A Liberation Health Approach to Examining Challenges and Facilitators of Peer-to-Peer Human Milk Sharing

J Hum Lact. 2018 Aug;34(3):438-447. doi: 10.1177/0890334418771301. Epub 2018 May 3.


Background: Human milk sharing between peers is a common and growing practice. Although human milk has been unequivocally established as the ideal food source for infants, much stigma surrounds the practice of human milk sharing. Furthermore, there is little research examining peer-to-peer human milk sharing. Research Aim: We used the liberation health social work model to examine the experiences of mothers who have received donated human milk from a peer. Research questions were as follows: (a) What challenges do recipient mothers experience in peer-to-peer human milk sharing? (b) What supports do recipient mothers identify in peer-to-peer human milk sharing?

Methods: Researchers conducted in-depth interviews with mothers ( N = 20) in the United States and Canada who were recipients of peer-to-peer human milk sharing. Researchers independently reviewed transcripts and completed open, axial, and selective coding. The authors discussed conflicts in theme identification until agreement was reached.

Results: Challenges to peer-to-peer human milk sharing were (a) substantial effort required to secure human milk; (b) institutional barriers; (c) milk bank specific barriers; and (d) lack of societal awareness and acceptance of human milk sharing. Facilitators included (a) informed decision making and transparency and (b) support from healthcare professionals.

Conclusion: Despite risks and barriers, participants continued to pursue peer-to-peer human milk sharing. Informed by a liberation health framework, healthcare professionals-rather than universally discouraging human milk sharing between peers-should facilitate open dialogue with parents about the pros and cons of this practice and about screening recommendations to promote safety and mitigate risk.

Keywords: Global Strategy for Infant and Young Child Feeding; breastfeeding; human milk; human milk expression; maternal health; qualitative methods.

MeSH terms

  • Adult
  • Breast Feeding / trends*
  • Canada
  • Cooperative Behavior*
  • Cross-Sectional Studies
  • Female
  • Humans
  • Interviews as Topic / methods
  • Milk Banks / organization & administration
  • Milk Banks / statistics & numerical data
  • Milk, Human*
  • Peer Group*
  • Prospective Studies
  • Qualitative Research
  • Social Media / instrumentation
  • Surveys and Questionnaires
  • United States