Knowledge and Attitudes of Donor Human Milk of Mothers in the Palestinian Territories and Israel.

Introduction: Donor human milk (DHM) is the next best option when mothers' milk is unavailable. The study objective was to examine mothers' knowledge and attitudes regarding DHM. Materials and Methods: A prospective, descriptive, online study using mixed methods. Regression analysis was used to control for confounding variables and content analysis for the qualitative component. Results: Eighty mothers from the Palestinian Territories and Israel participated. Mothers' mean objective knowledge score was 3.4/6, and self-evaluation knowledge score was 2.4/5, with religion significant for both scores (p < 0.001 and p = 0.002), respectively. Compared with Muslim mothers, Christian and Jewish mothers were more likely to prefer DHM to formula: (adjusted odds ratio [95% confidence interval], 4.9 [1.5-16.6], and 17.5 [4.3-71.4]), donate HM (human milk) to a friend or relative (7.8 [2.0-30.3]) and 60 [9.9-362.3]) or donate HM to a human milk bank (5.4 [1.3-23.3] and 11.2 [2.6-47.5]). Muslim and Christian mothers were more likely to state that DHM was permissible only under certain circumstances. Regression analysis revealed that only religion was significant for mothers' response that DHM was permissible (p < 0.001). Qualitative analysis revealed that differences in mothers' knowledge and attitudes were related to milk kinship. Conclusions: In this first study of mothers' knowledge and attitudes of DHM in the Palestinian Territories and Israel, results revealed low knowledge and negative attitudes regarding DHM correlated with the mother's culture. Future programs should include culturally competent initiatives regarding the benefits of DHM.