Human milk banking services: an umbrella review

Objective: Donor human milk (DHM) is excess breast milk a woman donates to a human milk bank (HMB) for use by another infant. HMB requires operational sustainability to ensure consistent and equitable DHM supply. This review synthesises evidence from systematic reviews on how HMB services have been developed and scaled internationally. Results will inform the co-design of an evidence framework that incorporates governance, quality and sustainability criteria for HM banking. Design: An umbrella review was conducted following the JBI Manual for Evidence Synthesis. CINAHL, MEDLINE, PsycINFO, Embase, JBI Evidence Synthesis, Epistemonikos and PROSPERO datasbases were searched along with grey literature searches using Google Scholar, BASE and the National Institute for Health and Care Excellence website. Studies published between 2000 and June 2025 were screened by two independent reviewers. Setting: HMB or HMB service operating in any middle- and high-income country. Participants: Prospective, current or past HM donors; donor milk recipient families; staff working within HMB service. Results: Thirteen reviews were identified. Limited information on HMB organisational and funding models were identified. Key stakeholders include DHM donors and recipients, healthcare professionals and social supports. Institutional support and providing information about HMB were found to be facilitators of DHM donation and acceptance of DHM among recipient parents. Barriers to HMB development included limited public information, religious beliefs and lack of support. Conclusions: A significant information gap was identified in HMB funding and organisational models. Establishing sustainable funding models, standardised governance structures and strategies to improve healthcare professionals knowledge and public awareness are opportunities for future research.