ABSTRACT
Abstract Barriers to the use of banked donor milk are numerous, and many patients are denied access to it because of lack of policy explicitly addressing its use. This examination of U.S. health policies, both governmental and professional, addressing child health and breastfeeding suggests where donor milk banking services should be included to fulfill the ethical principles of justice (fair access) and autonomy. The need for research to support future policy development is also highlighted.
Subject(s)
Health Policy , Milk Banks/standards , Milk, Human , Public Health , Female , Humans , Infant , Infant, Newborn , Milk Banks/ethics , Milk Banks/organization & administration , Policy Making , United StatesABSTRACT
This review examines the role of donor human milk banking in international human rights documents and global health policies. For countries looking to improve child health, promotion, protection and support of donor human milk banks has an important role to play for the most vulnerable of infants and children. This review is based on qualitative triangulation research conducted for a doctoral dissertation. The three methods used in triangulation were 1) writing as a method of inquiry, 2) an integrative research review, and 3) personal experience and knowledge of the topic. Discussion of the international human rights documents and global health policies shows that there is a wealth of documentation to support promotion, protection and support of donor milk banking as an integral part of child health and survival. By utilizing these policy documents, health ministries, professional associations, and donor milk banking associations can find rationales for establishing, increasing or continuing to provide milk banking services in any country, and thereby improve the health of children and future generations of adults.
ABSTRACT
BACKGROUND: This case study of donor human milk banking and the ethics that govern interested parties is the first time the ethics of donor milk banking has been explored. METHODS AND RESULTS: Two different models of ethics and their direct impact on donor milk banking are examined: biomedical ethics and public health ethics. How these models and principles affect different aspects of donor human milk banking and the parties involved in the delivery of this service are elucidated. Interactions of parties with each other and how the quality and type of interaction affects the ethical delivery of donor milk banking services are described. Crystallization is at the heart of the qualitative methodology used. Writing as a method of inquiry, an integrative research review, and personal experience are the three methods involved in the crystallization process. CONCLUSION: Suggestions are made for improving access and knowledge of banked donor human milk, a valuable public health resource.
Subject(s)
Bioethics , Milk Banks/ethics , Milk, Human , Public Health , Tissue Donors/ethics , Confidentiality , Female , Humans , Infant , Infant, Newborn , Male , Models, Theoretical , Personal Autonomy , Resource AllocationABSTRACT
Necrotizing enterocolitis (NEC) adds significantly to the cost of care for premature infants and to negative long-term and short-term outcomes for these infants. It is thus in the best interest of the health care system to prevent the occurrence of NEC through feeding protocols that foster NEC prevention (i.e., use of breast milk in the neonatal intensive care unit). Banked donor milk has been shown to be as effective in preventing NEC as mother's milk. Three models of cost analysis are presented to show savings that could accrue to a health care system or individual family if banked donor milk were provided as first feedings when mother's milk is not available. The cost of using banked donor milk to feed premature infants is inconsequential when compared to the savings from NEC prevention.
