Informal Human Milk Sharing: The Experiences and Practices of Informal Human Milk Sharing in Ireland.

Informal human milk sharing (IHMS) is a contemporary and evolving infant feeding practice. In the qualitative phase of a sequential explanatory mixed methods study, this research explored the experiences, practices, and perceived psychological and emotional impacts of IHMS from the perspectives of donors and recipients in Ireland. Fifteen participants were interviewed: ten donors, three recipients, and two who were donors and recipients. The study is reported according to the standards for reporting qualitative checklist (SRQR). Utilizing reflexive thematic analysis, five themes were identified: (1) Motivations for IHMS, (2) Formal milk banking: invisible, rigid and faceless, (3) The healthcare professional paradox, (4) Navigating risk and safety assurance by the "wee subculture," (5) Emotional and psychological impact of IHMS. Our findings reveal that participation in IHMS was propelled by personal imperatives and contextual motivations. Formal human milk bank's (HMB's) were described as rigid, invisible and "quite the effort." Participant narratives depict a culture where CMF was "pushed left, right and centre" in maternity settings as well as the intentional concealment of IHMS from healthcare professionals. Safety and risk mitigation were framed through "a huge trust network." IHMS has profound emotional and perceived psychological outcomes that were represented as a "light switch" release of maternal stress and anxiety for recipients while fostering a sense of pride and a "nice, warm, fuzzy feeling" for donors. There is an imminent need for policy reform and robust clinical frameworks to facilitate healthcare professional engagement, risk mitigation and enhancement of the visibility and accessibility of formal HMBs. Future research should evaluate HCP understanding of HMBs and IHMS in Ireland and similarly under-researched regions.