Peer-to-Peer Human Milk-Sharing Among Israeli Milk Donors: A Mixed-Methods Study in the Land of Milk and Honey

Background: Evidence is lacking on the phenomenon of peer-to-peer human milk-sharing in the Middle East, specifically, in Israel. Research Aims: This study aimed to uncover peer-to-peer human milk-sharing in Israel, learn about how and whether donors engage in safe milk handling and storage practices, and assess knowledge about human milk and breastfeeding among this milk-sharing population. We also aimed to investigate donors' selectiveness in their decisions about to whom they donate their milk and their perceptions about the sale and purchase of human milk. Methods: We conducted a semi-structured online survey, including both closed- and open-ended questions and used mixed methods to analyze responses descriptively. We used non-probability sampling to obtain a broad sample of human milk donors. Results: Out of 250 completed surveys, most participants (87.2%, n = 218) reported engaging in safe milk-sharing practices and were generally knowledgeable about the health risks associated with milk-sharing. Participant religiosity was associated with somewhat lower hygiene practices (r = -0.15, p =.05). Most of the participants (81.7%, n = 190) were against the sale of human milk. Participants generally expressed no preference about the recipient of their milk, with some exceptions. Conclusion: The milk-handling and storage practices of the participants in this study suggest a need to improve knowledge and awareness of safe milk storage temperature and the importance of washing hands before pumping milk, particularly within the religious sector. We propose that guidelines about safe milk-sharing practices be written and adopted by the Israeli Ministry of Health, and communicated through pediatricians, family doctors, nurses in Mother and Child Clinics (In Hebrew: Tipat Halav), and social media.

Automated summary

This study aimed to uncover the phenomenon of peer-to-peer human milk-sharing in Israel and assess the knowledge and practices of donors in safe milk handling and storage. The results showed that most participants followed safe sharing practices and had good awareness of the health risks associated with milk-sharing. Religion was found to be somewhat associated with lower hygiene practices. The study recommends the adoption of guidelines by the Israeli Ministry of Health to improve knowledge and awareness of safe milk-sharing practices.