Implementing a National Human Milk Bank Network in Iran: A Sustainable Model for Improved Neonatal Outcomes

Iran established its first human milk bank (HMB) in 2016 to address high rates of neonatal mortality and prematurity-related complications. A national network of 19 HMBs was developed using a sustainable model that integrated local technological innovation and religious consensus. By partnering with domestic knowledge-based companies to manufacture automated pasteurizers, the program successfully bypassed international trade sanctions that made imported equipment cost-prohibitive. Furthermore, the program secured official Fatwas from high-ranking Shia authorities and a formal letter of consent from the Urmia Sunni Clergy Council to resolve "milk kinship" concerns across diverse religious regions. By 2024, the network reached an annual collection volume of over 6,785 liters, serving thousands of infants. This sustainable model provides a practical blueprint for other resource-limited and Muslim-majority countries to enhance neonatal outcomes by ensuring equitable access to donor human milk through national coordination and cultural integration.