Table 2 Summary of main barriers and facilitators to donor human milk
| Major theme | Barriers | Facilitators |
|---|---|---|
| Existing practices and perceptions | Old assumptions of what is ok to provide such as cow’s milk, glucose and water | Benefits of breast milk acknowledged and some prior experience of DBM. |
| Fear of transmission of disease | Potential of HIV transmission | Robust, confidential HIV testing Recipient assured only negative donors permitted |
| Misconception of non-communicable disease transmission | Appropriate maternal and community education | |
| Processes of acquisition and storage of milk | Perception of poor hygiene | Ensure good hygiene practice throughout donation process |
| External influences | Husband as the final decision maker | Education of wider community using media and established community health resources |
| Transparency and health education | Negative rumors circulating in the community | Transparency and reassurance Trust in healthcare workers |
| Fear of being blamed for poor outcome in recipient’s baby | Anonymous donation Appropriate education and reassurance of donor and recipient |