Postnatal mothers’ knowledge, perceptions and sociocultural influences on donor human milk acceptance in Richards Bay, KwaZulu-Natal, South Africa
Year: 2026
Type: article
Abstract: Background Donor human milk (DHM) is a critical alternative for vulnerable infants when maternal milk is unavailable, but its clinical utilisation in South Africa is constrained by limited understanding of how maternal knowledge, perceived safety, cultural meanings and social contexts shape local acceptance. Aim To explore postnatal mothers’ knowledge, perceptions and sociocultural influences shaping acceptance of DHM in Richards Bay, KwaZulu-Natal. Methods A qualitative design informed by interpretive phenomenology was used. Twenty-two postnatal mothers were purposively recruited from a private hospital. Semi-structured interviews were conducted in English or isiZulu, and data were transcribed, translated where necessary, and analysed using reflexive thematic analysis supported by reflexivity, peer debriefing, member checking and an audit trail. Results Four themes were developed. DHM was largely unfamiliar, with participants reporting limited prior information and little exposure through routine maternal healthcare. Safety concerns centred on infection, donor health, screening, storage and milk processing, although confidence in healthcare institutions facilitated acceptance for some mothers. Acceptance was also shaped by maternal identity, emotional attachment to breastfeeding, spiritual and cultural beliefs, and family and community influence. Limited awareness did not equate to fixed rejection: after DHM was explained, participants distinguished between receiving and donating: willingness to receive DHM for their own infants was conditional on safety assurance and provider recommendation, whereas willingness to donate was expressed more readily and was often motivated by altruism and reciprocity. These findings indicate an interaction between informational uncertainty, institutional trust, cultural meaning and social legitimacy in shaping DHM decisions. Conclusion Supporting informed decision-making about DHM, and potentially its uptake, requires more than increasing awareness. Routine antenatal and postnatal education, provider training, transparent communication about safety, and culturally responsive family and community engagement may help convert conditional openness into informed acceptance and donation.
Source: Frontiers in Public Health
Institution: Walter Sisulu University
Language: English
Subfield: Epidemiology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,801
OpenAlex ID: W7223046907