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Understanding Barriers and Facilitators for Human Milk Banking Among Service Providers, Mothers, and Influencers of Preterm and Sick Neonates Admitted at Two Health Facilities in a Metropolitan City in India.
Breastfeed Med. 2018 12; 13(10):694-701.BM

Abstract

BACKGROUND

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.

MATERIALS AND METHODS

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.

RESULTS

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.

CONCLUSIONS

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.

Authors+Show Affiliations

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.3 Department of Neonatology, MBFI+ project, Lokmanya Tilak Municipal Medical College and Lokmanya Tilak Municipal General Hospital, Sion, Mumbai, India.3 Department of Neonatology, MBFI+ project, Lokmanya Tilak Municipal Medical College and Lokmanya Tilak Municipal General Hospital, Sion, Mumbai, India.3 Department of Neonatology, MBFI+ project, Lokmanya Tilak Municipal Medical College and Lokmanya Tilak Municipal General Hospital, Sion, Mumbai, India.4 Department of Community Health, Jawaharlal Nehru University, New Delhi, India.5 Department of Maternal, Newborn, Child Health and Nutrition, PATH, Seattle, WA.6 Department of Food and Nutrition, University of Delhi, New Delhi, India.

Pub Type(s)

Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

30383389

Citation

Mondkar, Jayashree, et al. "Understanding Barriers and Facilitators for Human Milk Banking Among Service Providers, Mothers, and Influencers of Preterm and Sick Neonates Admitted at Two Health Facilities in a Metropolitan City in India." Breastfeeding Medicine : the Official Journal of the Academy of Breastfeeding Medicine, vol. 13, no. 10, 2018, pp. 694-701.
Mondkar J, Chugh Sachdeva R, Shanbhag S, et al. Understanding Barriers and Facilitators for Human Milk Banking Among Service Providers, Mothers, and Influencers of Preterm and Sick Neonates Admitted at Two Health Facilities in a Metropolitan City in India. Breastfeed Med. 2018;13(10):694-701.
Mondkar, J., Chugh Sachdeva, R., Shanbhag, S., Khan, A., Manuhar Sinha, M., Dasgupta, R., Israel-Ballard, K., & Sabharwal, V. (2018). Understanding Barriers and Facilitators for Human Milk Banking Among Service Providers, Mothers, and Influencers of Preterm and Sick Neonates Admitted at Two Health Facilities in a Metropolitan City in India. Breastfeeding Medicine : the Official Journal of the Academy of Breastfeeding Medicine, 13(10), 694-701. https://doi.org/10.1089/bfm.2018.0103
Mondkar J, et al. Understanding Barriers and Facilitators for Human Milk Banking Among Service Providers, Mothers, and Influencers of Preterm and Sick Neonates Admitted at Two Health Facilities in a Metropolitan City in India. Breastfeed Med. 2018;13(10):694-701. PubMed PMID: 30383389.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Understanding Barriers and Facilitators for Human Milk Banking Among Service Providers, Mothers, and Influencers of Preterm and Sick Neonates Admitted at Two Health Facilities in a Metropolitan City in India. AU - Mondkar,Jayashree, AU - Chugh Sachdeva,Ruchika, AU - Shanbhag,Sunita, AU - Khan,Aisha, AU - Manuhar Sinha,Minu, AU - Dasgupta,Rajib, AU - Israel-Ballard,Kiersten, AU - Sabharwal,Vandana, Y1 - 2018/10/31/ PY - 2018/11/2/pubmed PY - 2019/4/30/medline PY - 2018/11/2/entrez KW - MBFI KW - Mother Baby Friendly Initiative model KW - breastfeeding KW - comprehensive lactation management center KW - donor human milk KW - human milk banking KW - low birth weight KW - preterm KW - qualitative research SP - 694 EP - 701 JF - Breastfeeding medicine : the official journal of the Academy of Breastfeeding Medicine JO - Breastfeed Med VL - 13 IS - 10 N2 - BACKGROUND: 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. MATERIALS AND METHODS: 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. RESULTS: 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. CONCLUSIONS: 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. SN - 1556-8342 UR - https://www.unboundmedicine.com/medline/citation/30383389/Understanding_Barriers_and_Facilitators_for_Human_Milk_Banking_Among_Service_Providers_Mothers_and_Influencers_of_Preterm_and_Sick_Neonates_Admitted_at_Two_Health_Facilities_in_a_Metropolitan_City_in_India_ DB - PRIME DP - Unbound Medicine ER -