Human Milk Banking Services: An Umbrella Review

Area of Science:

• Public Health
• Health Services Research
• Neonatal Care

Background:

• Donor Human Milk (DHM) is vital for infants whose mothers cannot provide sufficient breast milk.
• Human Milk Banks (HMBs) are essential for collecting, processing, and distributing DHM.
• Ensuring the operational sustainability of HMBs is critical for equitable access to DHM.

Purpose of the Study:

• To synthesize evidence from systematic reviews on the development and scaling of HMB services internationally.
• To identify factors influencing the establishment and operation of HMBs.
• To inform the co-design of an evidence framework for HMBs, including governance, quality, and sustainability.

Main Methods:

• An umbrella review methodology was employed, adhering to the JBI Manual for Evidence Synthesis.
• Searches were conducted across multiple databases (CINAHL, MEDLINE, PsycINFO, Embase, etc.) and grey literature sources.
• Studies published between 2000 and June 2025, focusing on HMBs in middle- and high-income countries, were screened by two independent reviewers.

Main Results:

• Thirteen systematic reviews were identified, revealing limited information on HMB organizational and funding models.
• Key stakeholders in DHM provision include donors, recipients, healthcare professionals, and social support systems.
• Facilitators for DHM donation and acceptance include institutional support and accessible information, while barriers include limited public awareness, religious concerns, and lack of support.

Conclusions:

• A significant knowledge gap exists regarding sustainable funding and organizational structures for HMBs.
• Opportunities for future research include establishing robust funding models and standardized governance.
• Strategies to enhance healthcare professional knowledge and public awareness are needed to support HMB development.