Background: In the UK, to date, there is little evidence to support the safe use of donor human milk (DHM) from a human milk bank beyond extremely premature babies in neonatal intensive care units. The HMB operates as part of a new charity, the Human Milk Foundation, and foremost aim to fill gaps in the provision of donor human milk (DHM) to hospital neonatal units. Secondary aims of the HMB are to facilitate research into operational aspects of human milk banking, the clinical use of DHM and the science of human milk.

Objective(s): This study aimed to assess the growth and tolerance of infants provided with DHM from the Hearts Milk Bank (HMB) in the UK over the course of their first 18 months of operation, as well as the range of indications for which DHM was provided. The study also aimed to understand the impact of DHM use on infant and mother from this case series, and provide the first national and international profile of DHM usage beyond extremely premature babies cared for in NICUs.

Materials/Methods: Interviews were conducted over the telephone with follow up questions answered by email when required. All interviews were conducted at the Hearts Milk Bank premises, and no identifiable data left the milk bank premises. Questionnaires were sent electronically using Qualtics to all UK‐based milk banks as well as milk banks internationally, including North America, Europe and Australia, to determine the provision of DHM beyond the NICU. Finally, infant feeding leads in hospitals offering maternity and paediatrics care across the UK was surveyed using a Qualtrics questionnaire to understand the geographical variability in DHM provision, and to understand the reasons that underpinned this. This study was assessed as a service evaluation project by the Imperial Research Ethics team, and formal ethics was not required.

Conclusions: DHM that is surplus to the requirements of hospitals has been provided to more than 40 families in the community for a range of indications, after request by a clinician caring for the infant or mother. Indications ranged from lack of maternal breastmilk (e.g., maternal cancer, maternal psychosis), or to support maternal supply (e.g., hypothyroidism, stress related to infant illness, insufficient glandular tissue). The costs of the milk have been covered by the HMB or the Human Milk Foundation; funding requests to local Clinical Commissioning Groups have to date all been rejected. Donor milk use variability was mapped across the UK and other developed and developing world countries.