Factors Associated with the Use of Pasteurized Donor Milk for Healthy Newborns: Experience from the First Human Milk Bank in Vietnam

Abstract

Background: Pasteurized donor milk (PDM) is typically prescribed to preterm or low birthweight newborns when their mother’s own milk is unavailable. In surplus, PDM is prescribed to meet the nutritional needs of healthy newborns in the first few days of life. However, its overuse can undermine efforts to promote and support breastfeeding, waste resources, and reduce the availability of PDM for at-risk newborns. We conducted this study to examine factors associated with the prescription and prolonged use (>48 h) of privately purchased PDM to healthy newborns. Methods: Prospective observational study of 2440 mothers of healthy, term, and normal birthweight newborns born at Da Nang Hospital for Women and Children between April and August 2019. In addition to the descriptive analysis, we performed multiple logistic regressions to examine factors associated with the prescription of PDM (n = 2440) and prolonged PDM use among those who used PDM (n = 566). Results: Twenty-three percent (566/2440) of healthy, term, and birthweight ≥2500 g newborns received PDM and were included in the study. The prevalence of PDM use was higher for cesarean births (OR: 2.05; 95% CI: 1.66, 2.55) and among male newborns (OR: 1.33; 95% CI: 1.09, 1.62), but lower for farmers or workers (vs. other jobs; OR: 0.71; 95% CI: 0.54, 0.93), family income <10 million VND (vs. ≥10 million VND; OR: 0.67; 95% CI: 0.55, 0.82), and duration of skin-to-skin ≥90 min (vs. <90 min; OR: 0.54; 95% CI: 0.39, 0.76). Prolonged PDM use (12.4% of 566 newborns who used PDM) was associated with the mother having a higher socioeconomic status job (professional, small trader or homemaker; OR: 4.00; 95% CI: 1.39, 12.5), being a first-time mother (OR: 3.39; 95% CI: 1.92, 6.01) or having a cesarean birth (OR: 2.09; 95% CI: 1.02, 4.28). Conclusions: The prescription and prolonged use of privately purchased PDM was associated with non-medical factors unrelated to the ability to breastfeed effectively. The findings suggest the need for improved breastfeeding communication, counseling and support skills for health staff, development, and application of strict criteria on PDM use for healthy newborns and better routine monitoring of PDM use over time.

Postpartum women’s views on human milk banking in a city in Southeast China: a cross-sectional survey

“…Our findings indicated that the willingness to use DHM decreased with monthly household income in the previous year. In contrast, a study done in Vietnam showed that families with a higher income were more likely to use pasteurized DHM to feed their healthy newborns [45]. The difference might be explained by the fact that the mothers in our study were unfamiliar with human milk banks and were unsure of the safety of DHM, whereas in good economic circumstances, they would rather afford expensive but relatively safe infant food, such as formula, to feed their infants.…”

“…In our study, parity was not significantly associated with women's willingness to donate human milk. However, the results of other studies [29,45] indicated that multiparous mothers had a positive attitude toward human milk donation. A possible explanation for the difference might be that new mothers in our study, although inexperienced, learned about the benefits of human milk through breastfeeding promotion programs provided by the government and hospitals, made their own efforts to breastfeed, and supported other mothers in feeding their infants with human milk.…”

Eight-year operation status and data analysis of the first human milk bank in East China

“…The DHM in our HMB was only supplied to the neonates in our NICU and was not continued after discharge, and it was provided free of cost. This model is different from that described in previous reports from Thailand and the UK,which provide DHM for non-hospitalized infants [24,25]. During the 8-year period, 9,207 newborns received DHM, most of whom were premature infants (80.1%), and the newborns had severe infection, feeding intolerance, and necrotizing enterocolitis.…”

Determining Knowledge and Opinions of Neonatal Intensive Care Unit Nurses on Wet-Nursing and Human Milk Banks: A Cross-Sectional Study in Türkiye

“…Breastfeeding is an unequalled way of providing ideal food for the healthy growth and development of infants, and it plays a crucial role in ensuring their survival (World Health Organization [WHO], 2023). However, there are situations in which newborns cannot be breastfed for reasons that include illness, maternal death, lack of social support, an underdeveloped sucking reflex, low birth weight, premature birth, low lactation capacity, or separation of the mother and infant (Tran et al, 2021; Zhang et al, 2022). In such cases, the WHO (2022) recommends alternative feeding methods such as using donor milk, formula, or artificial feeding when breastfeeding is not possible or contraindicated.…”