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.