What are the characteristics of the ideal human milk donor?

Psychological factors and barriers to donating and receiving milk from human milk banks: A review

Human milk banks (HMBs), established in the early 20th century, aimed to provide safe breast milk for infants with challenges obtaining it. The spread of infections since the 1980s resulted in strict regulations and screening in HMBs, to ensure the safety of donated milk. Several social and personal factors discourage mothers from practicing breastfeeding, making donated milk a viable alternative because of its protective and immunity-enhancing properties. However, psychological barriers can affect the decision to donate or receive donated milk. To identify psychological factors related to donating and receiving human milk from HMBs, we searched PubMed to identify studies reporting psychological factors in donating and receiving milk and excluding studies not reporting psychological factors. The search identified 28 articles meeting the inclusion criteria. Eligible studies from various countries spanned from 1995 to 2023 and focused on psychological factors influencing milk donation and receiving. Most studies were descriptive-qualitative. Factors facilitating or hindering milk donation and reception included perceptions, psychological aspects, and previous experiences. Positive factors for donors included the desire to help other mothers, support from health care professionals, and personal well-being. Negative factors included breast milk exclusivity and discomfort caused by health checks. For recipients, awareness of donated milk benefits was a positive factor, whereas fear regarding safety was negative. The altruistic motivation to help other mothers drove many women to donate. Proper awareness and support from health care professionals and families can help women understand the value of milk donation and support their personal and identity reintegration, especially in cases of the loss of a child.

Body dirt or liquid gold? How the 'safety' of donated breastmilk is constructed for use in neonatal intensive care

When mothers of preterm infants are unable to produce sufficient volumes of breastmilk, neonatologists in many Western countries prescribe pasteurized donor breastmilk. Breastmilk has a paradoxical presence in the neonatal intensive care unit while it has therapeutic properties, it also has the potential to transmit disease. National health authorities and local neonatal intensive care unit policies each delimit the safety of donor milk by focusing on the presence or absence of pathogens. It is in this light that breastmilk from the human milk bank is both sought and legitimated to minimize safety concerns. This research uses data arising from an ethnographic study of two human milk banks and two neonatal intensive care units in the United States, and 73 interviews with milk donors, neonatal intensive care unit parents and clinicians. The primary research question framing the study was 'What are the underlying processes and practices that have enabled donor milk to be endorsed as a safe and legitimate feeding option in neonatal intensive care units?' This study is framed using three key principles of Latour's 'new critique', namely, adding to reality rather than debunking it, getting closer to data rather than turning away from fact and creating arenas in which to assemble. As a result, conceptions of donor milk's safety are expanded. This case study of donor milk demonstrates how Latour's new critique can inform science and technology studies approaches to the study of safety in health care.

"I'm happy to be able to help:" why women donate milk to a peer via Internet-based milk sharing networks

The process by which women came to donate milk via online milk sharing networks was explored via a questionnaire administered to 97 peer milk donors. Seventy-one respondents stated that they were motivated to donate milk because they wanted to help someone. Many described milk donation as an empathic response to women with insufficient milk. Seventy-four respondents donated milk that they had previously expressed but did not need. Their desire to ensure that their milk was not wasted contributed to their decision to donate. Fifty-one respondents expressed milk specifically for donation, including 20 donors who initially donated previously expressed surplus milk but then expressed milk specifically for recipient peers. The motivations of peer-to-peer donors are the same as those reported for women donating to a milk bank. Respondents who donated previously expressed milk had originally expressed so they had milk when separated from their baby, to manage an overabundant milk supply, because their baby was unwilling or unable to breastfeed, in case of emergency, and to maintain milk supply. This study is the first to clearly identify that some women express milk because they believe this is required for milk supply maintenance. Peer milk donors appeared satisfied with their experience of donating milk. The importance of altruistic motivation should be considered in discussions of the desirability of financial compensation for milk donation. Further research is needed on why women express their milk and whether such expression is beneficial to them.

Donor milk volume and characteristics of donors and their children

BACKGROUND

Little is known regarding the effect of the characteristics of donors and their children on the volume of donor milk delivered to a human milk bank (HMB).

AIMS

Our study aimed to determine the relationship between different social and demographic variables of donors and their infants with the volume of human milk delivered.

METHODS

We included donors accepted at the Hospital Doce de Octubre HMB from January 1st, 2009 until April 31st, 2013, and who had finished their donation. Data of social and demographic characteristics of the donors and their children, and the total volume of DHM given were obtained from our HMB database. Included variables were previous donors, donor age, number of children, place of residence, gestational age of the infant at birth, child's age at the start of the donation, hospital admission, and death of the infant. A linear regression model was used to study the relationship between independent variables that were significant in bivariate analysis and the volume of donated milk.

RESULTS

A total of 415 donations from 391 women were included. The median volume of milk delivered was 3.1l (IQR-interquartile range-1.3-8.3l). In the linear regression model, previous donors, smaller gestational age of children, and the start of donation at earlier stages of lactation were associated with a larger quantity of HMB donated (p≤0.001).

CONCLUSION

Previous donors, smaller gestational age of children, and the start of donation at earlier stages of lactation are associated with a larger quantity of milk donated to the HMB.

The experience of expressing and donating breast milk following a perinatal loss

BACKGROUND

The continued ability for a mother to produce breast milk following the death of her baby in utero, at birth, or during the postpartum period is an aspect of perinatal loss that is rarely acknowledged.

OBJECTIVE

To explore the lived experience of bereaved mothers who chose to express and donate their breast milk to a milk bank to feed premature and sick babies following the loss of their own babies.

METHODS

Twenty-one bereaved mothers who donated their milk between January 2003 and December 2006 to the Mothers Milk Bank in San Jose, CA or Columbus, OH participated in an in-depth, semistructured interview process about their experiences expressing and donating their milk.

RESULTS

Each transcribed interview revealed 4 essential themes, as follows: (1) identifying as a mother, grieving the loss of motherhood; (2) meanings associated with the experience of pumping milk; (3) finding meaning in and integrating the experience of perinatal loss; and (4) the importance of addressing lactation with bereaved mothers. Various subthemes were explored within each essential theme.

CONCLUSION

The experiences of these participants reflect the importance of addressing lactation more thoroughly with bereaved mothers who have lost their babies in utero, at birth, or during the postpartum period and providing them with adequate support and education during the healing process.

The human milk donation experience: motives, influencing factors, and regular donation

The aim of this investigation was to identify factors that influenced or motivated women (N = 737) to donate human milk to human milk banks in Alagoas, Brazil. The most common characteristics of a regular donor were having 4 to 7 pregnancies (relative risk [RR] = 1.9285; 95% confidence interval [CI] = 1.0388-3.5800) and having obtained a higher education level (RR = 2,0625; 95% CI = 1.0097-4.2130). The most commonly reported reasons for donating were "encouragement of a health professional" (61.3%), followed by "the needs of the babies the banks serve" (25.3%). Most of the donors (49.9%) were introduced during their stay in the hospital to the human milk bank to which they donated, and 25.8% chose the bank recommended by a health professional. Health professionals play an indispensable role in motivating mothers to become human milk donors.

Characterization of human milk donors

The primary objective of this research was to create a detailed characterization of human milk donors, including descriptive information about demographics and lifestyle, involvement with the milk bank, reasons for donating, problems encountered while breastfeeding and pumping milk, barriers to donating milk, affective experiences, and personal values. Data were collected via telephone interview of 87 donors and 19 nondonor controls. Few relationships were found between the descriptive information and amount of milk donated. Donors reported fewer problems pumping milk than nondonors. Strategies for recruiting new donors and strategies for increasing donation amounts are presented.

Breast milk donors in France: a portrait of the typical donor and the utility of milk banking in the French breastfeeding context

Although information regarding attitudes and characteristics of human blood donors has been researched, little is known about the motivations and demographic and personality characteristics of women who choose to donate their breast milk. Eight milk banks in France participated in a study examining donor characteristics, providing data on 103 women. The results showed that the donors were women of average childbearing age with strong support at home. Almost half did not work outside of the home, compared to the national average of 80% of women in this age group; similarly, a large number (currently working or not) were from the health and social services fields. Reasons for donation were largely altruistic, and a general optimistic attitude prevailed within the participants. The results of this study provide useful information for the recruitment of potential donors as well as information on how to facilitate and provide optimal service through milk donation.