Maternal Knowledge, Attitudes, and Perceptions Towards the Use of Human Donor Milk

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Submission ID :
ESPR347
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Abstract: :

Background: The health benefits of breast milk in term and pre-term infants are extensively described in the literature. Aside from providing optimal nutrition, human milk possesses digestive enzymes to enhance absorption, immunological and bioactive factors, prebiotics, probiotics and multiple other elements that make it the most cost effective way to improve child mortality rates. When maternal milk is not available in sufficient quantities, the World Health Organization and the American Academy of Pediatrics recommend the use of human donor milk (HDM) as the feeding method of choice. As milk banks and human donor milk become more accessible and in some states a Medicaid covered benefit, it is important to investigate maternal attitudes towards HDM. Multiple international studies have evaluated maternal knowledge and attitudes towards the use of human donor milk. In the United States, few studies have addressed maternal perspectives towards human donor milk at institutions where HDM is readily available for term and pre-term infants and with unique demographic characteristics. 

Objective:  To explore maternal knowledge, acceptability and barriers towards the use of HDM in an underserved population. 

Design/Methods: This cross-sectional study enrolled a convenience sample of post-partum women in the mother-baby unit of a university-affiliated community hospital. Data was collected using an interviewer guided questionnaire focused on feeding practices, knowledge and attitudes regarding the use of HDM before and during the COVID19 pandemic. 

Results: 85 women participated in the study with a mean age of 28.3±6.6 years. 70% identified themselves as Hispanic and 22% as Black. The majority of study subjects (69%) had never heard of HDM. 61% planned on both breast milk and formula  feedings for their infants with only 32% planning to exclusively breastfeed. 62% of women preferred the use of formula compared to HDM if their infant were to require supplemental feedings, and the most common reason cited was discomfort in using someone else's milk. Those who chose HDM (38%), perceived it as more beneficial and containing more nutrients compared with those who chose formula. There was no significant difference in maternal willingness to use HDM with regard to age, education, marital status, religion or parity. Hispanic women were less willing to choose HDM, but when the data was analyzed pre-Covid pandemic and during the pandemic, there was a significant relationship only during the pandemic. Women who were intending to breastfeed 6 months or more were more likely to choose HDM. 

Conclusion: Although donor breast milk is the best alternative when maternal milk is insufficient or unavailable, there is lack of knowledge and poor acceptance of its use in our population. Future interventions should be directed towards maternal education regarding  the benefits of breast milk and the use of human donor milk when maternal breast milk is not available. 


St. Barnabas Hospital
St. Barnabas Hospital
CUNY School of Medicine
St. Barnabas Hospital
St. Barnabas Hospital
St. Barnabas Hospital

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