A feasibility project using pasteurized human donor milk (PHDM) for medical supplementation of the general newborn population in Atlantic Canada: Policy, practice and consumer implications.

Overview: Pasteurized human donor milk (donor milk) is the best nutrition for infants when they cannot access their mother's own milk. In Atlantic Canada only 3 hospitals offer donor milk to premature infants in neonatal intensive care units. I argue that other infants need access, such as those born at 34-37 weeks, with neonatal abstinence syndrome or low blood sugar, or separated from their biological mothers for social and medical reasons. Although more expensive than formula, greater use of donor milk could save costs by increasing breastfeeding and improving health. There are ethical concerns with offering some infants donor milk and not others. Understanding families' and health care providers' perceptions of donor milk for general newborn use and their response to this feasibility pilot will help identify ways to make donor milk more accessible. Anticipated outcomes: Understanding families' and health care providers' perceptions of donor milk will help me develop educational plans to support a 6-month feasibility project. The project aims to enhance understanding of and increase use of donor milk, support breastfeeding by providing a bridge when mother's own milk supply is delayed, improve outcomes, and be affordable. I will use findings to inform local and national policy and as a foundation for research to improve equality in access. Contributions to the field: This research contributes to breastfeeding medicine by identifying what values, norms and concerns promote and hinder use of donor milk, and by exploring the ethical, economic and practical issues with making it available through a feasibility pilot for the general newborn population. It contributes to knowledge translation by improving understanding of perceptions of using donor milk outside of critical care settings and how to change behaviour to improve access. I aim to find ways to support the uptake of donor milk to increase access and improve mother/infant health.