title: "It's Somebody Else's Milk": Unraveling the Tension in Mothers of Preterm Infants Who Provide Consent for Pasteurized Donor Human Milk.
abstract: BACKGROUND
  Pasteurized donor human milk (DHM), rather than preterm infant formula, is recommended for premature infants when mother's milk is not available.
  
  
  OBJECTIVE
  This study explored the maternal decision-making process in providing consent for DHM feedings.
  
  
  METHODS
  In-depth semistructured interviews were conducted with 20 mothers of premature (mean gestational age = 27 weeks, birth weight = 942 grams) infants hospitalized in the neonatal intensive care unit (NICU) in this qualitative, descriptive study. Conventional content analysis was used to analyze the data.
  
  
  RESULTS
  Although only 1 mother had any previous knowledge of DHM, all mothers provided consent for DHM because they "wanted what is best for my baby." Mothers trusted that DHM was better than formula when their infant's feeding requirements exceeded their own milk supply. However, most mothers described a tension between wanting their infants to receive only "their" milk and DHM being "somebody else's milk." This desire to be the only provider of human milk was more common than concerns about the quality and safety of DHM. The mothers' tension was mediated by trusting the NICU clinicians' recommendations, having adequate time to make an informed decision, observing the positive outcomes of DHM, and feeling empowered that they made the best decision for their infant.
  
  
  CONCLUSIONS
  The experiences of these mothers reflect the importance of approaching mothers for consent only when DHM is needed, respecting mothers' beliefs and values about DHM, and providing help in mediating any tension with regard to their infants receiving "somebody else's milk."
authors.affiliation: Department of Women, Children, and Family Nursing, Rush University, Chicago, IL, USA Anita_L_Esquerra-Zwiers@rush.edu.
authors.forename: Anita
authors.initials: A
authors.lastname: Esquerra-Zwiers
authors.affiliation: Department of Women, Children, and Family Nursing, Rush University, Chicago, IL, USA.
authors.forename: Beverly
authors.initials: B
authors.lastname: Rossman
authors.affiliation: Department of Women, Children, and Family Nursing, Rush University, Chicago, IL, USA Pediatrics, Section of Neonatology, Rush University Medical Center, Chicago, IL, USA.
authors.forename: Paula
authors.initials: P
authors.lastname: Meier
authors.affiliation: Department of Women, Children, and Family Nursing, Rush University, Chicago, IL, USA.
authors.forename: Janet
authors.initials: J
authors.lastname: Engstrom
authors.affiliation: Pediatrics, Section of Neonatology, Rush University Medical Center, Chicago, IL, USA.
authors.forename: Judy
authors.initials: J
authors.lastname: Janes
authors.affiliation: Department of Women, Children, and Family Nursing, Rush University, Chicago, IL, USA Pediatrics, Section of Neonatology, Rush University Medical Center, Chicago, IL, USA.
authors.forename: Aloka
authors.initials: A
authors.lastname: Patel
mesh_terms: D000328:Adult; D061186:Breast Milk Expression; D003657:Decision Making; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007224:Infant Care / Q000379:methods* / Q000523:psychology; D007231:Infant, Newborn; D007234:Infant, Premature; D007258:Informed Consent / Q000523:psychology*; D007363:Intensive Care Units, Neonatal; D007407:Interviews as Topic; D017784:Milk Banks; D008895:Milk, Human; D009034:Mother-Child Relations / Q000523:psychology*; D009035:Mothers / Q000523:psychology*; D036301:Qualitative Research
keywords: NICU; breastfeeding; decision making; donor milk; premature infants