Tanya M. Cassidy

Helen Ball is professor of anthropology and Director of the Durham Infancy & Sleep Centre. She obtained her PhD in anthropology from the University of Massachusetts, Amherst, in 1992. Her new book How babies sleep: A factful guide to the first 365 days and nights was published by Penguin Random House in May 2025. Helen studies infant sleep and the parent–infant sleep relationship from a biosocial perspective, focusing on the sleep ecology of infants, young children, and their parents. She pioneers the translation of academic research on infant sleep into evidence for use by parents and healthcare staff via Basis—the Baby Sleep Information Source website. She serves on the Lullaby Trust Scientific Advisory Group, and the United Nations Children’s Fund (UNICEF) UK Baby Friendly Initiative Qualifications Board, and was recently appointed as a National Mentor (United States) for the Betty Irene Moore Fellowship in Leadership and Innovation Program. She has previously served as an associate editor for the journal Sleep Health , and as an editorial board member for the Journal of Human Lactation . From 2016 to 2025, she was Chair of the Lullaby Trust Research & Grants Committee, and from 2018 to 2024, she was elected as a board member of the International Society for the Study and Prevention of Infant Deaths (ISPID). In 2013, Helen received an award for Outstanding Impact in Society from the Economic and Social Research Council, and in 2018, Durham University received the Queen's Anniversary Prize for her research and outreach on parent–infant sleep.

Introduction: Breastfeeding is the biological norm for infant nutrition. In certain scenarios, feeding at the breast is not possible, because of either maternal or neonatal reasons. In those cases, infants can still receive expressed mother’s own milk (MOM) and its beneficial properties. Mothers can express their milk using a variety of methods, while applying different hygiene practices, in different settings; moreover, expressed milk might receive processing before it is fed to the infant, particularly to reduce transmission of viruses such as cytomegalovirus to premature infants. The present protocol was designed to gather the evidence on the effect that the expression method, the hygiene regimen and setting and any processing used on expressed MOM can have on the clinical outcomes of recipient infants. Methods: This systematic review will follow the methodological recommendations of the Cochrane Collaboration, in accordance with WHO recommendations and Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We will apply a hybrid search strategy, by combining structured database search with predefined snowballing searches. We will include primary research studies only, without restrictions on the type and including observational studies; no publication time, setting or language restriction will be applied, provided the abstract is available in English. Studies evaluating different methods of MOM expression, hygiene practices or settings during expression, processing of MOM and reporting clinical outcomes on recipient infants will be eligible. The searches have been planned to be performed in April–May 2024. Two reviewers will independently perform the reference screening, data extraction and risk of bias analysis of eligible studies, by using standardised tools specific for each study design. Quantitative and thematic narrative data synthesis will be performed and statistical heterogeneity between studies tested. Meta-analyses of extracted data will be performed where applicable. For relevant outcomes, certainty of the evidence will be tested by using the Grading of Recommendations Assessment, Development and Evaluation approach. Ethics and dissemination: Ethical approval is not required for this study since no original data will be collected. There is patient and public involvement throughout this research process. The results of this review will be disseminated through publication in a peer-reviewed journal and through conference presentations. Moreover, this systematic review will inform recommendations on milk banking of the WHO Department of Nutrition and Food Safety. PROSPERO registration number: CRD42024523299.

Introduction Donor human milk (DHM) is the first alternative if mother’s own milk is unavailable or contraindicated. Much DHM research has focused on its nutritional, immunological and biochemical composition in response to various maternal variables, standard human milk banking procedures and storage protocols. The current systematic review protocol, however, aims to systematically gather and analyse existing data pertaining to the impact of these aforementioned factors on the clinical, health-related and developmental outcomes observed in infants fed with DHM. Methods and analysis We will apply a predefined search strategy including Cochrane Central Register of Controlled Trials, Global Index Medicus, CINAHL on Ebscohost, Medline, Embase, Emcare, Pubmed, Global Health on OVID, Google Scholar, clinicaltrials.gov, the WHO International Trials Registry and Platform and the European Union/European Economic Area Clinical Trials Register. No setting, patient population, date or language restrictions will be applied. The search strategy will consist of search words on the key concepts of ‘donated human milk’ and ‘effect on infants’. Published or unpublished primary research studies are eligible for inclusion if there is an abstract available in English. Conference proceedings, animal studies and publications with no original data will be excluded. Authors of unpublished or partially published studies will be contacted and eligible data added if provided. Risk of bias will be evaluated according to CASP using appropriate tools depending on study type (RoB 2, ROBINS-I, Newcastle Ottawa Scale). Data will be synthesised in a quantitative format describing significant results as well as presenting the results of the quality assessment of studies. Ethics and dissemination This systematic review does not require ethical approval, as we will not collect primary data. The review will be published in a peer-reviewed journal and disseminated electronically and in print. PROSPERO registration number CRD42024522015.

Professor Joao Aprigio Guerra de Almeida graduated in Food Engineering (UFV-1981) with a Master in Microbiology (UFV-1986) and a doctorate in Women’s and Children’s Health (Fiocruz/IFF, 1998) He is founder and coordinator of the Brazilian Human Milk Banks Network (Ministry of Health-Brasil/Oswaldo Cruz Foundation-Fiocruz, 1987 to 2024); Head of the National Reference Center for Human Milk Banks at the National Institute of Women, Children and Adolescent Health Fernandes Figueira-IFF (Fiocruz/IFF, 1987 to 2024); Executive Secretary of the Ibero-American Human Milk Banks Network Program (Ibero-American General Secretariat-SEGIB/Brazilian Cooperation Agency-ABC/MS-FIOCRUZ, 2008 to 2020); Coordinator of International Technical Cooperation in Human Milk Banks ABC/Fiocruz/MS (2005 to 2024); and Coordinator of the Human Milk Banks Network of the Community of Portuguese Speaking Countries – CPLP (2017 to 2024). He has been recognized with the Sasakawa Health Prize (World Health Organization [WHO], 2001); as Officer of the Order of Rio Branco (Presidency of the Federative Republic of Brazil, 2001); with Global Health Challenges and Responses of the South in Time of Crisis (WHO, 2009); as Commendator of the Order of Rio Branco-Ministry of Foreign Affairs/Presidency of the Federative Republic of Brazil (2018); and Dr LEE Jong-wook Memorial Prize for Public Health (WHO, 2020). His areas of activity include Public Health, breastfeeding, Human Milk Banks, Public Management, and International Technical Cooperation.

Professor Fiona Dykes is Professor Emerita of Maternal and Infant Health at the University of Central Lancashire in the United Kingdom (UCLAN). Fiona has a particular interest in the global, sociocultural, and political influences upon infant and young child feeding practices; her methodological expertise is in ethnography and other qualitative research methods. She founded the Maternal and Infant Nutrition and Nurture Unit (MAINN) in 2000 which she led until she retired from her full-time professorship in 2020. Fiona established the associated MAINN Conference in 2007. The MAINN conference is a 3 day, international, peer reviewed event held bi-annually in the United Kingdom and, more recently, in alternate years overseas (Sydney, Australia; Falun, Dalarna, Sweden; and Florida, United States). The conference draws together key researchers in the field of infant and young child feeding from around the world. Fiona was a founding member of the journal Maternal and Child Nutrition. She is author of Breastfeeding in Hospital: Mothers, Midwives and the Production Line (Routledge) and co-author, with Dr Tanya Cassidy, of Banking on Milk: An Ethnography of Donor Human Milk Relations (Routledge). She is also joint editor of several books including Infant and Young Child Feeding: Challenges to Implementing a Global Strategy (Wiley-Blackwell) and Ethnographic Research in Maternal and Child Health (Routledge). This interview was conducted on April 20, 2023, by Dr. Tanya Cassidy, and is based on a verbatim transcription and edited for readability. TC = Tanya Cassidy; FD = Fiona Dykes

Culture competence is a concept that can be traced back to health care considerations in the 1960s and 1970s, and in particular to nursing education. Critics of the concept have argued that this was not simple a listing of cultural facts, behaviors, and practices, but instead follow a more ethnographic understanding of culture. In this article, I recognize that culture is not simply about the other, but something we all possess, and is also always changing throughout our lives. Understanding and respecting diversity and culture is key to improving services, including lactation support.

Despite a number of public health and policy‐based initiatives, Ireland's national breastfeeding rates are among the lowest globally. Regionally, the Mid‐West of Ireland has historically had low breastfeeding initiation rates, and parts of its major urban area such as Limerick City suffer the highest levels of economic deprivation in the country. In that context, this repeated cross‐sectional study analysed breastfeeding initiation trends in the Mid‐West of Ireland for two decades, from 2001 to 2020 inclusively. Statistical analysis revealed persistently low percentages of women initiating breastfeeding in the region. Time series analyses of the data demonstrated that overall breastfeeding rates are increasing, but continue to be lower than Irish national averages. From these findings and a narrative review of published research, we determined 10 plausible reasons for these consistently low breastfeeding rates. Arising from these, we propose ‘10 Priorities’ to increase the breastfeeding initiation rates in Ireland.