (range: 3–6 weeks).
Growth was assessed by deriving z-scores using the WHO standard for infant growth and compared with 200 exclusively breastfed infants. Multivariate regression analysis revealed no feeding method-specific association between z-score and age, nor between weight and age, suggesting that z-scores and growth velocity were not affected by feeding exclusive MOM, supplemental DHM or exclusive DHM. DHM was well-tolerated with no adverse events that led to early cessation. After receiving supplemental DHM group, 63% of infants whose mothers had no physical barrier to breastfeeding (5/8 infants) were exclusively breastfed.
This novel study reports adequate growth outcomes of healthy nonhospitalized infants receiving DHM, either as the sole milk source or supplement. Prospective studies are needed to confirm whether DHM is a suitable feeding alternative for term infants in the community, optimal durations, as well as the impact of DHM availability on breastfeeding rates and maternal mental health.
Reference
Use of donor human milk in nonhospitalized infants: An infant growth study. Bramer, S., Boyle, R., Weaver, G., Shenker, N., First published: 06 January 2021
Author Information:
Solange Bramer, Robert Boyle, Gillian Weaver, Natalie Shenker
Copyright Open Access This article is licensed under a Creative Commons Attribution 4.0 International License.
DONATING MILK AFTER BEREAVEMENT
The Voice of Mothers Who Continue to Express Milk After Their Infant's Death for Donation to a Milk Bank
Abstract
Background
The second stage of lactation with copious milk production occurs after birth regardless of the infant’s survival. Previous research indicates that milk donation following a perinatal loss may help some bereaved mothers come to terms with their loss. The purpose of this study was to explore the experience of women choosing to continue to express milk after a perinatal loss specifically for donation to a nonprofit milk bank governed by the Human Milk Banking Association of North America (HMBANA).
Materials and Methods
Participants were recruited through HMBANA’s milk bank directors’ listserv, their bereavement committee, and through their website. Participants were eligible if they donated to an HMBANA milk bank and specifically continued to pump milk for the purpose of milk donation following a perinatal loss. Qualitative interviews were conducted with each participant using a secured web-based platform. Data collection and analysis occurred concurrently using qualitative content analysis until there was acknowledged informational redundancy. Participants’ demographic and lactation data were collected and analyzed using descriptive statistics.
Results
Over 10 months, 21 participants were interviewed. Donating after perinatal loss has been described as a positive, valuable, and nurturing experience. Diminished grieving, enhanced connection to the infant, establishment of legacy, and creation of a positive from a negative are highlighted in several themes that illuminate the phenomena of bereaved donation.
Discussion
The findings of this research are consistent with published literature, but in this study, two subgroups were formed. This enabled the researchers to compare the experience of those with previous breastfeeding experience and those without, which adds to the knowledge about the phenomenon. It provides information for health care professionals (HCPs) to understand the experience of bereaved milk donors and serves as a call to action for HCPs to develop best practices and incorporate lactation management in enhanced, individualized bereavement care for these women.
Reference
The Voice of Mothers Who Continue to Express Milk After Their Infant’s Death for Donation to a Milk Bank, Paraszczuk, AM., Candelaria, LM,. Hylton-McGuire, K., Spatz, LM.,
Published Online:9 Aug 2022
Author Information:
Copyright © 2022, Mary Ann Liebert, Inc.
FEEDING IN EMERGENCIES
Infant and Young Child Feeding in Emergencies (IYCF-E)
Literature Repository
January 1, 2022 – March 31, 2023
Contributors
John Hopkins Center for Humanitarian Health
Tufts University – Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy
UNC – Gillings School of Global Public Health
PDF document of various investigations
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