Immigrant Fathers’ Perceptions of Human Milk Banks and Pasteurized Donor Human Milk in the United States: A Qualitative Study

BACKGROUND: Pasteurized donor human milk (DHM)is the best alternative for sick and preterm infants when mother's own milk is unavailable. Prior studies have examined perceptions of human milk banks (HMBs) and pasteurized DHM among mothers of diverse backgrounds, yet little is known about fathers' perceptions. It is important to understand fathers' beliefs about DHM and their role in infant feeding decisions to inform public health programs and interventions that promote infant wellbeing. RESEARCH AIM: This study aimed to explore immigrant fathers' perceptions of pasteurized DHM and HMBs in the United States, including perceived benefits, concerns, and conditions shaping acceptability. METHODS: This descriptive qualitative study involved semi-structured interviews with 19 immigrant fathers from East and West Africa and South Asia. Participants were recruited in the United States using snowball sampling through community organizations and social media. Interviews were audio-recorded, transcribed, and analyzed using rapid qualitative methods, including matrix-based synthesis and thematic analysis with constant comparison. RESULTS: Participants described limited awareness of DHM and milk banks. Acceptability was shaped by concerns about safety and process transparency (screening, storage, and disease transmission) and by cultural and religious meanings of shared milk, including beliefs about transfer of traits, bonding, and kinship. Despite reservations, fathers viewed DHM as acceptable when medically indicated and if communicated clearly through trusted institutions. CONCLUSION: Immigrant fathers' perspectives suggest the need for father-inclusive, culturally responsive education that emphasizes safety processes, clarifies clinical indications, and transparently addresses access and costs.