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Benefits of breast milk

· Nutritional superiority

· “Breast milk surpasses infant formulas in nutritional value, making any comparison between them incomparable. Its nutrient composition aids in combating diseases, making breast milk the superior choice” (respondent 1, educated FDG).

· Immune protection

· “Breast milk is optimal feed for babies as it provides essential nutrients, and immune protection against diseases, and promotes the overall health and well-being of a preterm baby”.

· Emotional connection

· “I believe nothing compares to my own breast milk for my baby. There’s a connection, a natural goodness that comes with it. Formula feels like a compromise, and I want the best for my preterm baby” (respondent 3, 18 - 30 years FDG).

Awareness of Donor Breast Milk

· Lack of awareness

· “I never knew there was such a thing as donor breast milk. It’s surprising how little we know about it, and it makes me realize the importance of spreading awareness so that mothers like me can make informed choices for our babies” (respondent number 3, 3 - 7 days, FGD).

· Comparison to blood donation

· “It closely resembles blood donation, the only distinction being the substance—milk, which undergoes disease screening just like blood, before transfusion” (respondent number 6, grade 9, FGD).

Potential acceptance

· Perceived benefits

· “Donor breast milk, akin to natural breast milk, contains all the essential nutrients required by the baby in the correct proportions, as ordained by nature” (responded 2, unavailable mum FGD).

· Importance of health

· Lifesaving initiative

· “Knowing that donor milk can contribute to my baby’s health, especially when one has insufficient breast milk, makes it a viable option for me. It’s about giving our child the best possible start in life” (respondent number 7, 3 - 7 days FGD).

· “At first, I lacked breast milk, and the doctor cautioned against using formula for my twins because of their extreme prematurity. I think this situation led to a delay in their weight gain, as they lost weight during that time. If a donor milk initiative had been available, my babies could have gained weight sooner, potentially reducing my hospital stay” (responded 4, educated).

Hindrance to utilization of Donor Milk

· Fear of disease transmission

· “If breast milk is not thoroughly screened, there is a risk of transmitting HIV/AIDS and other blood-related illnesses to the baby” (respondent number 8, above 7 days FGD).

· Cultural considerations

· “Our culture do not allow for such practices; I can only offer my baby milk from a relative” (respondent number 2, 3 - 7 days FGD).

· Unfamiliarity

· “I am unfamiliar with the concept of donor breast milk, which makes it exceedingly challenging for me to provide consent for it” (respondent 4, 3 - 7 days FGD).

· Spousal approval

· “I cannot make this decision independently; I need to consult with my husband before opting for donated breast milk” (respondent number 6, above 7 days FGD).