Informal human milk exchange is the practice of donating and receiving expressed human milk based on mutual consent between the donor and receiver in the need of human milk for infants below 2 years old. Main concerns related to informal human milk exchange is related to milk siblings and safety handling of the expressed breastmilk. Even though there are countries which have policies and procedures related to human milk bank, informal milk exchange has not been given much attention. Compared to human milk bank, informal human milk exchange is not regulated. This study aims to identify the system focused on personalized breastfeeding tracking and monitoring, online discussion forum, web-based consultation, and breastfeeding station locator. Review of current applications in supporting breastfeeding practices was conducted based on the PRISMA-ScR framework. A literature search was conducted in Scopus and Google Scholar databases to identify articles published in English or Malay and containing systems/applications related to breastfeeding, milk sharing, milk exchange, milk siblings/kinship within the societal context. According to the scoping review, current scientific publications mostly focused on breast milk, breastfeeding, and milk banking concerns, with recurring themes including social reasons, lactation insufficiency, and unsolved nursing problems. These themes highlight the complexities and complexities of informal human milk exchange practices. Two reviewers screened the articles, and the data were extracted and narratively synthesized. During the primary database search, 360 articles were found based on the related titles, abstracts, and keywords. Seventy eight met the inclusion criteria and were finalized in this review. We found that most scholarly works focused on breast milk, breastfeeding and milk banking challenges and issues with recurrent themes i.e., societies, lactation inadequacy and unresolved nursing problems. Based on our literature search and to the best of our knowledge, there is no recent scoping reviews which focuses on technology-based approaches on informal human milk exchange. Findings from this scoping review is important for advancing research and practice in this field, as well as improving outcomes for individuals and families affected by informal human milk exchange.
The World Health Organisation (WHO) recommends that all babies be exclusively breastfed, stating that donor milk is the next best alternative in the absence of the mother's own milk. Milk sharing takes many forms, namely wet nursing, co-feeding, cross-feeding, and a human milk bank (HMB). However, the establishment of a human milk bank is still not widely accepted and is a debatable topic because of religious concerns in Malaysia. The aim of this study is to determine the facilitators and barriers among Malaysians towards the acceptance of an HMB. A cross-sectional study with 367 participants was conducted; the participants answered an online-validated, self-administered questionnaire. Data on sociodemographic, knowledge on breastfeeding benefits, knowledge and attitude on HMB-specific issues were analysed in terms of frequency before proceeded with multiple logistic regression. The majority of the respondents were Muslim (73.3%), had completed their tertiary education (82.8%), and were employed (70.8%). Only 55.9% of respondents had heard of HMB, stating the internet as their main source of information, but many respondents were agreeable to its establishment (67.8%). Most respondents had a good score on knowledge of breastfeeding benefits and on HMB-specific issues (70% and 54.2%, respectively), while 63.8% had a positive attitude towards HMB. In the multivariate analysis, mothers with a good score on general knowledge of breastfeeding (AOR: 1.715; 95% CI 1.047-2.808) were more likely to accept the establishment of HMB, while being a Muslim was negatively associated with its establishment (AOR = 0.113, 95% CI 0.050-0.253). The study found a high prevalence of mothers who were willing to accept the establishment of HMB. By educating mothers on the benefits of breastfeeding, as well as addressing their religious concerns, the establishment of a religiously abiding HMB in Malaysia may be accepted without compromising their beliefs or the health benefit of donor milk.
Human milk banks are vital for providing donor milk to infants for whom there are maternal or postnatal barriers to the mother's own milk. Although more than 35 countries have active milk banks, not one of those is a Muslim country.(1) Despite widespread support for breastfeeding across the Muslim world, religious constraints surrounding milk-sharing have created challenging barriers to the creation of milk banks. The religious objection centres around the Islamic tenet that consuming human milk builds a kinship bond between individuals who have consumed the same woman's milk which prohibits future marriage between the 'milk-brothers and sisters.' While a small-scale, experimental 'milk exchange' programme has been attempted in two Muslim countries (Kuwait and Malaysia), the only proposed milk bank in the Muslim world was a pilot programme in Turkey that was halted because of religious concerns. The problem with milk banking is the step in the process during which the milk from individual donors is pooled and de-identified, making it impossible to trace its origins and acknowledge the newly formed kinship relationship. To meet the need for Muslim children to be able to access human milk while remaining compliant with the prevalent understanding of Islamic doctrine on milk-sharing, we propose a new approach to milk banking that we term the Conditional Identified Milk Banking System (CIMBS). In this new system, both the donor's and recipient's identities are accessible to all parties through a voluntary registry, and the milk-pooling is limited to three milk donors. Based on recent survey data, we believe that there would be receptivity among practicing Muslims and religious leaders to this alternative approach.
The process by which women came to use internet-facilitated peer-to-peer shared milk was explored via a written questionnaire administered to 41 peer milk recipients from five countries. Respondents were universally unable to provide some or all of the milk their infants required. Twenty-nine dyads had a medical condition that could have affected their ability to breastfeed. Many respondents had had great difficulty in finding health workers who could assist them with their breastfeeding challenges. Before obtaining peer-shared milk, respondents had tried to increase their own milk supply, used infant formula or sought donor milk from personal contacts. Health workers dealing with breastfeeding women require greater training in the recognition and treatment of conditions that adversely affect breastfeeding including a physiological incapacity to fully breastfeed. Peer-to-peer milk recipients appear to be very satisfied with the solution milk sharing provides to their problem of being unable to fully breastfeed their infants.
Human milk bank is a source of human milk supply in many neonatal intensive care units. However, there are some hospitals without this facility because of financial or religious impediments, such as the Muslim community.