Stakeholder attitudes and acceptability on donating and receiving donated human breast milk

Abstract

Background Benefits of breastfeeding for infants and mothers are well recognized. South Africa has a very low breastfeeding rate. Strategies to improve and promote exclusive breastfeeding rates include implementation of human milk banks (HMB). The North West Province started its first HMB in 2012 and the success and sustainability will depend on numerous factors, including identification of possible barriers to donation or receiving donor human milk. In support of such an intervention, the attitudes of each relevant stakeholders, mothers, community members and health care providers on acceptability of donating and receiving donated breastmilk is therefore important for the success of such an intervention Objectives The objective of this dissertation was determining the attitudes on acceptability regarding the donation and receiving of human breast milk for key stakeholders, namely mothers, healthcare workers and the elderly representing grandmothers. Methods This study was conducted at a public hospital and nearby clinics in North West province, South Africa using qualitative research methodology of focus group discussions (FGDs) for data collection. Eight focus groups discussed the attitudes, 3 of mothers of 0 to 12 month old infants (n=13), 3 of elderly participants older than 60 years (n=17) and 2 of healthcare professionals, working with infants younger than 1 year (n=11). Results Important attitudes on acceptability of receiving and donating human donor milk were identified from the literature and this research project. Stakeholders had safety and cultural concerns regarding donation and receiving of donated human milk. Participants also indicated the need for education that may improve the attitudes. These findings may inform future policy planning and HMB promotion in communities. The identified attitudes reflected barriers to exclusive breast feeding, donating and receiving breast milk. These included, the need for HIV screening; cultural beliefs relating to transfer of personality traits and bonding and fears of not having enough milk for their own infants; perceived changes in quality of donated milk during pasteurisation and transportation as well as HIV transmission. Conclusion The study identified important attitudes that may be possible barriers and fears to accepting or donating human breast milk. Some of the identified attitudes could also limit exclusive breast feeding. Further research is recommended to determine how prevalent the identified attitudes are in this and similar community settings.