ArticleBMJ open2026
Exploring UK breastmilk donors' perspectives on breastfeeding as a protective factor against breast cancer: a qualitative study.
Article in BMJ open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectivesBreastfeeding is associated with a reduced risk of breast cancer yet awareness of this maternal health benefit remains limited. Public health messaging in the United Kingdom has traditionally emphasised infant benefits of breastfeeding with less attention to long-term maternal outcomes. This study aimed to explore breastmilk donor awareness of breastfeeding as a protective factor against breast cancer and their perspectives on communicating this information.
designQualitative study using semistructured interviews analysed through reflexive thematic analysis, adopting a constructivist epistemological position.
settingParticipants recruited from across the United Kingdom through the Hearts Milk Bank took part online using Microsoft Teams. Interviews were conducted between June and July 2025.
participantsTwelve milk bank donors recruited as part of the Breastmilk Epigenetics Cohort Study (BECS). Participants discussed breastfeeding experiences, awareness of breast cancer risk factors, perceptions of personal risk and views on breastfeeding-related health messaging.
resultsFive themes were generated. 'Know more, breastfeed for longer?', describes uneven awareness of breastfeeding as a protective factor against breast cancer. 'Breast cancer is seen as fate, not risk, and breastfeeding is not a part of the picture', describes risk perceptions related to breast cancer. 'A communication system that centres the baby, not the mother-infant dyad', highlights the lack of maternal-focused education postnatally. 'Information reaches women by chance, not design', explores the routes by which participants find breastfeeding and breast cancer information and finally, 'What women want: clear, shame-free, integrated communication', represents participants' clear preferences for non-judgemental, evidence-based information delivered by trusted sources.
conclusionBreastfeeding-related breast cancer risk reduction appears poorly integrated into routine health communication for women of reproductive age in the United Kingdom. The fact that breastmilk donors, a niche group of women who are highly motivated and capable of donating excess supplies of breastmilk, had a variable awareness of the maternal benefits of breastfeeding, is not only significant in its own right, but carries broader implications; if awareness gaps exist at this level of commitment, they are almost certainly more pronounced across the general breastfeeding population. As such, while these data are not intended to be representative of breastfeeding women in the UK, these findings offer a compelling case for reform of how breastfeeding benefits are communicated. Future research with broader and more diverse populations is needed to examine whether these patterns extend beyond highly motivated breastfeeding women, and to develop and evaluate targeted communication strategies.
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