Acceptability of donor breast milk banking, its use for feeding infants and associated factors

What is it about?

Abstract Background: The first priority for infant feeding is to encourage the use of infant’s mother’s breast milk, but when this is not possible, donated breast milk is the second best option. In developing countries, very few studies have been conducted on the acceptance of donor breast milk. Hence, this study was planned to discover the acceptability of donor breast milk banking, its use for feeding infants, and associated factors among mothers in eastern Ethiopia. Methods: A mixed method study was conducted in eastern Ethiopia from December 2015 to February 2016. Data were collected through a pre-tested structured interview based questionnaire. A total of 1085 mothers participated in the survey and six focus group discussions were held with 33 mothers. Descriptive statistics have been used to report results from the survey and qualitative data were analyzed using the thematic data analysis approach. Results: The study revealed that 119 (11%) of participants were willing to donate breast milk for banking and 165 (15.2%) of mothers were willing to use for feeding infants. The acceptance of donor milk banking was 5.8 times more likely among the mothers who had heard about donor milk banking previously (Adjusted Odds Ratio [AOR] 5.8; 95% Confidence Interval [CI] 3.1, 10.72), 4.2 times more likely among the mothers who heard about wet-nurses (AOR 4.2; 95% CI 2.5, 6.99) and 2 times more likely among mothers who had visited a neonatal intensive care unit (AOR 2; 95% CI 1.1, 3.73). Conclusions: Generally, this study showed that the acceptance of breast milk donation for banking and its use for feeding infants was very low, due to lack of information and misconceptions about the safety of breast milk. Therefore, before initiation of any donor milk banking program awareness should be created about donor breast milk and its safety. Keywords: Human milk banking, Donated human breast milk, Eastern Ethiopia

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Why is it important?

Worldwide, 4 million babies die each year in their first four weeks of life. This represents more than 10,000 deaths per day. Most neonatal deaths occur at the very beginning of life; three-quarters of them occurring within one week of birth [13, 14]. The three major causes of neonatal mortality are severe neonatal sepsis (36%), prematurity (28%), and birth asphyxia (23%) [13, 14]. In Ethiopia, the Neonatal Mortality Rate (NMR) has always been very high with an estimated 63% of infant deaths occurring during the first month of life. According to the Ethiopian Demographic and Health Survey (EDHS) of 2011 report, the Neonatal Mortality Rate accounted for 42% of Under-Five Mortality (U5MR) [13]. In spite of many efforts made for the improvement of maternal and child health care services by the government and other stakeholders, the reduction of NMR has remained insignificant. For the years 1991–1995 NMR was reduced from 46 per 1000 live birth to only 42 for 1996–2000, to 39 for 2001–2005, and to 37 for 2006–2011 [14–16]. In Ethiopia, a study conducted in 2007 and 2013 also indicated that prematurity (26.4%), pneumonia (22.6%), neonatal tetanus (9.4%) and sepsis (7.5%) were the leading causes of neonatal mortality [14, 16]. Breastfeeding promotion and the collection of donor breast milk are linked. By offering correct information about breastfeeding, women have an increased chance of successfully breastfeeding their infant [15]. Having a human milk bank in a health facility increases awareness about breastfeeding among families and the community [17]. It is also known that successful breast feeding significantly reduces neonatal mortality and morbidity worldwide [18, 19]. In addition, the availability of donor breast milk is very significant for infants whose mother cannot breastfeed because of medical problems such as maternal open pulmonary tuberculosis, cancer chemotherapy, HIV and other viral infections [1, 3]. To fulfil this need, establishing donor breast milk banking is crucial. In Africa, very few studies have been conducted on the acceptance of breast milk donation for banking and use of donor breast milk for feeding infants [5, 20, 21]. In Ethiopia, no study has been conducted on this topic. Hence, these conditions have prompted us to conduct the study on the acceptance of breast milk banks for feeding infants among mothers who were attending selected public hospitals in eastern Ethiopia. For the purposes of the study, acceptance of breast milk banks was measured by the willingness of mothers to donate breast milk or to use the pasteurized donated breast milk for feeding their infant

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