Family, Child, Adolescent Health (Includes Maternal & Child Health)
Mother-to-mother milk sharing among breastfeeding women with low milk supply
(School of Public Health (UMD) Family Science/Maternal and Child Health Doctoral Student)
Background: Mother-to-mother milk sharing, though controversial for social and medical reasons, is increasing among breastfeeding mothers with lactation insufficiency who must either supplement their own breastfeeding or replace it with a nutritionally appropriate substitute. Even as the World Health Organization deems "breast milk from a healthy wet nurse" superior to breastmilk substitutes (formula) in these cases, little information exists about milk recipients and the factors that motivate them to choose another mother's milk over commercially-prepared products. This study compares the experiences of women with lactation insufficiency who supplement with donor milk to those who use other breastmilk substitutes. Methods: Breastfeeding mothers with lactation insufficiency were recruited via social media platforms (blogs, discussion forums, Facebook, Twitter) where such mothers virtually convene for information and support) to complete an online questionnaire. Questionnaires were completed between February and December 2013. Closed and open-ended questions focused on the mothers' experiences in attempting to exclusively breastfeed their infants. Results: Approximately 500 women with lactation insufficiency during the first 6 months postpartum were sampled. Nearly 1/3 of mothers reported using some donor milk acquired via mother-to-mother sharing. Mothers who used another mother's breastmilk were more likely to be influenced by concerns about the healthfulness of their choice and the risks associated with alternatives (p < .001) and mothers who used breastmilk substitutes reported pediatrician advice, lack of awareness about alternatives to formula use (p < .001) and that other families made similar choices (p < .05) as influential to their choice. Those who used donor breastmilk were more likely to be satisfied with their supplement choice (p < .001) and were less likely to be unsatisfied with their overall breastfeeding experience (p < .05). Conclusion: Understanding the factors that underlie women's decision-making in selecting milk supplementation can assist healthcare practitioners and public health professionals to more effectively target their education and counseling regarding supplementation for women with lactation insufficiency.