新西兰的正规和非正规人乳捐赠：一项混合方法的全国性调查。

Formal and informal human milk donation in New Zealand: a mixed-method national survey.

机构信息

Liggins Institute, University of Auckland, Auckland, New Zealand.

出版信息

Int Breastfeed J. 2024 Sep 2;19(1):61. doi: 10.1186/s13006-024-00667-4.

DOI:10.1186/s13006-024-00667-4

PMID:39223587

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11370131/

Abstract

BACKGROUND

Mother's milk provides optimal nutrition for infants. Donor human milk (DHM) is recommended for low birthweight infants when mother's milk is unavailable. Little is known about human milk (HM) donation practices in New Zealand (NZ), where few HM banks are available. This study aimed to investigate parents' and health professionals' (HP) experiences with formal and informal HM donation in NZ.

METHODS

Two electronic surveys were disseminated in 2022 to parents and HPs involved with HM donation in NZ. The surveys covered respondents' views and experiences with HM donation. HPs were also asked about HM donation practices in their workplace. Chi-squared and Fisher-Freeman-Halton exact tests were used for quantitative analysis and qualitative data were thematically analysed using inductive approach.

RESULTS

A total of 232 HP and 496 parents completed the surveys. Most parents either donated (52%) or sought DHM (26%) for their infant and most donations were informal, arranged between individuals (52%) or through hospital staff (22%). HP reported DHM was used in 86% of facilities, with only 20% of donations facilitated by HM banks. Almost half (48%) of HP stated they would like to use DHM in their workplace but access was limited. The most common screening processes undertaken by parents and HP before informal HM donation were lifestyle including smoking status, medication, drug and alcohol intake (44% and 36%, respectively) and serological screening such as CMV, HIV, Hepatitis C or B (30% and 39%, respectively). Pasteurisation of DHM obtained informally was not common. Most donors were satisfied with their HM donation experiences (informal and/or formal, 91%) and most respondents supported use of DHM in hospitals and community. Participants reported HM donation could be improved (e.g., better access) and identified potential benefits (e.g., species-specific nutrition) and risks (e.g., pathogens) for the infant. Potential benefits for the donor were also identified (e.g., altruism), but respondents acknowledged potential negative impacts (e.g., cost).

CONCLUSION

Informal HM donation in NZ is common. Most parents and HP support the use of DHM; however, improvements to current practices are needed to ensure safer and more equitable access to DHM.

摘要

背景

母乳为婴儿提供最佳营养。当母乳无法获得时，推荐使用捐赠人母乳（DHM）。新西兰（NZ）的母乳（HM）捐赠实践鲜为人知，那里只有少数母乳库。本研究旨在调查父母和医疗保健专业人员（HP）在 NZ 参与正式和非正式 HM 捐赠的经验。

方法

2022 年向参与 NZ HM 捐赠的父母和 HP 分发了两份电子调查。这些调查涵盖了受访者对 HM 捐赠的看法和经验。HP 还被问及他们工作场所的 HM 捐赠实践。使用卡方和 Fisher-Freeman-Halton 精确检验进行定量分析，使用归纳方法对定性数据进行主题分析。

结果

共有 232 名 HP 和 496 名父母完成了调查。大多数父母要么为他们的婴儿捐赠（52%）要么寻求 DHM（26%），大多数捐赠都是非正式的，是个人之间（52%）或通过医院工作人员（22%）安排的。HP 报告说，86%的设施都使用了 DHM，只有 20%的捐赠是由母乳库促成的。近一半（48%）的 HP 表示他们希望在工作场所使用 DHM，但获得的途径有限。父母和 HP 在进行非正式 HM 捐赠之前进行的最常见的筛选过程是生活方式，包括吸烟状况、用药、药物和酒精摄入（分别为 44%和 36%）和血清学筛查，如 CMV、HIV、丙型或乙型肝炎（分别为 30%和 39%）。非正式获得的 DHM 的巴氏消毒并不常见。大多数捐赠者对他们的 HM 捐赠体验（正式和/或非正式）感到满意（91%），大多数受访者支持在医院和社区使用 DHM。参与者报告说，HM 捐赠可以改进（例如，更好的获取途径），并确定了对婴儿的潜在益处（例如，特定物种的营养）和风险（例如，病原体）。还确定了捐赠者的潜在益处（例如，利他主义），但受访者承认可能存在负面影响（例如，成本）。