How Does Pasteurised Donor Human Milk Support Women's Breastfeeding Journeys? A Mixed-Method Study in Collaboration...

Pasteurised donor human milk (PDHM) is increasingly available to support vulnerable infants when maternal milk is temporarily unavailable. While evidence suggests benefits for very preterm infants, the impact of PDHM on breastfeeding outcomes for late preterm and early term infants remains unclear.

This study investigated the impact of PDHM on breastfeeding journeys among mothers and infants admitted to the neonatal unit (Te Whare Poipoi) at Palmerston North Hospital, New Zealand.

We employed a mixed-methods design combining retrospective quantitative data (2019-2022) and qualitative interviews (n = 55). Quantitative data were compared to assess breastfeeding outcomes before and after the availability of PDHM, including maternal and infant characteristics, feeding indicators, and breastfeeding status at hospital discharge. Qualitative interviews explored mothers' experiences with PDHM.

Following the introduction of PDHM, use rose from 18% before 2021 to 50% after. Among PDHM users, 60% of infants achieved exclusive and fully breastfeeding at discharge, compared with 52% among non-users (p = 0.031). Qualitative findings highlighted PDHM as a "bridge" to breastfeeding, reducing stress during lactogenesis, providing alternatives to formula, and supporting maternal recovery from complex births. Mothers described PDHM as enabling bonding and persistence with breastfeeding while creating space for healing. Challenges included limited supply and ongoing breastfeeding difficulties for some.

Findings indicate that PDHM positively supports breastfeeding, particularly among late preterm and early-term infants, and contributes to maternal well-being. Strengthening donor milk services can play a crucial role in protecting, promoting, and supporting breastfeeding.