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Milk Banking and the Uncertain Interaction between Maternal Milk and Ethanol (MUIMME)

Donor human milk banks are expanding around the world at an exponential rate, related to global increases in preterm births and the evidence base for the benefits of giving human milk to these vulnerable babies. The importance of human milk for prematurely born infants has been extensively identified in the scientific literature. In addition, research also shows that a significant percentage of the mothers of preterm infants, at least initially, experience lactation problems. Europe is taking a leadership role in the expansion of human milk banks, although issues associated with alcohol consumption and maternal donations are a concern for clinicians and health care staff, given the increasing problems associated with drinking among women of childbearing age.

The fact that Europe has the highest alcohol per capita consumption rates in the world makes these issues particularly urgent. The United Kingdom (UK), with its long history and global leadership role in the field of human milk banking is an ideal place to study these considerations which will inform these larger issues of human milk for the preterm infant. The UK supports not only one of the oldest hospital based banks in Europe (Queen Charlotte and Chelsea Hospital milk bank), but also important cross-border collaborations in Ireland (simply called The Human Milk Bank), along with a research based national bank in Scotland (the NHSGGC Donor Milk Bank), and a newly amalgamated university based research bank in Chester (the Northwest Human Milk Bank).

Each of these banks represents different cases contributing to the re-birth of the medical control of human milk. The UK is poised to offer the world vital information regarding donor human milk banking, maternal bodies and ‘trust’ (an important sociological social psychological theoretical concept) and lifestyle issues, in particular alcohol related issues. To illuminate these issues, this study will gather complimentary ethnographic social and cultural qualitative data, including ethnographic observations, narrative interviews, and archival/documentary data. In addition, staff of the milk banks will also perform a more objective anonymized qualitative test using breastmilk alcohol strips. These issues are of central concern for health care services around the world. MUIMME is an old Irish word for wet-nurse.

In summary, this project is both multidisciplinary and interdisciplinary, engaging social sciences and health sciences, including sociology, anthropology, psychology, history as well as paediatrics, neonatology and perinatology.

Employing complimentary analytic ethnographic social and cultural qualitative methods, the chief investigator (TC) will collect and analyse:

  • Qualitative ethnographic observations of everyday processes, practices and policies;
  • Qualitative narrative interviews with staff, donors and parents of recipients;
  • Archival and document materials on donor human milk banking in the UK.

In addition, during each of her four observational visits to the banks (over a year) the chief investigator (TC) will provide the donor human milk bank manager with a box of breastmilk alcohol testing strips. During their routine quality assurance testing, the manager or her nominated staff will use these strips to perform an additional qualitative test (positive or negative) on milk that would not be available for clinical purposes, and therefore is ethically available for research purposes. These more objective qualitative results will be provided anonymously to the chief investigator (TC) who will at no point handle breastmilk herself.

All of these data will then be organized and analysed using analytic abduction and the software package MAX QDA.

Project Lead/Contact

Dr Tanya M. Cassidy

Project Staff

Dr Gillian Thomson (ethical advisor)

Collaborators and Partners

Professor Fiona Dykes

Clients or Funders

European Commission (Horizon 2020)