Providing Choice: Exploring Maternal Perceptions of Infant Feeding When Supplementation Is Required.

Exclusive breastfeeding is recommended for the first 6 months of life. However, many full-term infants require supplementation in the first few days of life, with formula often being the only supplementation option provided. With increased awareness and availability, donor human milk is becoming a viable alternative for supplementation in full-term infants. This study aimed to understand how having a choice to supplement infants with donor human milk rather than formula informed maternal experiences with infant feeding. Using a qualitative descriptive design, we conducted 15 semi-structured interviews with mothers who chose to supplement their infant with donor human milk. The semi-structured interview guide was co-developed with milk banking associations to elicit feeding goals, perceptions of donor human milk, infant feeding experiences in the first weeks of life and perceived well-being, health, and feelings around supplementation. Interviews were analyzed using reflexive thematic analysis. Of the 15 participants, over half delivered via cesarean section (n = 8), the majority were primiparous and had no previous breastfeeding experience (n = 12) and most wanted to exclusively breastfeed their infant (n = 11). Four overarching themes were identified: (1) feeding experience, (2) supplementation, (3) maternal well-being, and (4) feasibility. Choosing donor human milk positively impacted participant mental health, helped relieve stress from the pressure to breastfeed, and provided peace of mind. Donor human milk may provide a feasible intervention that may help to mitigate maternal distress by providing a supplement that is more to similar breastmilk, while breastfeeding is being established.