Infant Feeding Practices Among a U.S. Network of Milk-Sharing Parents

Objectives Over the past decade, peer-to-peer human milk sharing (PHMS) as an infant feeding strategy has been growing in popularity. Given the emergent nature of modern PHMS, little is known about the infant feeding practices (IFP) of parents who engage in PHMS. The objective of this study was to characterize the IFP among a network of PHMS families and identify differences in IFP by recipient/donor status. Methods A cross-sectional survey was circulated among a network of PHMS families in the Washington, DC region. Eligible participants completed a detailed online survey about their milk sharing experiences and IFP. Bivariate analyses of IFP were conducted by PHMS status. To assess for differences in IFP by PHMS status, independent t and chi-square tests were used for continuous and categorical variables, respectively. Results Among a sample of 168 PHMS parents, 58% were donors and 42% were recipients. Compared to recipients, donors had a longer mean duration of most recent lactation (17.4 vs. 12.3 months; p < 0.005). During the first 3 months of their children's lives, recipients were more likely than donors to have fed them commercial infant formula (41.4% vs. 23.5%; p < 0.05) and banked donor milk (15.7% vs. 1%; p < 0.005). Donors were more likely than recipients to report ever having produced more milk than needed by their children (91.8% vs. 28.6%; p < 0.001), and less likely to report ever having difficulty producing enough milk for their children (20.4% vs. 77.1%; p < 0.001). Over a quarter of participants had ever exclusively pumped to feed their children, with no difference by PHMS status. While milk sharing, 86% of recipient infants were still consuming their mother's own milk and 58% were still feeding at their mother's breast. Conclusions This descriptive analysis demonstrates that PHMS participants are achieving a high duration of human-milk-feeding, far above the U.S. average. Lactation duration and breastfeeding experience between donors and recipients differed in predictable ways. Exclusive pumping was a common IFP among this sample of PHMS parents. Recipients in this sample were largely using PHMS as a strategy to supplement the mother's own milk. Additional research is needed to understand how PHMS is being practiced and to identify infant health and growth outcomes associated with PHMS. Funding Sources NIH Training Grant T32 HD087137.