Knowledge, attitudes and awareness regarding donor breast milk: a crosssectional study of mothers in a high HIV-prevalent area

Abstract

Background: The use of donated expressed breast milk (DBM) is encouraged in South Africa, with donor milk banks and legislated  policies and programmes available in hospitals serving populations with a high HIV prevalence. Concerns over poor attitudes amongst  mothers towards DBM seem to persist.

Methods: A cross-sectional mixed-methods approach was used in a cohort of mothers of neonates in a regional hospital. Between April  2021 and January 2022, survey data on knowledge, awareness and attitudes towards DBM was collected. Qualitative data from open- ended questions were thematically analysed. Comparative analysis using independent sample t-tests and logistic regression to  determine differences in variables and to understand associations related to knowledge was conducted.

Results: A total of 163 mothers with a mean (SD) age of 27.1 ± 6.3 years were included; 49.7% of mothers had post-high-school qualifications, 82.8% were unemployed and 87.0% received social security. Some 64.4% had inadequate knowledge of DBM. Awareness of  DBM had the strongest association with better knowledge concerning DBM and AdjOR (25.25 95% CI 10.60– 68.40; p < 0.001). Negative  attitudes towards DBM were largely driven by a lack of knowledge regarding human immunodeficiency virus (HIV) screening of donor  mothers and fears of HIV transmission when using DBM.

Conclusion: Lack of awareness concerning DBM was associated with poor  knowledge of DBM, which may drive poor uptake of this critical nutritional source for at-risk neonates. Implementing targeted awareness  programmes on DBM, which begin in the antenatal period and specifically address HIV screening of donor mothers, could  address the poor uptake of DBM.