INTRODUCTION:

India faces high rates of low-birth-weight and very-low-birth-weight babies, contributing to neonatal mortality and morbidity. In 1989, Dr. Armeda Fernandez established Asia’s first human milk bank, “Sneha”, in Mumbai, leading to reduced NEC rates and improved exclusive breastfeeding.^1,2The American Academy of Pediatrics states that breastfeeding supports better growth and development in premature babies than formula. Human milk banks collect and distribute donated breast milk, offering a safe alternative for mothers unable to breastfeed due to medical or other challenges.^3,4,5A 2020–2021 study found young women had good knowledge and positive attitudes toward milk donation. Recognizing its benefits, the Indian government introduced national guidelines in 2017 to make donor milk more widely available.^6,7The American Academy of Paediatrics (AAP) recommends exclusive breastfeeding for 6 months and continued breastfeeding for at least 1 year. Approximately 15.5% of all breastfed newborns in the India receive formula supplementation in the first days of life.⁸Many working women lack awareness about the benefits of breast milk and how to express and store it, making pre- and postnatal support essential, while issues like nipple soreness—though common and easily treatable—often lead to early breastfeeding discontinuation.^9,10Breast milk adapts to each baby's needs, helping prevent constipation and diarrhoea, while the health and well-being of healthcare professionals are essential for delivering effective, high-quality care in resource-efficient health organizations.^11,12

Program for Appropriate Technology in Health (PATH) has developed a model called the “Mother Baby Friendly Initiative Plus” (MBFI+) model. In this model, human milk banks do more than just collect, process, and store donated human milk. These banks also serve as centres that support mothers by offering lactation help and kangaroo mother care. This approach aims to provide a comprehensive support system for both mothers and babies.

NEED FOR THE STUDY:

Mother's milk is the best feeding option for full -time infants and provides significant health benefits for ill and premature infants in NICU. Human milk, often fortified, is best for supporting the growth and development of very low birth weight infants, benefiting both their short- and long-term health.^13,14Mother's own milk is ideal for newborns, but when unavailable, donor milk (DM) is a safe option. Holder Pasteurization is the standard heat treatment used in human milk banks (HMB) to ensure safety while maintaining the quality of milk.¹⁵Mother’s milk reduces infections and NEC in preterm infants compared to formula. When unavailable, donor milk is a good but costly option. DHM and mother’s own milk also lower the risk of BPD. Direct breastfeeding may not be possible in cases of prematurity, illness, or separation, increasing infection risk.^16,17,18Nowadays, with more working mothers and travel constraints, expressing and storing breast milk offers a practical alternative to direct breastfeeding.¹⁹The criteria for donating human milk include that lactating women must be in good health, practice healthy behaviours and not regularly take medications or herbal supplements. Donors should also be willing to undergo blood testing to screen for infections. Additionally, they must have enough milk after feeding their baby adequately, and the baby should be thriving well.²⁰

Hence, studying of human milk banking is crucial for advancing neonatal nutrition, improving the health outcomes of premature and sick infants. Human milk banks are promoting the health outcomes of premature, sick infants and promoting evidence – based practices in maternal and child health. It contributes to our understanding of human milk composition, safety protocols, ethical considerations and ultimately benefiting the well – being of infants and also their families.

OBJECTIVES OF THE STUDY:

1) To assess the pre-test knowledge score of nursing officers regarding human milk banking.

2) To assess the effectiveness of structured teaching programme on knowledge of nursing officers regarding human milk banking.

3) To find out the association between the pre-test knowledge scores of nursing officers regarding human milk banking with selected socio-demographic variables.

HYPOTHESIS:

H₁: There may be significant difference between mean pre-test and post-test knowledge score of nursing officers regarding human milk banking.

H₂: There may be significant association between pre-test knowledge score of nursing officer’s human milk banking with selected socio- demographic variables.

MATERIALS AND METHODS:

Research design: Pre-experimental one group pre-test and post-test research design was selected in order to assess the effectiveness of STP on knowledge of nursing officers regarding human milk banking.

Study population:

The sample size for the current study is 110 nursing officers working at Kempegowda Institute of Medical Sciences (KIMS) Hospital and Research Centre, Bangalore.

Sampling Technique:

Purposive sampling technique was used to select the samples for this study.

Description of tool:

The structured knowledge questionnaire consists of two parts:

Part A: It consists of 9 items related to socio-demographic characteristics.

Part B: Structured knowledge questionnaire consists of 32 items to assess the knowledge of nursing officers regarding human milk banking.

Scoring pattern

· Each correct question carries 1(one) mark.

· Each wrong answer is scored 0(zero).

· Maximum mark is 32.

· Minimum mark is 0.

RESULTS:

The data was presented under the following sections:

Section 1: Analysis of Pre - Test and Post - Test Knowledge and Level of Practice

Section 1a: Overall and Aspect wise Pre - test Knowledge and level on Human milk banking

Table 1: Classification of Respondent Pre - test Knowledge level on Human milk banking

Knowledge Level	Category	Respondents
Knowledge Level	Category	Number	Percent
Inadequate	≤ 50 % score	76	69.1
Moderate	51-75 % score	34	30.9
Adequate	> 75 % score	0	0.0
Total		110	100.0

Table 1 depicts the classification of respondent pre - test knowledge level on human milk banking. Majority (69.1%) of the nursing officers had inadequate knowledge (with a score of less than 50%) and 30.9% of the nursing officers had moderate knowledge (with a score between 51-75%).

Table 2 depicts the aspect-wise pre-test mean knowledge percentage in general information on breast milk, safe storage of expressed milk and knowledge of human milk banking were 32.4%, 36.9%, and 39.9% respectively.

Table 3 depicts the classification of respondent post - test knowledge level on human milk banking. Majority (77.3%) of the nursing officers had adequate knowledge (with a score of more than 75%) and (22.7%) of the nursing officers had moderate knowledge (with a score between 51-75%) indicates the effectiveness of structured teaching programme on knowledge of nursing officers regarding human milk banking.

Table 4 depicts the aspect-wise post-test mean knowledge percentage in general information on breast milk, safe storage of expressed milk and knowledge of human milk banking were 87.1%, 83.0% and 88.0% respectively.

Table 2: Aspect wise Pre - test Mean Knowledge scores on Human milk banking

S. No.	Knowledge Aspects	Statements	Max. Score	Knowledge Scores
S. No.	Knowledge Aspects	Statements	Max. Score	Mean	SD	Mean (%)	SD (%)
I	General information on Breast milk	5	5	1.62	0.72	32.4	14.3
II	Safe storage of expressed milk	7	7	2.58	1.26	36.9	18.0
III	Human milk banking	20	20	7.98	2.88	39.9	14.4
	Combined	32	32	12.18	3.57	38.1	11.2

Section – 1b: Overall and Aspect wise Post - test Knowledge level on Human milk banking

Table 3: Classification of Respondents of Post - test Knowledge level on Human milk banking

Knowledge Level	Category	Respondents
Knowledge Level	Category	Number	Percent
Inadequate	≤ 50 % score	0	0.0
Moderate	51-75 % Score	25	22.7
Adequate	> 75 % score	85	77.3
Total		110	100.0

Table 4: Aspect wise Post - test Mean Knowledge scores on Human milk banking

S. No.	Knowledge Aspects	Statements	Max. Score	Knowledge Scores
S. No.	Knowledge Aspects	Statements	Max. Score	Mean	SD	Mean (%)	SD (%)
I	General information on Breast milk	5	5	4.35	0.74	87.1	14.7
II	Safe storage of expressed milk	7	7	5.81	0.99	83.0	14.2
III	Human milk banking	20	20	17.60	1.67	88.0	8.3
	Combined	32	32	27.76	2.37	86.8	7.4

Table 6: Aspect wise Mean Pre - test and Post - test Knowledge scores on Human milk banking

No.	Knowledge Aspects	Respondents Knowledge (%)						Paired ‘t’ Test
		Pre test		Post test		Enhancement
		Mean	SD	Mean	SD	Mean	SD
I	General information on Breast milk	32.4	14.3	87.1	14.7	54.7	22.1	25.96*
II	Safe storage of expressed milk	36.9	18.0	83.0	14.2	46.1	19.2	25.18*
III	Human milk banking	39.9	14.4	88.0	8.3	47.1	14.2	34.79*
	Combined	38.1	11.2	86.8	7.4	48.7	10.0	51.08*

Table 7: Classification of Respondents on Pre – test and Post test Knowledge level on Human milk banking

Knowledge Level	Category	Classification of Respondents				χ ²Value
		Pre - test		Post – test
		N	%	N	%
Inadequate	≤ 50 % score	76	69.1	0	0.0	162.37*
Moderate	51-75 % score	34	30.9	25	22.7
Adequate	> 75 % score	0	0.0	85	77.3
Total		110	100.0	110	100.0

* Significant at 5% level,

χ² (0.05,2df) = 5.991

Table 5 depicts the pre-test mean percentage of knowledge scores was 38.1% and the post-test mean percentage of knowledge scores was 86.8% which showed the enhancement mean percentage of knowledge scores of 48.7%. Paired ‘t’ value was found to be 51.08 which was significant at 5% level (df=109).

Table 6 depicts the aspect-wise pre-test mean knowledge percentage in general information on breast milk, safe storage of expressed milk and knowledge of human milk banking were 32.4%, 36.9%, 39.9% and aspect-wise post-test mean knowledge percentage of human milk banking were 87.1%, 83.0%, 88.0% respectively. The above table depicts the aspect-wise enhancement mean knowledge percentage in general information on breast milk, safe storage of expressed milk and knowledge of human milk banking were 54.7%,46.1%, and 47.1% respectively.

Aspect-wise paired ‘t’ test in general information on breast milk, safe storage of expressed milk and knowledge of human milk banking were found to be 25.96, 25.18 and 34.79 respectively which were significant at 5% level (df=109).

Table 7 denotes that before the administration of STP i.e., in the pre-test, the majority (69.1%) of the nursing officers had inadequate knowledge on human milk banking, the remaining (30.9%) had moderate knowledge and none of them had adequate knowledge on human milk banking.

Table 7 also depicts that after the administration of STP i.e., in the post-test, the majority (77.3%) of the nursing officers had adequate knowledge on human milk banking, the remaining (22.7%) of them had moderate knowledge and none of them had inadequate knowledge on human milk banking.

Hence, the research hypothesis stated as H₂:

“There is a significant association between pre-test knowledge level of nursing officers and selected demographic variables on Human milk banking’’was partially accepted.

DISCUSSION:

The STP significantly improved nursing officers’ knowledge on HMB. Most participants lacked adequate knowledge prior to the intervention. Post-intervention, knowledge levels improved substantially. Results are consistent with previous studies emphasizing the importance of educational strategies to enhance knowledge in healthcare professionals.

CONCLUSION:

The findings were extracted from analysis, implications, limitations, suggestions and recommendations. The main objective of the study was to assess the current knowledge of nursing officers about human milk banking and to conduct a structured teaching program about human milk banking. The data was collected from 110 nursing officers and the conclusions prepared from the study were as follows: The findings showed that the structured teaching program for nursing officers improved its knowledge about human milk banking. After STP, the majority 85 (77.3%) had enough knowledge about human milk banking, the remaining 25 (22.7%) had moderate knowledge of them and none of them had insufficient knowledge about human milk banking.

CONFLICT OF INTEREST:

None declared.

ACKNOWLEDGEMENTS:

I would like to thank my parents, Mrs. Lina Hazra, for instilling in me the virtues of perseverance and commitment and for her relentless encouragement to strive for excellence, and my dear friend, Ms. Spandita Bose, for her unwavering support and constant presence throughout the completion of this study.

ETHICAL CONSIDERATION:

The investigator ensured ethical neutrality by obtaining Institutional Ethics Committee clearance and securing prior written informed consent from all voluntary participants.

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Received on 25.07.2025 Revised on 22.08.2025

Accepted on 15.09.2025 Published on 25.10.2025

Available online from November 04, 2025

Asian J. Nursing Education and Research. 2025;15(4):205-209.

DOI: 10.52711/2349-2996.2025.00042

This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. Creative Commons License.

Aspects	Max.Score	Knowledge Scores				Paired ‘t’ Test
Aspects	Max.Score	Mean	SD	Mean (%)	SD (%)	Paired ‘t’ Test
Pre test	32	12.18	3.57	38.1	11.2	51.08*
Post test	32	27.76	2.37	86.8	7.4	51.08*
Enhancement	32	15.58	3.21	48.7	10.0