Knowledge and Attitude of Lactating Mothers and Health Professionals Towards Pasteurized Donor Human Milk Banking: A Preliminary Study on the Feasibility of Establishing Donor Human Milk Banking in Neonatal Intensive Care Unit of Selected Hospitals in Addis Ababa

Abstract

Background: Breast milk provides the optimal nutrition for growing infants. This is because it contains all the nutrients a baby needs in exactly the right proportions. It also contains biologically active live cells which promote health and helps to develop a passive acquired immunity by transferring antibodies developed by the mother. But, there are a large group of infants such as; pre-term, low birth weight and ill infants who are unable to breastfeed. On such condition, WHO recommends pasteurized donor human milk as the next best feeding option? However, its use is limited to industrialized countries and few developing countries. Thus, this study was designed to generate preliminary information on the knowledge and acceptability of pasteurized donor human milk banking. Methods: An institutional based descriptive cross sectional study was conducted to analyze the knowledge and attitude of mothers and health professional towards pasteurized donor human milk banking. In addition, the microbial safety of raw and pasteurized breast milk stored at -20 0C for 60 days was studied. Moreover, the flavor change of raw and pasteurized breast milk over 60 days of storage time was assessed. Result: Small number of mothers (5%) ever heard about donor human milk banking. About 53.7% of health professionals did not know donor human milk banking. All health professionals use infant formula as alternative to breast milk when mother unable to breastfeed. Only 20% of study mothers could accept feeding their baby donor human milk by physician prescription. Safety or fear of transfer of disease (85.1%) was the main factor for mothers not interested to feed their baby donor human milk. On the contrary, about two-third of study mothers were willing to donate their breast milk if human milk banking will be established. Three-fourth of health professionals believed that it is feasible to establish pasteurized donor human milk banking. Lack of knowledge about its safety by mothers and health professionals is the major challenge in establishing pasteurized donor human milk banking. In pasteurized breast milk sample stored at -20 0C (deep freezer) for 60 days no bacterial growth was detected. However, in raw breast milk samples a mean of 4.66 log10 CFU/ml of total aerobic plate count, 3.22 log10 CFU/ml of Enterobacteriaceae, 3.49 log10 CFU/ml of Staphylococcus aureus were detected. Within 60 days of storage time, pasteurized milk samples did not devolve off flavor. However raw breast milk samples developed off flavor. Conclusion: the present study showed that majority (95%) of mothers never heard about pasteurized donor human milk banking and substantial number (80%) of mothers did not went to feed their baby even after short description due to fear to transfer of disease. Additionally, more than half of health professionals never heard about pasteurized donor human milk banking. Similarly, fear of disease transfer and safety during processing of pasteurized donor human milk banking is the major concern mentioned by most health professionals on its acceptability. In our microbiological analysis Within 60 days of storage time pasteurized donor human milk was bacteriological safe and has acceptable sensory quality.