An Alternative to Mother’s Own Milk: Maternal Awareness of Donor Human Milk and Milk Banks

2020 ◽  
pp. 089033442093954
Author(s):  
Lindsay Ellsworth ◽  
Julie Sturza ◽  
Kate Stanley
Keyword(s):  
Human Milk ◽  
Survey Design ◽  
The United States ◽  
Medical Providers ◽  
Cross Sectional ◽  
Maternal Experience ◽  
Donor Human Milk ◽  
Hypothetical Scenario ◽  
Milk Banks ◽  
Mother’S Own Milk

Background The use of donor human milk is rising. Maternal awareness of donor human milk use, milk donation, and milk banks has not been well described in the United States. Research Aims To explore maternal experience, knowledge, and attitudes regarding donor human milk use and milk donation. We also assessed counseling by medical providers about donor human milk use and donation. Methods A cross-sectional prospective survey design was used in this study. We anonymously surveyed mothers ( N = 73) attending the 1 to 2-week well newborn appointment. Analyses were completed using one-way ANOVA and logistic regression. Results Participants’ infants primarily received their own mother’s milk (87%, n = 61). No infants received donor human milk, but 4% ( n = 3) of participants donated milk. The majority of participants had positive responses to attitudinal statements about donor milk. When presented with a hypothetical scenario, participants chose formula (89%, n = 59) over donor human milk (11%, n = 7) for their infant. Moreover, if donor human milk was the only option available, they chose donor human milk from a relative or friend (60%, n = 40) over a milk bank (40%, n = 26). Medical providers had discussed donor human milk use or donation with 4% ( n = 3) of participants. Conclusions The majority of participants previously had minimal experience using donor human milk and limited knowledge regarding donor human milk and milk banks. According to participants, medical providers did not routinely discuss milk donation and the role of donor human milk with families.

scholarly journals SARS-CoV-2 in human milk is inactivated by Holder pasteurization but not cold storage

2020 ◽  
Author(s):  
Gregory J. Walker ◽  
Vanessa Clifford ◽  
Nidhi Bansal ◽  
Alberto Ospina Stella ◽  
Stuart Turville ◽  
...  
Keyword(s):  
Viral Load ◽  
Human Milk ◽  
Cold Storage ◽  
Control Medium ◽  
Live Virus ◽  
Donor Human Milk ◽  
Milk Bank ◽  
The Stability ◽  
Milk Banks ◽  
Mother’S Own Milk

ABSTRACTAs the COVID-19 pandemic evolves, human milk banks worldwide continue to provide donor human milk to vulnerable infants who lack access to mother’s own milk. Under these circumstances, ensuring the safety of donor human milk is paramount, as the risk of vertical transmission of SARS-CoV-2 is not well understood. Here, we investigate the inactivation of SARS-CoV-2 in human milk by pasteurisation, and the stability of SARS-CoV-2 in human milk under cold storage (freezing or refrigeration). Following heating to 63°C or 56°C for 30 minutes, SARS-CoV-2 replication competent (i.e. live) virus was undetected in both human milk and the control medium. Cold storage of SARS-CoV-2 in human milk (either at 4°C or - 30°C) did not significantly impact infectious viral load over a 48 hour period. Our findings demonstrate that SARS-CoV-2 can be effectively inactivated by Holder pasteurisation, and confirm that existing milk bank processes will effectively mitigate the risk of transmission of SARS-COV-2 to vulnerable infants through pasteurised donor human milk.

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

2022 ◽  
Vol 17 (1) ◽  
Author(s):  
Haixia Tu ◽  
Ping Li ◽  
Lianlian Zhu ◽  
Xiaozhen Quan ◽  
Shuli Fan ◽  
...  
Keyword(s):  
Human Milk ◽  
Multivariable Logistic Regression Analysis ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Southeast China ◽  
Donor Human Milk ◽  
Willingness To Donate ◽  
Human Milk Banking ◽  
Milk Banking ◽  
Milk Banks

Abstract Background Donor human milk is the best alternative for preterm infants when their mother’s own milk is insufficient or unavailable. The development of human milk banks in China started late, and in most of these banks, the amount of donor human milk is insufficient for clinical demand. Moreover, many mothers are reluctant to use donor human milk due to safety concerns. It is important to understand the potential supply and demand of donor human milk before establishing a new human milk bank. This study aimed to understand women’s acceptance of human milk banking in Wenzhou, southeastern China. Methods A cross-sectional study was conducted in three community health centers in Wenzhou, southeast China, in December 2020. Data were collected from 305 postpartum women selected through convenience sampling. Sociodemographic, perinatal and breastfeeding characteristics, awareness and knowledge of human milk banking and willingness to donate human milk, and to accept donor human milk were assessed. Multivariable logistic regression analysis was used to explore independent predictors of willingness to donate human milk and to accept donor human milk. Results Only 17% (52/305) of our participants had heard of human milk banking prior to this survey. The prevalence of willingness to donate human milk and use donor human milk in our study was 73.4% (224/305) and 44.6% (136/305), respectively. Employment (adjusted odds ratio [AOR] 2.30; 95% confidence interval [CI] 1.17, 4.50) and human milk banking knowledge (AOR 1.23; 95% CI 1.12, 1.35) were independent predictors of willingness to donate human milk. Monthly household income in the previous year (AOR 2.18; 95% CI 1.17, 4.06), awareness of human milk banking (AOR 2.41; 95% CI 1.24, 4.67) and knowledge of human milk banking (AOR 1.22; 95% CI 1.11, 1.35) were significantly associated with willingness to accept donor human milk. Conclusions In our study, awareness of human milk banks among women in the first year postpartum was low. More mothers were willing to donate human milk than to use donor human milk to feed their children. In our study, knowledge of human milk banking was a predictor of both willingness to donate human milk and willingness to use donor human milk. Programs with detailed information on human milk banking are needed to help mothers improve their knowledge and increase acceptance of human milk banking.

Factors Affecting the Decision of Postnatal Mothers to Donate Milk at a Government Satellite Human Milk Bank Site, in KwaZulu Natal, South Africa

2020 ◽  
pp. 089033442098291
Author(s):  
Priya Bhoola ◽  
Chara Biggs
Keyword(s):  
Human Milk ◽  
Prior Knowledge ◽  
Sample Population ◽  
Potential Donor ◽  
Cross Sectional ◽  
Black African ◽  
Factors Affecting ◽  
Donor Human Milk ◽  
Willingness To Donate ◽  
Milk Banks

Background The need for donor human milk has accelerated both locally and globally. To remain sustainable, human milk banks need to maintain effective recruitment including frequent donations of adequate volumes. Research aims To determine (1) which factors influenced mothers’ willingness to give or receive donor human milk, and the influence of (2) socio-demographics, (3) pregnancy, (4) breastfeeding history, (5) prior knowledge of human milk banks, and (6) general factors on milk donations. Methods This was a cross-sectional, prospective, descriptive study. Interviewer administered questionnaires were used ( N = 148). Independent sample t-tests and one-sample t-tests were used to determining differences in variables. Results The sample population consisted of mainly single ( n = 104, 70.3%) Black African mothers ( n = 127, 85.8%) who identified as Christian ( n = 97, 65.6%) with a mean age of 24.8 ( SD = 5.63) years. The majority ( n = 120, 81.1%) had no prior knowledge of human milk banks; however, most ( n = 78, 52.7%) were significantly likely to donate. The main factors that influenced the participants’ willingness to donate were altruism ( n = 99, 66.9%), information provided by staff at hospitals/clinics ( n = 92, 62.2%), amount of milk produced ( n = 69, 46.4%), fear of not having enough milk for their own infant ( n = 68, 45.9%), and support from family/friends/partner ( n = 67, 45.3%). Conclusion There is a strong need to increase visibility and information sharing with potential donor mothers to ensure a sustainable supply and system of human milk banks.

scholarly journals High-Temperature Short-Time and Holder Pasteurization of Donor Milk: Impact on Milk Composition

Life ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. 114
Author(s):  
Diana Escuder-Vieco ◽  
Juan M. Rodríguez ◽  
Irene Espinosa-Martos ◽  
Nieves Corzo ◽  
Antonia Montilla ◽  
...  
Keyword(s):  
High Temperature ◽  
Human Milk ◽  
Milk Composition ◽  
Donor Human Milk ◽  
High Temperature Short Time ◽  
Lactose Concentration ◽  
C 30 ◽  
Milk Banks ◽  
Short Time

Holder pasteurization (HoP; 62.5 °C, 30 min) is commonly used to ensure the microbiological safety of donor human milk (DHM) but diminishes its nutritional properties. A high-temperature short-time (HTST) system was designed as an alternative for human milk banks. The objective of this study was to evaluate the effect of this HTST system on different nutrients and the bile salt stimulated lipase (BSSL) activity of DHM. DHM was processed in the HTST system and by standard HoP. Macronutrients were measured with a mid-infrared analyzer. Lactose, glucose, myo-inositol, vitamins and lipids were assayed using chromatographic techniques. BSSL activity was determined using a kit. The duration of HTST treatment had a greater influence on the nutrient composition of DHM than did the tested temperature. The lactose concentration and the percentage of phospholipids and PUFAs were higher in HTST-treated than in raw DHM, while the fat concentration and the percentage of monoacylglycerides and SFAs were lower. Other nutrients did not change after HTST processing. The retained BSSL activity was higher after short HTST treatment than that following HoP. Overall, HTST treatment resulted in better preservation of the nutritional quality of DHM than HoP because relevant thermosensitive components (phospholipids, PUFAs, and BSSL) were less affected.

Strategic Planning in Emergency Management: Evaluating the Impacts on Local Program Quality

2020 ◽  
Vol 17 (3) ◽  
Author(s):  
Scott Robert Manning
Keyword(s):  
Strategic Planning ◽  
Emergency Management ◽  
Survey Design ◽  
Management Practice ◽  
The United States ◽  
Program Quality ◽  
County Level ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Local Program

AbstractThis study examined the strategic planning practices of county-level emergency management agencies (EMAs), with a specific focus on strategic planning adoption and its relationship to local program quality. The study utilized a descriptive, cross-sectional survey design to collect planning- and program-related data from more than 300 county-level EMAs across the United States. The study findings revealed that most of the county EMAs included in the final sample had previously engaged in strategic planning activities, with nearly all of them continuing to use strategic planning as part of their general management practice. The study findings further revealed that strategic planning had a direct and significant impact on the overall quality of local emergency management programs, and that the strategic planning EMAs had significantly higher mean quality scores across all program dimensions when compared to the non-strategic planning EMAs.

Neonatal Staff and Advanced Practice Nurses’ Perceptions of Bereavement/End-of-Life Care of Families of Critically Ill and/or Dying Infants

2004 ◽  
Vol 13 (6) ◽  
pp. 489-498 ◽  
Author(s):  
Arthur J. Engler ◽  
Regina M. Cusson ◽  
Renee T. Brockett ◽  
Charlene Cannon-Heinrich ◽  
Michelle A. Goldberg ◽  
...  
Keyword(s):  
End Of Life ◽  
Critically Ill ◽  
End Of Life Care ◽  
Survey Design ◽  
The United States ◽  
Influential Factors ◽  
Life Care ◽  
Cross Sectional ◽  
Neonatal Nurses ◽  
Nurses Perceptions

• Background Parents need compassionate care when an infant dies. Nurses can provide such care and possibly facilitate grieving, yet often have inadequate preparation in bereavement/end-of-life care. • Objective To describe neonatal nurses’ perceptions of bereavement/end-of-life care of families of critically ill and/or dying infants. • Methods A cross-sectional, descriptive, correlational mailed survey design was used. The 55-item Bereavement End-of-Life Attitudes About Care: Neonatal Nurses Scale containing 4 sections (comfort, roles, involvement, and demographics) was mailed to 240 hospitals in the United States. • Results The final response rate was 52% (190 completed data sets from 125 hospitals). Respondents were comfortable with many aspects of bereavement/end-of-life care. Comfort and roles scores correlated significantly with number of years as a neonatal intensive care nurse. Respondents agreed about many important aspects of their roles with patients’ families, especially the importance of providing daily support to the families. Most respondents identified caring for a dying infant, the actual death of an infant, and language or cultural differences as influential factors in the level of their involvement with families. • Conclusions Education on bereavement/end-of-life care could affect nurses’ comfort with caring for families of critically ill and/or dying infants. Additional education on cultural competence would be helpful. Educators must promote the inclusion of content on bereavement/end-of-life care in nursing curricula. Finally, researchers must focus more attention on factors that promote and inhibit bereavement/end-of-life care of families of critically ill and/or dying infants.

scholarly journals Knowledge, Beliefs, and Attitudes of Emergency Nurses Toward People With Chronic Pain

2019 ◽  
Vol 5 ◽  
pp. 237796081987180 ◽  
Author(s):  
Geraldine Martorella ◽  
Michelle Kostic ◽  
Anaïs Lacasse ◽  
Glenna Schluck ◽  
Laurie Abbott
Keyword(s):  
Chronic Pain ◽  
Survey Design ◽  
The United States ◽  
Considerable Proportion ◽  
Clinical Environment ◽  
Cross Sectional ◽  
Complex Needs ◽  
Negative Beliefs ◽  
Increased Risk ◽  
Beliefs And Attitudes

More and more people suffering from chronic pain (CP) utilize the emergency department (ED). However, their needs are not properly addressed. Stigmatization toward people with CP can partially explain this gap. Most studies in the ED have been focused on measuring nurses’ pain management knowledge in general, not negative attitudes toward CP. Hence, understanding of the determinants of the stigma related to CP is needed. The objectives of this study were to (a) describe the knowledge, beliefs, and attitudes of ED nurses toward people suffering from CP and (b) identify nurses’ characteristics associated with these perceptions. A cross-sectional web-based survey design was conducted using the KnowPain-12 questionnaire and the Chronic Pain Myth Scale. A total of 571 participants from 20 different states across the United States were recruited among whom 482 completed the entire survey. The sample included about one third of the ED nurses suffering from CP. Negative beliefs and attitudes toward people with CP were present in a considerable proportion of participants (up to 64%), even in nurses suffering from CP (up to 47.5%). Nevertheless, our results suggest that higher levels of education and suffering from CP were associated with better beliefs and attitudes toward people with CP. The ED presents an increased risk of stigmatization of people with CP as compared with the general population. Identifying determinants of the stigma associated with CP is crucial, as it will help tailoring awareness and educational campaigns. In addition, CP patients utilizing the ED often have complex needs which are difficult to address in this clinical environment. This situation can contribute to negative beliefs and attitudes. Given the scarcity of specialized care clinics for this population, health-care stakeholders should devise solutions to improve continuity of care in primary care settings and between the latter and ED.

Antibody Profile of Colostrum and the Effect of Processing in Human Milk Banks: Implications in Immunoregulatory Properties

2017 ◽  
Vol 34 (1) ◽  
pp. 137-147 ◽  
Author(s):  
Claudio Rodríguez-Camejo ◽  
Arturo Puyol ◽  
Laura Fazio ◽  
Analía Rodríguez ◽  
Emilia Villamil ◽  
...  
Keyword(s):  
Cross Sectional Study ◽  
Enzyme Linked Immunosorbent Assay ◽  
Cross Sectional ◽  
Convenience Sample ◽  
Specific Antibodies ◽  
Specific Reactivity ◽  
Antibody Profile ◽  
Milk Banks ◽  
Antibody Levels ◽  
Mother’S Own Milk

Background: When feeding preterm infants, donor milk is preferred if the mother’s own milk is unavailable. Pasteurization may have detrimental effects on bioactivity, but more information is needed about its effects on the immunological compounds. Research aim: This work has two main aims: evaluate the antibody profile of colostrum and study the quantitative variations in the antibodies’ level and specific reactivity after undergoing Holder pasteurization. The authors focused on immunoregulatory components of colostrum (antidietary antibodies and TGF-β2) in the neonatal gut. Methods: This is a descriptive cross-sectional study of a convenience sample of 67 donated colostrum samples at different days after delivery, both raw and pasteurized. Antibody profiles were analyzed at different times during breastfeeding, and total and specific antibodies (IgM, IgA, and IgG subclasses) were compared with tetanus toxoid and ovalbumin using enzyme-linked immunosorbent assay. The processing effect on total and specific antibodies, as well as TGF-β2, was evaluated by paired analyses. Results: No variations in immunological compounds were observed throughout the colostrum stage. The TGF-β2, antibodies’ concentrations, and antibodies’ specific reactivity after pasteurization did not vary significantly as days of lactation varied. Changes in antibody levels were dependent on isotype and IgG subclass, and IgG4 showed remarkable resistance to heating. Moreover, the effect of the pasteurization on specific reactivity was antigen dependent. Conclusion: The supply of relevant immunological components is stable throughout the colostrum stage. The effects of pasteurization on antibodies depend on isotype, subclass, and specificity. This information is relevant to improving the immunological quality of colostrum, especially for preterm newborns.

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