目的:母乳是所有婴儿的最佳营养来源。当母亲自己的牛奶不可用时,世界卫生组织建议对有或没有医疗并发症的早产儿使用供体母乳。探索母乳捐赠的障碍和促进因素及其可接受性对于制定这种干预措施至关重要。根据Arksey和O\'Malley(IntJSocResMethodol8:19-32,2005)开发的方法框架进行了范围审查。在PubMed(NCBI)进行了搜索,CINAHL(EBSCO),和WebofScience(Elsevier)。采用两阶段顺序筛选过程。使用试点数据提取表格进行数据提取。
结果:我们纳入了20篇叙事综合文章。捐赠和接受母乳的障碍和促进者分为六个主题:个人,家庭,社区,workplace,卫生系统,与政策相关。常见的个人障碍是BMD的时间要求,个人不喜欢这个过程,缺乏知识,牛奶不足,负面意见,缺乏信息。家庭耻辱,负面谣言,受教育程度较低的家庭成员,家庭成员的疾病被确定为与家庭有关的障碍。与社区有关的障碍包括不可接受的文化或宗教习俗,社会禁忌,和距离牛奶银行。与卫生系统有关的主要障碍是缺乏实际和心理支持,缺乏信息,储存和运输问题,HCWs缺乏知识,以及建立牛奶实验室的后勤挑战。与工作相关的常见障碍是缺乏足够的时间,哲学上的反对,对重返工作岗位感到不理解。确定的与政策相关的障碍包括对卫生要求的需求,捐赠费用,缺乏标准化的指导方针。让捐赠过程更快,为捐助者提供接送服务,社区教育和男性伙伴参与母乳捐赠可能有助于提高母乳捐赠的可接受性。
Human milk is the best source of nutrients for all infants. When a mother\'s own milk is unavailable, the World Health Organization suggests using donor human milk for premature neonates with or without medical complications. Exploring the barriers and facilitators for breast milk
donation and its acceptability is essential for developing this intervention. A scoping
review was conducted based on a methodological framework developed by Arksey and O\'Malley (Int J Soc Res Methodol 8:19-32, 2005). A search was conducted in PubMed (NCBI), CINAHL (EBSCO), and Web of Science (Elsevier). A two-stage sequential screening process was adopted. Data extraction was done using a piloted data extraction form.
We included 20 articles for narrative synthesis. Barriers and facilitators for donating and accepting breast milk were categorized under six themes: individual, family, community, workplace, health system, and policy-related. The common individual barriers were time requirements for BMD, personal dislike of the process, lack of knowledge, insufficient milk, negative opinions, and lack of information. Family stigma, negative rumors, less educated family members, and illness of a family member were identified as family-related barriers. Community-related barriers include cultural or religious unacceptable practices, societal taboos, and distance to milk banks. The major barriers identified in relation to the health system were lack of practical and psychological support, lack of information, storing and transportation issues, lack of knowledge among HCWs, and logistical challenges of creating a milk lab. The common work-related barriers were the lack of adequate time, philosophical objections, and incomprehension at returning to work. Policy-related barriers identified include the need for hygiene requirements,
donation costs, and lack of standardized guidelines. Making the
donation process faster, providing pick-up services for donors, and community education and male partner engagement regarding breast milk donation could help to boost the acceptability of breast milk
donation.