The legislative framework of donor human milk and human milk banking in Europe

• Published in: Maternal and child nutrition 2022-04, Vol.18 (2), p.e13310-n/a
• Main Authors: Klotz, Daniel, Wesołowska, Aleksandra, Bertino, Enrico, Moro, Guido E., Picaud, Jean‐Charles, Gayà, Antoni, Weaver, Gillian
• Format: Article
• Language: English
• Subjects: Banks; Breastfeeding & lactation; Classification; Cross-Sectional Studies; donor human milk; Europe; Food and Nutrition; Food products; Frame analysis; Governance; Humans; Infant; Infants; Jurisdiction; legislation; Life Sciences; Milk; milk banking; Milk Banks; Milk, Human; Neonatal care; Original; Premature babies; Premature birth; preterm; Questionnaires; Regulation; Tissue Donors
• ISSN: 1740-8695; 1740-8709
• DOI: 10.1111/mcn.13310

Data about the regulatory approaches to donor human milk (DHM) in European countries are lacking. The aim of this study is to describe the various regulations of DHM within European countries, to assess its legislative context and its impact in relation to donor milk banking. We performed a cross‐sectional survey using a semistructured online questionnaire addressing 29 national European milk‐banking representatives from June 2020 to February 2021. Representatives of 26 national DHM services participated in this study. The legal classification and regulatory status of DHM were defined in 9 out of 26 areas of jurisdiction (35%) as either food product (n = 6), product of human origin according to a blood, tissue, cell regulation (n = 2), or medicinal product (n = 1). In the remainder, DHM remains unclassified. Most legislations did not provide a comprehensive framework concerning DHM and costs to cover milk bank operations were rarely reimbursed. In general, the lack of national legislative governance and the actual legislative regulations in place do not support the use of DHM in European countries. National medical guidelines for the use of DHM have been issued in only 11 countries. The current number and distribution of milk banks (n = 239) within participating countries may not provide an equitable access to DHM for eligible infants. These findings could guide stakeholders aiming to establish a regulatory framework for DHM. Key messages There is a lack of a legislative framework concerning the use of donor human milk in the majority of European countries. Available national legislative frameworks differed widely with gaps in the regulation of safety and quality of donor human milk, protection of donors and recipients, and cost recovery. Despite clearly demonstrated benefits and unequivocal recommendations for the use of donor human milk there is a lack of national guidance in many European countries.