Factors Influencing Donations to Human Milk Bank: A Systematic Review of Facilitators and Barriers

Abstract

Introduction: Mother's own milk has long been accepted as the best source of nutrition for the newborn. In those cases where mother's milk is not available, the best choice is the human milk provided by selected donors. Human milk banks are the most institutionalized method of milk sharing and play a vital role for neonates that cannot be breastfed. This study aims at systematically reviewing factors influencing donation to human milk banks. Materials and Methods: A systematic review of the literature was performed on authentic electronic resources, including PubMed, Scopus, Embase, ScienceDirect, and Web of Science with no time limitation. To increase the sensitivity and to find additional studies for systematic review, the reference list of the published studies was examined as well. Data extraction and quality appraisal were carried out by two independent reviewers. The study was qualitatively summarized to generate descriptive and explanatory themes that emerged from the literature. Results: From a total of 1,157 articles, 31 met the inclusion criteria in which 64 factors are extracted. From these, 26 factors act as barriers and 38 factors act as facilitators of milk donation. Having excess milk, altruism, and helping other babies are found to be the most important facilitators of milk donation, while the most important barriers are religious and cultural concerns. Conclusion: Developing practical strategies to attract milk donors are crucial for successfully establishing human milk banks. These include providing reliable information regarding the milk bank goals and functions and developing breastfeeding polices with regard to differences in countries' contexts and trying to resolve any uncertainties regarding milk donation, especially those arising for religious concerns.