The long-term use of pasteurised donor human milk for infant feeding : mother’s perspectives : a thesis presented in partial fulfilment of the requirements for the degree of Master of Public Health at Massey University, New Zealand
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Date
2024
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Massey University
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Abstract
Infants have the greatest potential to thrive when provided with their optimal nutrition, breast milk (WHO, 2024). However, when faced with not being able to breastfeed for either personal, medical or environmental reasons, formula tends to be the most popular alternative feeding option that parents turn to. This could be due to accessibility issues, religious or cultural reasons, social stigma, or lack of knowledge and understanding of using PDHM. In the literature, there has been greater emphasis on researching the viewpoints of milk donor, and much less on the women receiving the milk. Although there is a benefit in understanding how women, nurses, midwives, fathers and milk donors feel about milk donation, it is vital to explore the lived experiences of mothers receiving donated milk for their infants. Within the limited capacity in which mother’s lived experiences have been explored, it is often mothers who have used PDHM short-term. Often these studies investigate the experiences of women who have used PDHM for a couple of feeds to a couple of days. As Meeks et al., (2019) explain, auditing of formula use within neonatal units (specifically in Christchurch, New Zealand), has demonstrated that late preterm infants are the greatest users of short-term formula following birth, and this has therefore been translated into this same group being the greatest users of short-term PDHM (following the opening of a local milk bank in this area). Despite the greatest use of PDHM being in the first 7-days of life, there are many scenarios where women are unable feed their own milk to their infant after this period or need to continually supplement their own milk supply. For these women, there is a lack of exploration into the experiences of mothers who have engaged with breast milk bank services and utilised PDHM long-term. These women should have their experiences, thoughts, beliefs and feelings considered to fill knowledge gaps and highlight areas of improvement for milk banks supporting long-term users. Women who use PDHM long-term may do so because of an inability or difficulty to breastfeed due to medical reasons such as previous breast surgery, receiving current cancer treatments, or taking other medications which are not proven to be safe for breastfeeding (Stanescu et al., 2019). In other scenarios, women simply cannot produce enough milk for their baby long-term. This study aims to investigate the lived experiences of mothers that have used PDHM on a long-term basis. For the purpose of this study, long-term is defined as equal to or greater than two weeks. Within the included dataset, women used PDHM from three weeks until six months. Through thematic analysis, as outlined by Braun & Clarke (2012), themes will be inductively identified, and it is hoped that these themes will shape the way that support for PDHM is offered within the maternal health space. The use of in-depth semi-structured interviews have been used to explore the physical and emotional journey of mothers who use PDHM to feed their child. To develop a comprehensive understanding of this journey, this research undertakes a narrative enquiry approach. This research has been guided by the following research questions (1) how do women describe using pasteurised donor human milk long-term? (2) how are mothers currently supported to use PDHM in a long-term sense (both from a medical and community standpoint)? (3) how does long-term use of PDHM affect their sense of being a mother? And (4) what more can be offered to women using PDHM long-term to support this part of motherhood?--From Study Justification