Mothers’ experiences of donor human milk in a Japanese NICU: a modified grounded theory approach

BACKGROUND: Breast milk reduces complications among very low birth weight infants (VLBWIs) admitted to neonatal intensive care units (NICUs). When mothers' own milk (MOM) is temporarily unavailable, donor human milk (DHM) is used as an alternative. In Japan, the first human milk bank was established in 2017, and the use of DHM remains relatively new. However, little is known about how mothers experience emotional changes and social interactions related to DHM use while continuing to express their own milk. METHOD: Semi-structured interviews were conducted with 10 mothers of VLBWIs who had used DHM immediately after birth, and data were analysed using the Modified Grounded Theory Approach. RESULTS: Mothers experienced emotional conflict between their desire to provide their own milk and the need to prioritize their infant's health and survival; however, support from family members and healthcare professionals facilitated emotional reconciliation through continued milk expression and observing their infants' growth. CONCLUSION: Mothers experienced emotional conflict regarding DHM use; however, support from spouses, family members, and healthcare professionals helped mothers gradually come to terms with these feelings through continued milk expression and observing their infants' growth.