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MUIMME Report Summary

Project ID: 654495
Funded under: H2020-EU.1.3.2.


Reporting period: 2015-04-01 to 2017-03-31

Summary of the context and overall objectives of the project

The increase in premature and low birth-weight infants surviving the birth trauma and requiring ongoing care has resulted in much concern with infant feeding strategies and an increasing recognition of the growing evidence that when mother’s own milk is not available (a frequent deficiency among mothers of premature babies), donated human milk represents the next best option. Donor human milk demonstrates medicinal as well as nutritional benefits that formula milk cannot provide – most urgently, its immunising properties which are particularly essential if infants are to avoid conditions such as necrotizing enterocolitis – the most significant life-threatening condition affecting premature infants.
Donor milk banking can only function effectively if concerns with transmission are satisfactorily addressed. Fears of milk contamination inhibit the growth development of milk banking. Specifically, anxieties regarding lifestyle choices of donor mothers, particularly with reference to alcohol consumption, may deter hospitals and medical practitioners from recommending the use of donor milk.
Donor human milk, with its immunising properties, has the ability to reduce the amount of time infants spend in Neo-Natal Intensive Care Units, thus saving health authorities money and resources. However, lack of adequate publicity and accurate information concerning milk-banking inhibits the growth of this life-saving (and cost-saving) practice. Indeed a widely reported so-called “Ick Factor” regarding the feeding of babies with other mothers’ milk, indicates a culturally prevalent gut reaction to the practice. For milk-banking to flourish, anxieties regarding both the prevalence and consequences of milk contamination need to be addressed in direct and forthright terms. At the heart of these anxieties is concern over the lifestyles of donor mothers. By researching the detailed life choices of milk donors, a human context can be established which can in turn influence informed policy making regarding future strategies in donor milk banking and milk donor recruitment.
This project was initiated with the objective of researching the human context of relevant stakeholders at four major human milkbanks across the UK and Ireland. This research is to be widely disseminated, both within academic sociological circles and in medical journals. The findings of this research are to be made widely available to the general public.
The research has served the purpose of illustrating the versatility of ways in which milk donation becomes normalised for very different women in very different circumstances By understanding the experiences of how women came to become milk donors, and what the life of a human milk donor consists of, donor recruitment will be focused more sensitively as well as efficiently.

Work performed from the beginning of the project to the end of the period covered by the report and main results achieved so far

Throughout the project Dr Cassidy was actively engaged with training/transfer of knowledge activities. The multi-sited health ethnography she conducted was linked to two Russell Group institutions, extending her research ties with UCLan to others at all of the universities involved in the data collection for this project. Dr Cassidy interacted on a regular basis with faculty staff and doctoral researchers involved with both the UCLan Maternal and Infant Nurture and Nutrition unit (MAINN), and the sister Research in Child Health research group (ReaCH), as well as kindred researchers from other disciplines throughout the faculty, especially in light of plans to develop a new institute of excellence in these areas.
Additionally DrCassidy was involved in a number of transfer of knowledge activities affiliated with the NHS UK Health Research Authorities (HRA) including best clinical practice training and loan researcher training. She also has been pursuing the UK Higher Education Authority (HEA) fellowship accreditation.
The following significant results should be noted:
• The collection of the most detailed multi-cited comparative ethnographic data regarding the donation of human milk ever conducted in the UK and Ireland. Data was collected from the four largest donor human milk banks in the UK, including observational field notes for twelve months, narrative interviews from staff, donors and parents of recipients, as well as documentary/archival data.
• In addition to these triangulated ethnographic data, twelve months of data relating to alcohol and donor breastmilk samples from each of the banks was collected.
• Following four extremely favourable reviews, we have been offered and have signed a contract with a major publisher.
• We have prepared for submission to major journals three papers based on these data,have had two abstracts published. and been asked to contribute to two more special publications on topics related to these data.
• Dr Cassidy participated and presented at over 31 occasions in 7 different countries during her two-year fellowship, and to conduct an online webinar on qualitative research.
• Dr Cassidy was able to extend her networking substantial through her participation in the ESRC funded Breastfeeding Seminar Series which ran throughout this project. As a result, Dr Cassidy has extended research collaborations with one of the organizers of this series.
• Dr Cassidy designed and delivered a workshop.
• Dr Cassidy was invited to participate in Science is Wonder-ful! European Researchers’ Night and was also showcased as an MSCA fellow of the week.

Progress beyond the state of the art and expected potential impact (including the socio-economic impact and the wider societal implications of the project so far)

A significant aspect of the workload during this fellowship consisted of applying for ethical approval at each of the four relevant sites. This very complex process forced Dr Cassidy to re-think the timeframe involving various deliverables. Meanwhile, the concerns, structures, hierarchies, and anxieties illustrated by the variety of difficulties generated by these applications is itself the source of both academic and practical interest and the candidate intends to write further regarding the broader implications of ethical approval for social science research in medical settings. These procedures were changed shortly after Dr Cassidy undertook these applications for approval, as a consequence of complaints received regarding the complexity and slowness of procedures which were deemed injurious to funded medical research.
This project has impacted on Dr Cassidy’s own career by raising her professional profile both inside and outside the academy.
At present, she is collaborating with the immunology department at Maynooth University on an application for an EU COST action.
A number of postgraduates and postdoctoral students have expressed interest in working with Dr Cassidy, wishing to take advantage of unique skills and experience and looking to engage her in a mentorship capacity. Her work has continued to engage high profile discussions of women’s health and lifestyle policies, with a significant comparative international component. In the course of the Fellowship, Dr Cassidy began to research questions related to the role of social media in facilitating human milk sharing as well as milk banking. Milk sharing and milk banking (very different phenomena) are sometimes (wrongly) conflated in existing academic discussions. Future publications derived from this research project will seek to clarify public conversations regarding this critical distinction as well as encouraging honest and critical dialogue and debate between milk-banking and milk-sharing organisations.

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