BACKGROUND:
There is a global consensus about the superiority of breast milk as the optimal source of nutrition for infants. It is strongly recommended that infants be exclusively breastfed for the first six months of life

OBJECTIVES:
To explore and describe milk donation practices and perspectives.

METHODS:
A cross-sectional study (online survey). A sample of 873 Belgian women and their partners during preconception, pregnancy and up to one year postpartum.

RESULTS:
A surplus (4.6 ±1.0) or shortage (3.9 ±1.7) of milk is the primary factor influencing the intention to donate or receive human milk, reported by 88% and 78% of respondents, respectively. Most donations (85.7%) occur through social media (50%) and personal networks (47.6%). Key perspectives of milk donation include healthcare providers’ familiarity (3.7 ± 0.5), public awareness (3.6 ±0.5), mandatory blood testing (3.50 ±0.7), and donor screening (3.5 ±0.6). Human milk banks are perceived as valuable resources (3.5 ±0.6), while altruism (3.4 ±0.6) is a key to donating. There is broad support for making donor milk accessible to all infants, not just those who are premature or ill (3.4 ±0.6).

CONCLUSIONS:
Personal attitudes and intentions shape informal, self-regulated milk donation. Healthcare providers need to consider these perspectives when advising on milk donation practices

KEY MESSAGE:
Informal, self-regulated milk donation is often used by women. Current legislation focuses on pathology. It is recommended to also regulate milk donation within physiology Breastfeeding - milk donation