Mondkar Jayashree, Chugh Sachdeva Ruchika, Shanbhag Sunita, Khan Aisha, Manuhar Sinha Minu, Dasgupta Rajib, Israel-Ballard Kiersten, Sabharwal Vandana
1 Department of Neonatology, Lokmanya Tilak Municipal Medical College and Lokmanya Tilak Municipal General Hospital, Sion, Mumbai, India.
2 Department of Maternal, Newborn, Child Health and Nutrition, PATH, New Delhi, India.
Breastfeed Med. 2018 Dec;13(10):694-701. doi: 10.1089/bfm.2018.0103. Epub 2018 Oct 31.
Scaling-up human milk banks (HMBs) is a promising solution for saving vulnerable newborns. Exploring perceptions and practices on donor human milk (DHM) and HMBs is essential to strengthen and scale-up an integrated HMB system resting on a model called the "Mother Baby Friendly Initiative Plus" (MBFI+), which includes promoting breastfeeding, encouraging kangaroo mother care, and providing safe DHM to vulnerable babies without access to mother's own milk.
A qualitative research was conducted among 56 service recipients including mothers and key influencers and 9 service providers to understand their perceptions and practices on DHM and HMBs.
Service providers opined that DHM is safe and lifesaving for vulnerable babies. Challenges shared were limited supply of DHM because of low awareness on milk donation, shortage of trained staff, and risk of milk contamination. They stated that although most mothers were comfortable in donating milk, few were reluctant to donate milk as they feared shortage of milk for their own babies, or milk expression may cause weakness. Recipient mothers accepted use of DHM as per facility norms but had concerns about donor mothers' health and hygiene and measures for ensuring milk safety. Most grandmothers were resistant toward donating or receiving DHM for their grandchildren. Many fathers were comfortable with donating once they knew it is lifesaving and did not compromise supply for their babies. Service providers shared opportunities for scale-up, like improving awareness and infrastructure, lactation counseling by skilled personnel, supportive hospital environment, and establishing HMBs in every city and district.
Human milk banking should be strengthened as part of the MBFI+ model. For this, behavior change communication targeted at mothers and influencers about breastfeeding and HMB from the antenatal period, capacity-building among service providers, and government ownership is necessary.
扩大母乳库规模是拯救脆弱新生儿的一项很有前景的解决办法。探究对捐赠母乳及母乳库的看法和做法，对于加强和扩大基于“母婴友好倡议升级版”（MBFI+）模式的综合母乳库系统至关重要，该模式包括促进母乳喂养、鼓励袋鼠式护理，以及为无法获得母亲自身母乳的脆弱婴儿提供安全的捐赠母乳。
对56名服务对象（包括母亲和关键影响者）以及9名服务提供者进行了定性研究，以了解他们对捐赠母乳及母乳库的看法和做法。
服务提供者认为捐赠母乳对脆弱婴儿来说是安全且能救命的。他们提到的挑战包括：由于对母乳捐赠的认识不足，捐赠母乳供应有限；训练有素的工作人员短缺；以及母乳受污染的风险。他们表示，虽然大多数母亲愿意捐赠母乳，但也有少数母亲因担心自己孩子的母乳不足，或者挤奶可能导致身体虚弱而不愿捐赠。接受服务的母亲按照机构规范接受使用捐赠母乳，但担心捐赠母亲的健康和卫生状况以及确保母乳安全的措施。大多数祖母反对为孙辈捐赠或接受捐赠母乳。许多父亲在知道捐赠母乳能救命且不会影响自己孩子的母乳供应后，愿意捐赠。服务提供者分享了扩大规模的机会，比如提高认识和改善基础设施、由专业人员提供泌乳咨询、营造支持性的医院环境，以及在每个市和区建立母乳库。
应加强母乳库建设，将其作为MBFI+模式的一部分。为此，有必要从孕期开始针对母亲和影响者开展关于母乳喂养和母乳库的行为改变宣传、对服务提供者进行能力建设，并争取政府的支持。
