Perceptions and Practice on Human Breast Milk Donation and Milk Banking Amongst Antenatal Mothers at Pumwani Maternity Hospital- a Mixed Methods Study

Abstract

Background: Breast milk is the primary source of nutrition for the newborns and is important for their healthy growth and development. When the mother’s own milk is not available, WHO recommends donor human milk as the best alternative. Kenya launched the first breast milk bank at Pumwani Maternity Hospital in 2019. Premature babies, sick babies and abandoned newborns have benefitted from the initiative though its uptake remains sub-optimal. Objective: To assess the perception and practices of human breast milk donation and banking among antenatal mothers at Pumwani Maternity Hospital. Methodology: The study was descriptive cross-sectional research with a mixed methods approach. It was conducted at Pumwani Maternity Hospital among antenatal mothers attending the hospital’s antenatal clinic. A sample of 233 participants was selected using systematic random sampling for quantitative data while purposive sampling was used for qualitative data. The research utilized a structured questionnaire and 3 focused group discussions (FGDs) of about 6-8 participants to collect the quantitative and qualitative data respectively. Quantitative data was analyzed various descriptive statistics with SPSS version 25. Bivariate logistic regression analysis, at 5% significance level, was also performed to establish associations between study variables. Quantitative data results were presented in form of tables and pie charts. Qualitative data from the FGDs were analyzed using thematic data analysis with results reported verbatim. Results: Majority of the respondents were aged 21-39 years (93.1%), were married (80.4%) and had 1-3 children (95.4%). Over half (54.3%) of the mothers had never heard of mothers who donated their own milk while 75.8% said they had never seen a child or children who were fed on donated human milk. Most (57.1%) said they would be willing to donate their breast milk to a human milk bank while 65.8% indicated that they would allow their babies to be fed on donated human milk but only when necessary or unavoidable. Fear of familial diseases (β=-0.729, p = .000, OR = 0.29) and fear that their own babies won’t have enough (β=-0.636, p = .000, OR = 0.37) were the leading hindrances to the mothers’ donation and use of donated human milk while educating the mothers on significance of donated human milk (β=0.681, p = .000, OR = 2.13) was the primary factor promoting the initiative. Conclusion: There was inadequate awareness of human breast milk donation and banking among the mothers. The mothers demonstrated willingness to donate their breast milk for use by babies in need, though most were less inclined to allowing their babies to be fed with donated human milk. Some factors acted as hindrances while others were promoters of human breast milk donation and banking. Recommendation: Healthcare workers at Pumwani Maternity Hospital’s antenatal care clinics should create more awareness on human breast milk donation and human milk banking among antenatal mothers attending the clinics through educating them about this existing intervention. Efforts should be made to address hindrances to the mothers’ donation and use of the donated human breast milk