Postnatal mothers’ knowledge, perceptions and sociocultural influences on donor human milk acceptance in Richards Bay, KwaZulu-Natal, South Africa
- 1School of Public Health, Faculty of Health Sciences, Walter Sisulu University
- 2Society and Health Research Institute, Faculty of Health Sciences, Walter Sisulu University
Abstract
Background: Donor human milk (DHM) is a critical alternative for vulnerable infants when maternal milk is unavailable, but its clinical utilisation in South Africa is constrained by limited understanding of how maternal knowledge, perceived safety, cultural meanings and social contexts shape local acceptance.
Aim: To explore postnatal mothers’ knowledge, perceptions and sociocultural influences shaping acceptance of DHM in Richards Bay, KwaZulu-Natal.
Methods: A qualitative design informed by interpretive phenomenology was used. Twenty-two postnatal mothers were purposively recruited from a private hospital. Semi-structured interviews were conducted in English or isiZulu, and data were transcribed, translated where necessary, and analysed using reflexive thematic analysis supported by reflexivity, peer debriefing, member checking and an audit trail.
Results: Four themes were developed. DHM was largely unfamiliar, with participants reporting limited prior information and little exposure through routine maternal healthcare. Safety concerns centred on infection, donor health, screening, storage and milk processing, although confidence in healthcare institutions facilitated acceptance for some mothers. Acceptance was also shaped by maternal identity, emotional attachment to breastfeeding, spiritual and cultural beliefs, and family and community influence. Limited awareness did not equate to fixed rejection: after DHM was explained, participants distinguished between receiving and donating: willingness to receive DHM for their own infants was conditional on safety assurance and provider recommendation, whereas willingness to donate was expressed more readily and was often motivated by altruism and reciprocity. These findings indicate an interaction between informational uncertainty, institutional trust, cultural meaning and social legitimacy in shaping DHM decisions.
Conclusion: Supporting informed decision-making about DHM, and potentially its uptake, requires more than increasing awareness. Routine antenatal and postnatal education, provider training, transparent communication about safety, and culturally responsive family and community engagement may help convert conditional openness into informed acceptance and donation.
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BibTeX
@article{mhlauli2026postnatal,
title = {{Postnatal mothers’ knowledge, perceptions and sociocultural influences on donor human milk acceptance in Richards Bay, KwaZulu-Natal, South Africa}},
author = {Leonora Luleka Mhlauli and Laston Gonah and Mirabel Kah-Keh Nanjoh and Sibusiso Cyprian Nomatshila and Ziphelele Peter},
journal = {Frontiers in Public Health},
year = {2026},
month = oct,
doi = {10.3389/fpubh.2026.1984123},
url = {https://www.frontiersin.org/articles/10.3389/fpubh.2026.1984123/full},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Postnatal mothers’ knowledge, perceptions and sociocultural influences on donor human milk acceptance in Richards Bay, KwaZulu-Natal, South Africa
AU - Leonora Luleka Mhlauli
AU - Laston Gonah
AU - Mirabel Kah-Keh Nanjoh
AU - Sibusiso Cyprian Nomatshila
AU - Ziphelele Peter
PY - 2026
DA - 2026/10/20
JO - Frontiers in Public Health
DO - 10.3389/fpubh.2026.1984123
UR - https://www.frontiersin.org/articles/10.3389/fpubh.2026.1984123/full
AB - Background: Donor human milk (DHM) is a critical alternative for vulnerable infants when maternal milk is unavailable, but its clinical utilisation in South Africa is constrained by limited understanding of how maternal knowledge, perceived safety, cultural meanings and social contexts shape local acceptance. Aim: To explore postnatal mothers’ knowledge, perceptions and sociocultural influences shaping acceptance of DHM in Richards Bay, KwaZulu-Natal. Methods: A qualitative design informed by interpretive phenomenology was used. Twenty-two postnatal mothers were purposively recruited from a private hospital. Semi-structured interviews were conducted in English or isiZulu, and data were transcribed, translated where necessary, and analysed using reflexive thematic analysis supported by reflexivity, peer debriefing, member checking and an audit trail. Results: Four themes were developed. DHM was largely unfamiliar, with participants reporting limited prior information and little exposure through routine maternal healthcare. Safety concerns centred on infection, donor health, screening, storage and milk processing, although confidence in healthcare institutions facilitated acceptance for some mothers. Acceptance was also shaped by maternal identity, emotional attachment to breastfeeding, spiritual and cultural beliefs, and family and community influence. Limited awareness did not equate to fixed rejection: after DHM was explained, participants distinguished between receiving and donating: willingness to receive DHM for their own infants was conditional on safety assurance and provider recommendation, whereas willingness to donate was expressed more readily and was often motivated by altruism and reciprocity. These findings indicate an interaction between informational uncertainty, institutional trust, cultural meaning and social legitimacy in shaping DHM decisions. Conclusion: Supporting informed decision-making about DHM, and potentially its uptake, requires more than increasing awareness. Routine antenatal and postnatal education, provider training, transparent communication about safety, and culturally responsive family and community engagement may help convert conditional openness into informed acceptance and donation.
SN - 2296-2565
ER -