Aims Access to donor human milk (DHM) has primarily been based on the health and development outcomes of premature infants but there has been little examination of the broader impact of an infant receiving it upon parental mental health. However, although significant research highlights the protective effect of being able to breastfeed for maternal mental health, less is known about the potential mental health impacts of being able to receive DHM for an infant. Previous work has established supporting the mental health and well-being of mothers for whom their infant receiving human milk is important. The aim of the current study was to explore the impact on standardised depression and anxiety scores in mothers receiving DHM and lactation support from a community milk bank programme.

Methods Between May 2020 and January 2021, consecutive parents referred to receive DHM for their infant from the Hearts Milk Bank, part of the Human Milk Foundation charity, were invited to complete a recipient questionnaire examining mental health using a combination of the Hospital Anxiety and Depression Scale and open-ended qualitative questions. Families were contacted 2 weeks after the cessation of support to complete a follow-up survey. The survey was prepared using input from previous recipient families, milk bank experts and academics, and the study had approval from the Swansea University Institutional Research Ethics Committee.

Results Almost all of the 107 participants (women=102) agreed that receiving DHM had a positive impact upon infant health and development, their own mental and physical health, and their family’s well-being. Parents felt relieved that their infant was receiving DHM for health reasons but also due to the experience of being listened to, supported and having their infant feeding decisions facilitated. Receiving DHM helped mothers to process some of their emotions at not being able to breastfeed, in part because knowing their baby was being fed gave them the space to focus on recovery and bonding with their baby. Some parents did experience challenges, feeling guilty at receiving DHM, insecure that another woman was able to feed their baby when they could not, or negative reactions from family. Although the impact of receiving DHM upon breastfeeding was not measured, some women who were working to build their own milk supply noted that it helped motivate them to continue.

Conclusion Breastfeeding and mental health are closely tied with women who experience breastfeeding difficulties or are unable to meet their own breastfeeding goals often experiencing feelings of guilt, sadness and anger, alongside an increased risk of postnatal depression. Access to DHM may play an important role not only in protecting infant health and development but in supporting the mental health and well-being of mothers for whom their infant receiving human milk is important. Future randomised controlled trials planned to explore this effect in the broader population. Given the significant personal, social and financial impact that postnatal depression and anxiety have upon parents, infants and communities, this research indicates a further reason to explore broadening the availability of milk bank lactation support services.