Table 2.

Summary of main barriers and facilitators to donor human milk

Major theme	Barriers	Facilitators
Existing practices and perceptions	Old assumptions of what is ok to provide such as cow’s milk, glucose and water	Benefits of breast milk acknowledged and some prior experience of DBM.
Fear of transmission of disease	Potential of HIV transmission	Robust, confidential HIV testing Recipient assured only negative donors permitted
	Misconception of non-communicable disease transmission	Appropriate maternal and community education
Processes of acquisition and storage of milk	Perception of poor hygiene	Ensure good hygiene practice throughout donation process
External influences	Husband as the final decision maker	Education of wider community using media and established community health resources
Transparency and health education	Negative rumors circulating in the community	Transparency and reassurance Trust in healthcare workers
	Fear of being blamed for poor outcome in recipient’s baby	Anonymous donation Appropriate education and reassurance of donor and recipient