Exploring the demographic, clinical, and behavioral attributes of approved milk bank donors in the United States and United Kingdom

UNCG Author/Contributor (non-UNCG co-authors, if there are any, appear on document)
Bruna Gutierrez dos Santos (Creator)
The University of North Carolina at Greensboro (UNCG )
Web Site: http://library.uncg.edu/
Maryanne Perrin

Abstract: The World Health Organization and the American Academy of Pediatrics support that low and very-low-birth-weight infants receive pasteurized donor human milk (DHM) from established milk banks when there is limited or no access to mother’s own milk. It is estimated that over 60 countries have operating milk banks, totalizing over 700 milk banks around the world and consequently, more than 800,000 infants receiving DHM annually. Although human milk banking continues to grow around the world, information about the individuals who donate their milk is limited. It is important to note that different milk banking models may have differing influences on donors. For example, the Human Milk Banking Association of North America (HMBANA) is a non-profit organization that currently has 31-member milk banks. In 2021, they had 13,000 donors and dispensed over 9 million ounces of milk. While the main focus of this research was the United States (US), we have included the United Kingdom (UK), another high-income geography, as a comparison for our study. The United Kingdom Association for Milk Banking (UKAMB) is also a non-profit organization and currently has 15 milk bank members. In aim 1, we described and compared milk bank donors’ demographic, clinical and lifestyle characteristics, and breastfeeding experiences in the US and UK. Donors were predominantly in their early 30s, White, married, educated, and identified as female. Donors from the UK were more frequently on maternity leave than donors from the US (32.6% vs 5.4%, p<0.001). Moreover, more donors in the US reported pumping several times a day compared to donors in the UK (57% vs 36%, p<0.001). Donors in the UK reported a longer average duration of breastfeeding a single child (21.2 vs. 13.3 months, p<0.001) and lifetime milk production (30.9 vs. 19.4 months, p<0.001) compared to donors in the US. The most common primary reason reported for pumping milk among US donors was returning to work (34% vs 11%, p<0.001 in the UK). While in the UK, the most common primary reason reported was related to breastfeeding difficulties (e.g., latching issues, sick infant) (45/187, 24.0%). Donors in both settings received information/assistance from more sources related to breastfeeding than to pumping (US – 2.8 vs 2.0 sources, UK – 2.8 vs 1.8 sources). In aim 2, we described and compare enablers, barriers, and patterns of donation among milk bank donors in the US and UK. Donors in the US donated on average a higher lifetime volume of milk than UK donors (1126 vs 966 fl. oz, p=0.002). Donors in both settings often reported participating in other forms of milk exchange including peer-to-peer milk sharing (51% of US donors and 39% of UK donors). The average number of information sources donors received about milk banks was relatively small in the US and UK (1.3 vs 1.2 sources, p=0.096), where the most common source of information about milk banks was the internet/social media (US: 63% vs UK: 70%, p=0.112), followed by information from healthcare providers (US: 41% vs UK: 30%, p=0.012). The top reasons reported for donating were wanting to help others (UK 66%, US 51%) and having excess milk (UK 27%, US 43%) with statistical differences by geography (p=0.039). In terms of donation barriers, 69-79% of donors reported encountering a barrier. In aim 3, we identified factors that predict lifetime donation volume of milk bank donors in the US. Our backward elimination model started by considering 14 variables and resulted in a final six-factor model to predict lifetime milk bank donation volume of US donors (R2=0.327). The significant predictors were: number of days since approved as a donor, number of milk types donated (e.g., colostrum, mature milk), pumping frequency, milk sharing/selling practices, duration breastfeeding single child, and child’s age at first donation. In conclusion, we observed that US donors are less frequently on maternity leave than UK donors and they also started pumping breast milk earlier and more frequently. In addition, US donors donated more milk to milk banks and participated more frequently in peer-to-peer milk sharing. Both pumping frequency and milk sharing practices were identified as significant positive predictor variables of donation volumes in US donors. Factors that impact donation volume in other milk banking settings warrants further investigation.

Additional Information

Language: English
Date: 2023
Breastfeeding experiences, Donation volume, Donors characteristics, Human milk bank, Milk bank donors, Pumping practices<
Breast milk $x Collection and preservation $z United States
Breast milk $x Collection and preservation $z Great Britain

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