Facilitators, barriers, and factors determining the willingness to donate human milk among postpartum mothers in a tertiary women's hospital in Nepal: a cross-sectional study.

Background: Breastfeeding is universally acknowledged as the most effective and efficient means of ensuring optimal growth, development, and survival of infants. However, in rare cases where breastfeeding is medically contraindicated or the mother's milk is insufficient, donor human milk from a milk bank serves as a critical alternative. At a time when Nepal's first milk bank is struggling to supply adequate milk for newborns, this study aimed to identify the facilitators, barriers, and factors determining willingness to donate human milk among postpartum mothers in a tertiary women's hospital in Nepal.

Methods: A cross-sectional analytical study was conducted among 318 postpartum women aged 18 years and above at Paropakar Maternity and Women's Hospital, Nepal. Data were collected from February to March 2025 using semi-structured interview. Systematic random sampling was used. Binary and multivariable logistic regression analyses were performed, and factors with a p-value of less than 0.05 were considered statistically significant at the 95% confidence level.

Results: Only 23.3% had heard about milk banks. Overall, 61.6% of postpartum mothers were willing to donate human milk. The most important facilitators for milk donation was having an adequate milk supply (44.7%) and barrier was fear of insufficient milk for one's own infant (24.5%). In multivariable logistic regression analysis, a positive opinion toward the milk bank concept (AOR = 3.39, 95% CI: 1.67-6.86, p < 0.05) and a positive perception of society regarding milk donation (AOR = 3.60, 95% CI: 2.10-6.16, p < 0.05) were independently associated with willingness to donate human milk. While the majority of mothers were willing to donate, only 4% were actual donors.

Conclusions: Willingness to donate was found to be determined by positive personal opinions and perceptions of society's attitude toward milk donation. These findings and the gap between willingness and actual donation practices highlights the need for educational interventions for individual and community-based education to foster supportive attitudes and encourage donation.