Diversity and trends of human milk banking: a scoping review from 1946 to 2021

This scoping review describes the published information on banked donor human milk and highlights areas for future research and increased access. Background The provision of donor human milk (DHM) through human milk banks is now widely practised globally. The study aimed to describe the current state, identify major topics and map out the emerging trends in human milk banking. Methods PubMed was systematically searched for publications related to DHM, with the last update on 14 May 2021, for papers published between 1946 and 2021. Titles and abstracts were screened and indexed into 8 main and 39 subcategories. A top-up search was done in April 2022, but these results have not been incorporated. Results A total of 1083 publications were identified, and more than a third (41%) were either observational or interventional studies. Predominant topics were milk type and milk composition. Almost half (49%) of the publications in the last decade were funded through government/research councils, and industry funding started shortly after links between formula and necrotising enterocolitis were published. Literature from high-income countries was six times more than publications from low-income or middle-income countries (LMICs). Conclusion The diversity and trends of publications included in this scoping review ranged from descriptive studies comparing biological and compositional differences of mother's own milk, DHM and/or formula. Very few studies have investigated associations of different milk types with infant outcomes. Evidence on breastfeeding and recipient psychological health outcomes is limited. Further research should identify the appropriateness of different funding sources. Future collaborations between academics, clinicians and milk banks in LMICs should be fostered to bridge the gap that exists between DHM and access.

Automated summary

This scoping review provides an overview of the current state and emerging trends in donor human milk banking. The predominant topics identified were milk type and composition, and there is a lack of research on the associations between different milk types and infant outcomes. Further research is needed to explore the appropriateness of different funding sources and to foster collaborations between academics, clinicians, and milk banks in low-income or middle-income countries to improve access to donor human milk.