The impact of donating human milk on the health of the donor and their infant: Evidence from two systematic reviews

Document Type

Article

Department

Paediatrics and Child Health

Abstract

Background: Using human milk has been associated with decreased morbidity and mortality in preterm/low birth weight infants. Donor human milk (DHM) is recommended when maternal milk is unavailable. The benefits of DHM for the recipient are well documented, but the impact of donation on donors and their infants is not clear.
Objective: To evaluate the effects of donation on donors and their infants.
Methods: Literature searches were conducted (April 2024) to identify studies (observational, quasi-experimental, and randomized control trials (RCTs)) assessing the impact of human milk donation on donor health, nutrition, well-being, and lactation and on their infants' health, growth and development. Bias was assessed using the Risk of Bias in Non-randomised Studies - of Interventions (ROBINS-I) scale. Meta-analysis was conducted when possible. Certainty of evidence was assessed using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach.
Results: Nine studies examined donor outcomes, and six studies examined donor infant outcomes. No differences were found between donors and non-donors regarding the prevalence of overweight (RR: 1.27, 95% CI [0.81, 2.01]), postpartum depression (RR: 0.60, 95% CI [0.21, 1.72]), postpartum anxiety (RR: 0.84, 95% CI [0.59, 1.18]), need to pump for their infant (RR 1.09, 95% CI [0.63, 1.89]), mastitis (RR: 1.48, 95% CI [0.71, 3.05]), chapped/cracked nipples (RR 0.61, 95% CI [0.34, 1.12]), and breast engorgement (RR 1.88, 95% CI [0.94, 3.77]). Similarly, no differences were found between donor and non-donor infants regarding feeding intolerance (vomiting) (RR: 1.26, 95% CI [0.53, 3.01]), slow weight gain (RR: 0.36, 95% CI [0.13, 1.02]), oral thrush (RR: 0.55, 95% CI [0.12, 2.37]), or need for phototherapy (RR: 2.21, 95% CI [0.93, 5.23]). Certainty of evidence was very low for all outcomes.
Conclusion: Limited, very low certainty evidence does not support any short-term harms or benefits of human milk donation for donors or their infants. Registry and registry number for systematic reviews or meta-analyses: The protocols for both studies were registered with the International Prospective Register of Systematic Reviews (PROSPERO) on March 26, 2024. Study IDs: CRD42024529222 and CRD42024528803.

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Volume,issue and pagination are not provided by author/publisher.

AKU Student

no

Publication (Name of Journal)

Advances in Nutrition

DOI

10.1016/j.advnut.2025.100581

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