Comparison of Breastfeeding and Pumping Experiences of Milk Bank Donors in the United States and United Kingdom.

Background/Objective: As human milk banking services expand, information about lifestyle characteristics and infant feeding experiences of milk bank donors is relatively limited. Our goal was to describe and compare milk bank donors' demographic, clinical, and lifestyle characteristics, and breastfeeding experiences in a variety of geographic settings. Methods: A cross-sectional online survey was conducted from August 2022 to December 2022 with approved donors from three milk banks in the United States (n = 369), and one milk bank in United Kingdom (n = 187). Results: Donors in all settings were predominantly in their early 30s, White, married, educated, and identified as female. U.K. donors reported more frequently being on maternity leave (33% versus 5%, p < 0.001), predominantly feeding directly at the breast in the first 3 months postpartum (51% versus 28%, p < 0.001), and breastfeeding a single child longer (21.2 versus 13.3 months, p < 0.001) than U.S. donors. Significantly more U.S. donors reported pumping due to work (34% versus 11%, p < 0.001) and pumping multiple times per day (57% versus 36%, p < 0.001). Most donors reported receiving information about breastfeeding from a health care provider (94% United States and 88% United Kingdom, p = 0.022), while the internet was the most popular source of information about pumping (65% United States and 64% United Kingdom, p = 0.751). Conclusion: Factors not directly related to milk banking (e.g., maternity leave, sources of breastfeeding/pumping assistance) may have an impact on how donors feed their children and ultimately on their milk donation pattern. The impact of donor characteristics and feeding practices on donation patterns warrants further investigation.

What is known about human milk bank donors around the world: a systematic scoping review.

OBJECTIVE: The WHO recommends that low birth weight infants receive donor human milk (DHM) when mother's milk is not available. Systematic reviews have been published regarding clinical outcomes of infants receiving DHM, as well as the impact of pasteurisation on the composition of DHM; however, information about milk bank donors has not been systematically assessed. DESIGN: We conducted a systematic scoping review of original research articles about milk bank donors published before August 2020. SETTING: Globally. PARTICIPANTS: Donors to milk banks. RESULTS: A total of twenty-eight studies were included across a variety of geographies: the USA (n 8), Brazil (n 7), Spain (n 4), India (n 2), and single studies in France, Norway, Poland, Italy, Taiwan, Korea and China. Study variables were grouped into six main categories: Donor Demographics (n 19), Clinical Characteristics (n 20), Donor Experiences (n 16), Donation Patterns (n 16), Lifestyle Characteristics (n 4) and Lactation/Breast-feeding History (n 8). Some demographic characteristics were commonly reported across regions, while other, including gender and race, were infrequently explored. Factors that might influence the composition of DHM, including birth timing (term or pre-term), milk type (colostrum, transition or mature) and maternal diet were not regularly studied. Other gaps in the literature included (1) donors' motivations and barriers to donation, (2) lactation and breast-feeding history, including factors that influence donors to pump and amass surplus milk, and (3) donation patterns, including whether donors are also selling milk to corporations or sharing milk with peers. CONCLUSION: What is known about milk bank donors in different geographies is often limited to a single study, with heterogeneity in the variables reported.

Method for Removing Thawed Human Milk From a Plastic Storage Bag Impacts Fat Retention.

OBJECTIVES: Determine how thaw stage and bag manipulation (folding and squeezing) influence the retention of fat and number of aerobic bacteria colony-forming units when decanting human milk (HM) from plastic storage bags. METHODS: Lactating women (n = 40) in the Greensboro, North Carolina area were recruited to provide fresh HM. Samples were equally divided and frozen in storage bags for 2 months. Two thaw stages (ice/liquid) and the use of bag manipulation (yes/no) were assessed. Fat was measured using ether extraction and bacteria were measured using plate enumeration. Paired t tests were used to compare the effects of thaw stage and bag manipulation on post-thaw fat content. Repeated measures analysis of variance was used to compare the effect of bag manipulation on pre- and post-thaw bacteria. RESULTS: Fat retention was not significantly different when thawing to liquid versus ice (mean difference = 0.10 g/dL; n = 17 paired samples; P = 0.07). Decanting with bag manipulation retained more fat than decanting without manipulation, but only when HM was thawed to liquid (mean difference = 0.13 g/dL; n = 11 paired samples; P = 0.005), not when HM was thawed to ice (P = 0.47). Bag manipulation did not increase total aerobic bacteria for either thaw stage (P = 0.49). CONCLUSIONS: Fat retention is influenced by the method of removing previously frozen HM from plastic storage bags. Folding and squeezing the storage bag when decanting HM thawed to a liquid state increases fat recovery without increasing bacterial contamination.