Improving resilience in human milk banking: workshop proceedings, 11th November, London UK.

Human milk banks (HMBs) are an essential clinical service, providing safe, screened donor human milk (DHM) to clinically vulnerable infants, which can enable mothers to establish their own milk supply. While HMB processes share similarities with other medical products of human origin (e.g., blood, platelets), HMBs remain marginalised services with limited resilience to external or internal pressures. As demand for DHM increases, understanding how to mitigate these vulnerabilities is essential. In November 2022, a workshop organised by the Human Milk Foundation brought together UK milk bank leaders, academics, and planners. The workshop aimed to understand existing pressures faced by UK HMBs and create a network to support strategic, evidence-based responses. Emergent themes highlighted that HMBs are stretched, facilitated largely by goodwill. Most services are reliant on limited workforces with limitations in service continuity, training, and succession planning. COVID-19 exacerbated pressures, but led to HMBs cooperating more. Proposed responses included investment in staffing, training and IT resources, greater public awareness and inter-HMB cooperation, and a national HMB Risk Register. Service continuity needs to be urgently addressed through external multiagency engagement, operational support, and research prioritization (including qualitative, technological and implementation science), defining optimal service design and financial resourcing to meet nationally agreed needs. Without intervention, the UK milk bank network may be unable to respond to future significant pressures, including specialist infant feed or infant formula shortages. With appropriate investment, a comprehensive National Service can be created to provide equitable services underpinned by robust research and innovation.