Milk Donation Following Perinatal Loss: Insights from a Survey across Italian Human Milk Banks

Background/Objectives: Milk donation after perinatal loss has been increasingly recognised as a potential healing practice for bereaved mothers. However, lactation support offered to bereaved mothers within hospital settings is still limited. The study aimed to explore the experiences and current practices of Italian Human Milk Banks (HMBs) regarding milk donation after perinatal loss, and to identify barriers and facilitators towards the implementation of this practice, in order to inform future quality improvement initiatives. Methods: An online survey was distributed to Italian HMBs between June and September 2023. Close-ended questions were reported as frequencies. Open-ended responses were analyzed through a comparative analysis. Results: forty-three Italian HMBs were contacted, and 34 replied (response rate 79%). Milk donation was offered as a possible option to manage lactation to bereaved mothers in 22 out of 34 Italian HMBs (65%). The lactation counselling was conducted by the HMB personnel in 18 out of 34 centers, by neonatologists in 17 centers, by neonatal nurses in 12 centers, by obstetricians in 4 centers. Twenty-two HMBs (65%) reported to have received from the mothers themselves the request to donate milk after losing their baby. Interviewees reported as main barriers towards implementation of this practice: lack of psychological preparation of the HMBs staff to handle the proposal of milk donation after a loss, to support the mother in processing the death through a gift to life and lack of adequate communication skills. Conclusion: in order to offer bereaved mothers adequate lactation counselling, specific training should be delivered to the healthcare workers involved, focusing on psychological, communication, and sociocultural aspects.