BACKGROUND: The Human Milk Banking Association of North America (HMBANA) is a nonprofit association that standardizes and facilitates the establishment and operation of donor human milk banks in North America. No study has characterized the demographics, characteristics, and geographic distribution of its donors. MATERIALS AND METHODS: Donors were eligible for inclusion if they were donors at MMBNE, provided a gestational age for their infant, and donated between 1/1/2011-9/1/2019. Data collected from donor surveys and milk collection procedures were analyzed using descriptive statistics, chi-square tests, t tests of independence and Mann-Whitney U tests. RESULTS: Data were analyzed from 3767 donors. On average, donors were 32.5 years old (range 17-52) and donated more than once (mean 2.8; median 2; IQR 1-3; range 1-41). The majority of donors gave birth to term infants, lived in New England, and were not bereaved. Massachusetts had the largest proportion of donors (40.9%), however donors were located in 39 states and four countries. The median total volume donated per donor was 21904mL (741Oz). The average volume of donation per donor increased over time. Mothers who had preterm births were more likely to be bereaved (66% vs. 13%; p<0.01) and the volume of donation (mL) was associated with term versus preterm birth status respectively (p<0.01). CONCLUSION: Donors to MMBNE were generally older, repeat donors with term infants, and broadly geographically distributed. Further research is warranted to understand additional characteristics associated with milk donation and any characteristics of mothers who are and are not able to donate milk in accordance with milk bank protocols.

With approximately 24,500 preterm children born annually in Canada and an estimated shortage of 6 million ounces of breast milk, the distribution of donor milk must be time-sensitive yet safe to efficiently meet this demand. Donor human milk banks take the greatest precautions to protect their users, but some of these microorganisms manage to circumvent the employed methods. The consumption of contaminated donor milk has the potential to be fatal particularly to the vulnerable, immunocompromised premature infants. The tools used by milk banks to ensure safe distribution rely heavily on the culture plate. It has been the gold standard in screening for microbiological specimens due to its wide availability, low cost, and simplicity. However, the procedural times for bacterial culture plates are tedious and long, lasting a minimum of 48 hours. Advances in microfluidics, particularly in combination with the concept of monitoring metabolites to indicate bacterial viability, hold much promise to significantly reducing the long processing times of culture plates. Combining the concept of compartmentalized culture and a chromogenic optical dye for the detection of metabolic changes as a diagnostic sensor would simplify the identification and quantification of microbial presence. The updated Rapid Culture Detection system is a nanowell device fabricated using polydimethylsiloxane (PDMS) that uses the oxygen-sensitive redox indicator Methylene Blue to determine the presence of bacteria. Preliminary studies have shown to detect bacteria in as little as 3.33 hours using these nanowells compared to the 24 hours required for microwell liquid culture (620%). Initial studies have also been conducted with human milk, indicating a slower detection than in LB media. The novel easy-to-use and low-cost Rapid Culture Detection system is a promising alternative detection tool for protecting infants from pathogenic illnesses caused by contaminated human milk and shortening the time required to access lifesaving nutrition. / Thesis / Master of Applied Science (MASc)

Mothers are known to have an emotional attachment to their infant; however, some mothers also experience an emotional attachment to their own milk. Exclusive breastfeeding in the first six months of life, followed by continued breastfeeding with complementary solids are recommended by the American Academy of Pediatrics and the World Health Organization. Some mothers produce enough surplus milk to donate to a human milk bank. This thesis considers the emotional attachment to milk experienced by women who donate milk to a milk bank. This research is based on participant observation in a human milk bank in Florida and interviews collected from 14 milk bank donors. These methods were informed by the frameworks of moral motherhood and emotive value to foreground and enhance understanding of mothers' experiences. The results of this study show that mothers do not emotionally attach to breastmilk itself, but rather what the breastmilk represents. This study starts a conversation and brings awareness to women's emotional experiences at the beginning of motherhood, especially as they pertain to breastfeeding and human milk.