Determinants of Breast Milk Donation and Use among Postpartum Women at a City Hospital in Nairobi, Kenya

Authors

  • Jane Wanjiku Kanyi Department of Community Health, Amref International University, Kenya
  • Alice Sipiyian Lakati Department of Community Health, Amref International University, Kenya
  • Theresa Odero Department of Community Health, Amref International University, Kenya

DOI:

https://doi.org/10.26911/jepublichealth.2025.10.05.09

Abstract

Background: The World Health Organization advocates donor human milk as a superior substitute for newborns unable to obtain their mother’s milk. Calls have been made to scale up human milk banks to provide infants without access to mother’s milk safe donor human milk. This research sought to assess determinants of breast milk donation and the use of donor human milk among postpartum women.
Subjects and Method: This cross-sectional study was conducted in May 2023 at a government hospital with human milk banking facilities. A consecutive sampling technique was used to recruit a sample of 370 postpartum women admitted to the postnatal wards. A pretested interview-based questionnaire was used to obtain participants’ sociodemographic data, breastfeeding history, peri-natal characteristics, awareness of human milk banking, and other general factors that might influence acceptance to donate breast milk and the use of donated human milk. Data was analyzed using R-4.3.0 software and descriptive statistics were done for all variables. Further inferential statistics including the Chi-Square test and multivariate logistics regression were computed with a significance level set at α=0.050.
Results: The mother’s willingness to donate breast milk and use donor human milk was 78.1% and 70.8% respectively. The respondent’s age (OR=0.42; 95% CI=0.19 to 0.94; p=0.035) was significantly associated with willingness to donate breast milk. Religion (OR=0.27; 95% CI=0.10 to 0.72; p =0.009) and awareness of human milk banking (OR=0.89; 95%CI= 1.07 to 3.36; p= 0.029) were significant predictors of willingness to use donor human milk.
Conclusion: Human milk banking awareness was low among the study population; however, mothers are willing to donate and use donated breast milk. Age in years is significantly associated with willingness to donate while religion and awareness of human milk banking are significant predictors of use.

Keywords:

Human milk bank, donor human milk,, breastfeeding, breast milk

Correspondence

Jane Wanjiku Kanyi, Department of Community Health, Amref International University, P.O Box 27691 – 00506, Nairobi, Kenya. Email address: kanyijane23@gmail.com.

References

Abhulimhen-Iyoha B, Okonkwo I, Ideh R, Okolo A (2015). Mothers’ perception of the use of banked human milk for feeding the infants. Niger J Paediatr. 42(3):223–227. doi: 10.4314/njp.v42i3.10.

Altobelli E, Angeletti PM, Verrotti A, Petrocelli R (2020). The impact of human milk on necrotizing entero-colitis: A systematic review and meta-analysis. Nutrients. 12(5): 1–13. doi: 10.3390/nu12051322.

Amundson K, Sachdeva R, Quynh NN, Muiruri J, Israel‐Ballard K (2017). Ensuring All Infants Have Access to Human Milk: A Systematic Approach for Establishing Sustainable and Integrated Human Milk Banking Programs. FASEB J. 31(1): 431. doi: 10.1096/fasebj.31.1_supplement.lb431.

Azema E, Callahan S (2003). Breast milk donors in France: A portrait of the typical donor and the utility of milk banking in the French breastfeeding context. J Hum Lact. 19(2): 199–202. doi: 10.1177/0890334403252476.

Bhoola P, Biggs C (2021). Factors Affecting the Decision of Postnatal Mothers to Donate Milk at a Government Satellite Human Milk Bank Site, in KwaZulu Natal, South Africa. J Hum Lact. 37(1): 95–104. doi: 10.1177/0890334420982915.

Couto GR, Dias V, Oliveira I de J (2020). Benefits of exclusive breastfeeding: An integrative review. Nurs Pract Today. 7(4): 245–254. doi:10.18502/npt.v7i4.4034.

Coutsoudis I, Petrites A, Coutsoudis A (2011). Acceptability of donated breast milk in a resource-limited South African setting. Int Breastfeed J. 6: 1–10. doi: 10.1186/1746-4358-6-3.

Darmstadt GL, Al Jaifi NH, Arif S, Bahl R, Blennow M, Cavallera V, Chou D et al. (2023). New World Health Organization recommendations for care of preterm or low birth weight infants: health policy. eClinicalMedicine. 63: 1–13. doi: 10.1016/j.eclinm.2023.102155.

De Nisi G, Moro GE, Arslanoglu S, Ambruzzi AM, Biasini A, Profeti C (2015). Survey of Italian Human Milk Banks. J Hum Lact. 31(2): 294–300.

Demarchis A, Israel-Ballard K, Mansen KA, Engmann C (2017). Establishing an integrated human milk banking appro-ach to strengthen newborn care. J Perinatol. 37(5): 469–474. doi: 10.1038/jp.2016.198.

Ekşioğlu A, Yeşil Y, Turfan EÇ (2015). Mothers’ views of milk banking: Sample of İzmir. Turk Pediatr Ars. 50(2): 83–89. doi: 10.5152/tpa.2015.2406.

Gelano TF, Bacha YD, Assefa N, Motumma A, Roba AA, Ayele Y, Tsige F (2018). Acceptability of donor breast milk banking, its use for feeding infants, and associated factors among mothers in eastern Ethiopia. Int Breastfeed J. 13(1):1–10. doi: 10.1186/s13006-018-0163-z.

Goodfellow HE, Reimers P, Israel-Ballard K, Coutsoudis A (2016). Perceptions of community-based human milk banks before and after training in a resource-limited South African setting. SAJCH South African J Child Heal. 10(1): 83–86. doi: 10.7196/SAJCH.2016.v10i1.1103.

Gürol A, Özkan H, Çelebioǧlu A (2014). Turkish women’s knowledge and views regarding mother’s milk banking. Collegian. 21(3): 239–244. doi: 10.1016/J.COLEGN.2013.05.002.

Hartmann BT, Pang WW, Keil AD, Hartmann PE, Simmer K (2007). Best practice guidelines for the operation of a donor human milk bank in an Australian NICU. Early Human Development. 83(10): 667–673). doi: 10.1016/j.earlhumdev.2007.07.012.

Ighogboja IS, Olarewaju RS, Odumodu CU, Okuonghae HO (1995). Mothers’ attitudes towards donated breastmilk in Jos, Nigeria. J Hum Lact. 11(2): 93–96). doi: 10.1177/089033449501100211.

Iloh KK, Osuorah CDI, Ndu IK, Asinobi IN, Obumneme-Anyim IN, Ezeudu CE, Oluchi UM, et al. (2018). Perception of donor breast milk and determinants of its acceptability among mothers in a developing community: A cross-sectio-nal multi-center study in south-east Nigeria. Int Breastfeed J. 13(1): 1–12. doi: 10.1186/s13006-018-0189-2.

Kim JH, Unger S, Canadian Paediatric Society, Nutrition and Gastroenterology Committee (2010). Human milk banking. Paediatr Child Health. 15(9): 595–598. doi: 10.1093/pch/15.9.595.

Kimani-Murage EW, Wanjohi MN, Kamande EW, Macharia TN, Mwaniki E, Zerfu T, Ziraba A et al. (2019). Perceptions on donated human milk and human milk banking in Nairobi, Kenya. Matern Child Nutr. 15(4): 1–11. doi: 10.1111/mcn.12842.

Mackenzie C, Javanparast S, Newman L (2013). Mothers’ knowledge of and attitudes toward human milk banking in South Australia: A qualitative study. J Hum Lact. 29 (2): 222–229. doi: 10.1177/0890334413481106.

McCloskey RJ, Karandikar S (2018). A Liberation Health Approach to Examining Challenges and Facilitators of Peer-to-Peer Human Milk Sharing. J Hum Lact. 34(3): 438–447. doi: 10.1177/0890334418771301.

Melwani V, Sethia S, Bansal M, Khan A, Melwani S, Priya A (2018). A study on acceptance to voluntarily participate in breast milk bank activities amongst antenatal and postnatal women in three hospitals of Bhopal. Natl J Community Med. 9(6): 411–414.

Namuddu MG, Kiguli J, Nakibuuka V, Nantale R, Mukunya D (2023). Acceptability of donated breast milk among pregnant women in selected hospitals in central Uganda: a cross-sectional study. Int Breastfeed J. 18(1):1–11. doi: 10.1186/s13006-023-00569-x.

NICE (2010). Quick reference guide. Donor breast milk banks. The operation of donor breast milk bank services. NICE Clinical Guideline, February 1–15.

Pal A, Soontarapornchai K, Noble L, Hand I (2019). Attitudes towards Donor Breast Milk in an Inner City Population. Int J Pediatr. doi: 10.1155/2019/3847283.

Parker MGK, Barrero-Castillero A, Corwin BK, Kavanagh PL, Belfort MB, Wang CJ (2013). Pasteurized Human Donor Milk Use among US Level 3 Neonatal Intensive Care Units. J Hum Lact. 29(3):381-389. doi:10.1177/0890334413492909.

Rosa-Mangeret F, Benski AC, Golaz A, Zala PZ, Kyokan M, Wagner N, Muhe LM et al.(2022). 2.5 Million Annual Deaths—Are Neonates in Low-and Middle-Income Countries Too Small to Be Seen? A Bottom-Up Overview on Neonatal Morbi-Mortality. Trop Med Infect Dis. 7(5): 1–21. doi:10.3390/tropicalmed7050064.

Sánchez C, Franco L, Regal P, Lamas A, Cepeda A, Fente C (2021). Breast milk: A source of functional compounds with potential application in nutrition and therapy. Nutrients. 13(3): 1–34. doi: 10.3390/nu13031026.

Shenker N, Aprigio J, Arslanoglu S, Aye NSS, Bærug A, Bar Yam N, Barnett D et al. (2020). Maintaining safety and service provision in human milk banking: a call to action in response to the COVID-19 pandemic. Lancet Child Adolesc Heal. 4(7): 484–485. doi: 10.1016/S2352-4642(20)30134-6.

Tian C, Li Y, Soowon L, Xu Y, Zhu Q, Zhao H (2021). Lactating Women’s Knowledge and Attitudes About Donor Human Milk in China. J Hum Lact. 37(1): 52–61. doi: 10.1177/0890334420939057.

Tu H, Li P, Zhu L, Quan X, Fan S, Wang Z (2022). Postpartum women’s views on human milk banking in a city in Southeast China: a cross-sectional survey. Int Breastfeed J. 17(1): 1–12. doi: 10.1186/s13006-021-00443-8.

Victora CG, Bahl R, Barros AJD, França GVA, Horton S, Krasevec J, Murch S et al. (2016). Breastfeeding in the 21st century: Epidemiology, mechanisms, and lifelong effect. The Lancet. 387 (10017):475–490. doi: 10.1016/S0140-6736(15)01024-7.

Virano A, Coscia A, Tonetto P, Perathoner C, Bertino E, Gardois P, Moro GE (2017). Human Milk Donation in Northern Italy: Barriers, Facilitators and Information Sources. World J Res Rev. 4(5): 64–70.

WHO (2003). Global Strategy for Infant and Young Child Feeding. World Health Organization .

World Health Organization (2011). Guide-lines on optimal feeding of low birth-weight infants in low-and middle-in-come countries. Geneva WHO .

Wu H, Clark H (2016). The sustainable development goals: 17 goals to transform our world. Furthering the Work of the United Nations [Internet]. 36-54. Available from: https://www.unilibrary.org/content/books/9789210583237s002c002.

You D, Hug L, Ejdemyr S, Idele P, Hogan D, Mathers C, Gerland P, et al. (2015). Global, regional, and national levels and trends in under-5 mortality between 1990 and 2015, with scenario-based projections to 2030: A systematic analysis by the UN Inter-Agency Group for Child Mortality Estimation. Lancet. 386(10010). doi: 10.1016/S0140-6736(15)00120-8.

Zhang N, Li JY, Liu XW, Jiang YL, Redding SR, Ouyang YQ (2020). Factors associated with postpartum women’s knowledge, attitude and practice regarding human milk banks and milk donation: A cross-sectional survey. Midwifery. 91(102837). doi:10.1016/j.midw.2020.102837.

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Published
2025-01-16

Issue
Vol. 10 No. 1 (2025)

Section
flow-chart-line Articles

How to Cite
Kanyi, J. W., Lakati, A. S., & Odero, T. (2025). Determinants of Breast Milk Donation and Use among Postpartum Women at a City Hospital in Nairobi, Kenya. Journal of Epidemiology and Public Health, 10(1), 91–105. https://doi.org/10.26911/jepublichealth.2025.10.05.09