Doctoral Dissertations

Date of Award

5-2023

Degree Type

Dissertation

Degree Name

Doctor of Philosophy

Major

Nutritional Sciences

Major Professor

Katherine F. Kavanagh

Committee Members

Sarah E. Colby, Dallas R. Donohoe, Laura E. Miller

Abstract

Background: Benefits of breastfeeding are well-established and breastfeeding rates continue to rise. Simultaneously, the practice known as informal milk sharing (IMS) is becoming more visible. However, little is known about IMS among individuals in different parenting stages. Additionally, as there is potential for pathogens in informal donor milk (IDM), it is important to understand the effect of home-pasteurization on bacterial composition of IDM and whether caregivers are receptive to home pasteurization education.

Objectives: The objectives of this study were to 1) develop and validate an online survey to better understand IMS, 2) to implement the survey, and 3) to conduct a feasibility trial of providing home pasteurization education to caregivers, a) by determining feasibility of recruitment, retention, and collection of IDM, and b) determining the effect of home-pasteurization on IDM.

Methods: Participants were > 18 years old, English-speaking, and included in one of the four sub-groups: planning to become a parent, pregnant for the first time, or were the mother or father of an infant < 4 months of age. For the feasibility trial, participants were caregivers of infants < 4 months of age who use IDM. They received education on how to pasteurize IDM at home and collected 1 sample of IDM at 3 time points. Samples were analyzed using 16S rRNA sequencing.

Results: Survey – Overall, 86% (n=427) of participants were aware of IMS. Almost 62% (n=306) of participants reported believing that IDM is “very safe”, with 41.4% (n= 205) reporting that they know someone who uses or has used IDM to feed their infant. Exposure to breastfeeding was positively associated with willingness to use IDM (p=

Conclusion: In general, awareness of IMS was high. Being exposed to breastfeeding increases willingness to use IDM. Bacterial composition of IDM is diverse and varies between donors. Home-pasteurization affects the bacterial composition in IDM. These changes should be explored among a larger sample of IDM, while emphasizing novel recruitment and retention strategies.

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