Exploring the Experience of Human Milk Use in Nigeria Neonatal Intensive Care Units: A Scoping Review

Human milk is the recommended feeding standard for preterm and low-birth-weight infants. The 2022 World Health Organization (WHO) guidance prioritizes mother's milk, donor human milk (DHM) when mother's milk is insufficient, early feeding initiation, and potential fortification for the smallest infants. However, evidence on current practices and alignment with these recommendations in Nigeria is limited. This scoping review examined human milk utilization practices, perceptions, and experiences in Nigerian neonatal intensive care units (NICUs) populations. A systematic search was conducted in March 2025 following PRISMA guidelines using PubMed and African Journals Online. Articles from 2008 onward were included to align with WHO resolutions on DHM use. Eligible studies were original research or reviews from Nigeria addressing infant feeding, milk pumping or storage, lactation support, infant health outcomes, and attitudes toward DHM. Of 137 records identified, 15 studies (2008-2025) met the inclusion criteria. Human milk was valued for NICU feeding, yet major knowledge gaps persist regarding recommended practices. There was a dearth of information related to lactation support and milk expression practices. Only one study mentioned fortification, and no included studies reported the use of donor human milk. Awareness of DHM among mothers was low, though willingness to donate exceeded willingness to receive. Critical gaps in the published literature exist regarding lactation support, milk expression practices, infant feeding protocols, and DHM availability in Nigerian NICUs. Given the high rates and numbers of preterm births in Nigeria annually, more research into NICU feeding practices is warranted.