Japanese Mothers’ Experiences and Sentiments Towards Donor Human Milk for Very Low Birth Weight Infants: A Modified Grounded Theory Approach

Background Breast milk reduces complications among very low birth weight infants (VLBWIs) admitted to neonatal intensive care units (NICUs). When mothers’ own milk (MOM) is temporarily unavailable, donor human milk (DHM) is used as an alternative. In Japan, where human milk banking has been introduced relatively recently, little is known about how mothers experience emotional changes and social interactions related to DHM use while continuing to express their own milk. Method Semi-structured interviews were conducted with 10 mothers of VLBWIs who had used DHM immediately after birth, and data were analysed using the Modified Grounded Theory Approach. Results Mothers experienced a conflict between their genuine feelings and the realities of donor human milk use; however, the words of those who stayed beside them, including midwives and physicians, facilitated meaning-making, enabling mothers to reconcile their experiences through expressing milk and their infant’s growth. 【Words from those who stay beside the mother】 provided insights for clinical nursing practice. Continued breastfeeding and the child’s growth supported mothers in negotiating and reconciling the tension between their authentic feelings and the realities of using donor human milk. Conclusion This study clarified how mothers negotiate and reconcile emotional conflicts related to DHM use in NICUs. Emotional support from healthcare professionals, together with ongoing lactation support and opportunities to share experiences, may help mothers come to terms with DHM use and sustain milk expression. These findings provide practical implications for nursing support in settings where DHM is implemented. Providing continuous lactation support and opportunities to share experiences may help mothers come to terms with DHM use and sustain milk expression. Additionally, building connections among mothers, creating opportunities for peer gatherings, offering antenatal education that includes breastfeeding preparation, and enhancing lactation education for healthcare professionals are beneficial. These findings offer practical implications for breastfeeding support in settings where DHM is implemented.