Factors Influencing Donations to Human Milk Bank: A Systematic Review of Facilitators and Barriers

Abstract

Introduction: Mother's own milk has long been accepted as the best source of nutrition for the newborn. In those cases where mother's milk is not available, the best choice is the human milk provided by selected donors. Human milk banks are the most institutionalized method of milk sharing and play a vital role for neonates that cannot be breastfed. This study aims at systematically reviewing factors influencing donation to human milk banks. Materials and Methods: A systematic review of the literature was performed on authentic electronic resources, including PubMed, Scopus, Embase, ScienceDirect, and Web of Science with no time limitation. To increase the sensitivity and to find additional studies for systematic review, the reference list of the published studies was examined as well. Data extraction and quality appraisal were carried out by two independent reviewers. The study was qualitatively summarized to generate descriptive and explanatory themes that emerged from the literature. Results: From a total of 1,157 articles, 31 met the inclusion criteria in which 64 factors are extracted. From these, 26 factors act as barriers and 38 factors act as facilitators of milk donation. Having excess milk, altruism, and helping other babies are found to be the most important facilitators of milk donation, while the most important barriers are religious and cultural concerns. Conclusion: Developing practical strategies to attract milk donors are crucial for successfully establishing human milk banks. These include providing reliable information regarding the milk bank goals and functions and developing breastfeeding polices with regard to differences in countries' contexts and trying to resolve any uncertainties regarding milk donation, especially those arising for religious concerns.

“Ain't No Hood Like Motherhood”: The Complexity of Human Milk Donor Identity

“…Our findings are consistent with the motivations for other bodily gifting such as the desire to help others, personal values and beliefs, and a personal connection to the cause. Additionally, we find that the motivations for milk donation comprise having an excess amount of milk and a strong belief in the importance of human milk for babies, as well as a desire to save babies and help other mothers in need, consistent with previous studies (Doshmangir, Naghshi, and Khabiri, ; Pimenteira Thomaz et al., ). However, we found a further complexity in the milk donor identity, which encompasses several components, all of which motivate the act of giving human milk and set it apart from other bodily gifting.…”

“…We recognize a limitation to our study, in which we only examined nonprofit human milk banks in North America. The number of milk banks is increasing at the global scope: in 2015 there were 233 nonprofit milk banks in 28 countries within Europe, 44 in Asia, five in Australia, 10 in Africa, and 27 in the United States and Canada, and 258 in South America, Central America, and the Caribbean Islands (Doshmangir, Naghshi, and Khabiri, ). We welcome more empirical studies about human milk donation in other contexts.…”

“…Additionally, the research suggests that several motivations to donate are likely unique to the context of donations to nonprofit milk banks. For example, motivations to donate include having a surplus of milk and wanting to avoid waste (e.g., Azema and Callahan, 2003;Osbaldiston and Mingle, 2007;O'Sullivan, Geraghty, and Rasmussen, 2016); anticipating reciprocity from others, in case the donor comes across the need in the future; a strong belief that human milk is the best nutrition option for babies; and feeling empathy and the desire to ease other babies' and mothers' suffering (Doshmangir, Naghshi, and Khabiri, 2019;Pimenteira Thomaz et al, 2008). Mothers' altruistic motivations are expressed in their desire to help mothers whose milk supply is low or who are having difficulties nursing, or to help undernourished, mal-developed, or orphaned infants (Pimenteira Thomaz et al, 2008).…”

“…In this article, we wish to qualitatively explore milk donation from a social science lens, namely, from the literature of philanthropic giving. Surprisingly, although milk banking has existed for more than 100 years (Doshmangir, Naghshi, and Khabiri, 2019) and that there are more than 500 nonprofit milk banks around the world (Williams et al, 2016), the subject of milk donations has received very little attention in the literature on philanthropy (Pimenteira Thomaz et al, 2008). The field of nonprofit and philanthropic studies has focused on the motivations for giving; however, it has done so with limited attention to organ and body fluid donations, with the exception of blood donations.…”

Knowledge and attitudes of Lebanese women towards Baby Friendly Hospital Initiative practices

“…If the donor is unknown to the biologic mother, then the parents of the recipient child would reject donor milk out of fear that their infant may later marry a sibling, even though it is a remote possibility. Religious beliefs are considered strong social barriers to human milk donation in Islamic countries, where sharing a woman’s milk creates kinship and constitutes an impediment to marriage [ 22 – 24 ]. However, several Islamic countries reported success stories with regards to wet nursing by establishing milk banks that respect the Islamic rules of donor milk and marriage [ 25 , 26 ].…”