Operations Research for Human Milk Banking: Investigating Equitable Access, Operational Efficiency and Effective Policy for Informed Decision-Making

Human Milk Banks (HMBs) provide screened donor human milk (DHM) for infants when mother's milk is unavailable, and formula is undesirable. While DHM is primarily used in hospitals for premature infants, there is also community provision (CP). As a perishable donation-based resource, careful management of DHM is essential to minimise waste and ensure availability. However, balancing supply and demand requires robust strategic and operational decision-making.
The PhD will investigate the potential needs for DHM for the neediest recipients- premature infants- and the effect of allocation policies on estimated demand. A generalised framework for estimating the potential demand will be developed; and Monte Carlo Simulation used to estimate demand across England and Wales, aiming to inform future planning and infrastructure for local HMBs.
With strict safety and quality requirements, variable processing times, and fluctuating demand HMBs face difficult operational decisions. A second research avenue is therefore the study of DHM inventory. Working with the HMB stakeholders, and using Discrete-event Simulation, the PhD will investigate strategies around inventory control, waste reduction, and the balance between hospital and community, thus enhancing HMB decision-making.
With a limited DHM supply, there are questions on prioritisation, especially when demand exceeds supply. This is particularly challenging if, as currently, no formal DHM allocation processes exist. The third research theme thus investigates the criteria guiding CP to develop a structured triage framework. Using co-production principles and a multi-criteria approach, the study will engage donors, HMB stakeholders and the wider public to ensure fair and socially responsible decision-making.
By integrating policy, operations, and ethics, this research aims to support milk banks and decision-makers in making informed, equitable, and sustainable choices, ultimately ensuring that more infants receive human milk.