Factors Related to Mother’s Intention to Donate Breastmilk at Ramathibodi Milk Bank

Abstract

Breast milk is an essential source of nutrition for newborns,particularly for preterm infants,as it supports growth and development, strengthens immune protection,and reduces the risk of complications such as necrotizing enterocolitis.Preterm infants are especially vulnerable because their organs and immune systems are not fully developed.Breast milk contains essential nutrients, antibodies, and bioactive components that promote infant health and survival.However,many preterm infants have immature sucking and swallowing reflexes and are unable to breastfeed directly from the breast.As a result, mothers may experience difficulties establishing an  adequate milk supply during the early postpartum period, especially when infants are hospitalized. To address this challenge, the World Health Organization and the American Academy of Pediatrics recommend the use of donor human milk from human milk banks when a mother’s own milk is unavailable or insufficient, particularly for preterm or low birth weight infants. Donor human milk provides protective benefits similar to maternal breast milk and is considered the safest alternative feeding option.Human milk banks,therefore,play a crucial role in supporting neonatal care and enhancing health outcomes among vulnerable infants. However, statistics from Ramathibodi Hospital indicate that the number of preterm infants has steadily increased in recent years, resulting in a growing demand for donor human milk. Meanwhile, the current supply of donated breast milk remains insufficient to meet this demand. This shortage highlights the importance of encouraging more mothers to participate in breast milk donation programs. Understanding  the factors influencing mothers’ intentions to donate breast milk is essential for developing effective strategies to promote donation and ensure an adequate supply of donor milk for infants in need. Identifying these factors can provide valuable baseline information for healthcare providers and policymakers in designing interventions that support and encourage breast milk donation.This study employed a descriptive cross-sectional design to examine factors associated with mothers’ intention to donate breast milk to the human milk bank at RamathibodiHospital. The Theory of Planned Behavior was used as the conceptual framework guiding the study, which proposes that behavioral intentionis influenced by attitudes, subjective norms,and perceived behavioral control. The study sample consisted of 83 mothers who donated breast milk to the human milk bank at Ramathibodi Hospital between March 2019 and June 2023.Participants were recruited using purposive sampling based on predetermined inclusion criteria. Eligible participants were breastfeeding mothers whose current infant was aged four months or younger and who had passed the screening criteria of the breastfeeding clinic. These criteria ensured that participants were healthy and suitable donors,in accordance with the human milk bank’sstandards.Data were collected using a structured questionnaire consisting of four sections: demographic characteristics; attitudes toward breast milk donation; subjective norms related to breast milk donation; perceived behavioral control for breast milk donation, and intention to donate breast milk.Descriptive statistics were used to analyze participants’ characteristics, including frequencies,percentages, means, and standard deviations. The relationships amongthe study variables were examined using Spearman’s rank correlation coefficient to determine the associations between attitudes, subjective norms, perceived behavioral control, and intention to donate breast milk.The results showed that most mothers donated breast milk during their maternity leave. The average amount of donated breast milk was 16.43 liters per person.Mothers demonstrated positive attitudes toward breast milk donation, with a mean score of 24.57 (SD = 1.16). Subjective norms regarding breast milk donation were high, with a mean score of 13.00 (SD = 2.54),indicating that mothers generally perceived strong social support from people around them regarding breast milk donation.Perceived behavioral control for breast milk donation was also high, with a mean score of 33.40 (SD = 2.19), suggesting that mothers felt confident in their ability to donate breast milk. In addition, intention to donate breast milk was at a high level, with a mean score of 18.73 (SD = 1.51).Further analysis revealed that perceived behavioral control had a low but positive statistically significant correlation with the intention to donate breast milk (r =.26, p =.02). This finding suggests that mothers with greater confidence in their ability to donate breast milk were more likely to report a stronger intention to donate. In contrast,attitudes toward breast milk donation and subjective norms were not significantly associated with mothers’intention to donate in this study. These results highlight the importance of strengthening mothers’confidence in donating breast milk. Healthcare professionals,particularly nurses,play a key role in promoting breast milk donation by providing information, education, and practical guidance about donor human milk and the operation of human milk banks. Such support can enhance mothers’ confidence and encourage their intention to donate breast milk, ultimately increasing the availability of donor human milk for vulnerable infants inneed.

Keywords: Breast milk, Donor human milk, Human milk bank,Mothers’ intention,Perceived behavioral control

Author Contributions:
WK: Conceptualization, Method and design, Tool validation, Data collection, Data analysis,Writing and revising the manuscript
TD: Conceptualization, Method and design, Tool validation, Data analysis, Writing and revising the manuscript, Corresponding with the editor-in-chief
JP: Data analysis, Writing and revising the manuscript
PN: Conceptualization, Method and design, Tool validation