Objective To explore the effect of donor human milk usage on the emotional experience of mothers with premature infants in a multiracial Asian population.

Design A qualitative descriptive study. Semistructured individual interviews were audio-recorded, transcribed and analysed using Braun and Clarke’s process of thematic analysis.

Setting and patients Seventeen mothers whose premature infants received donor human milk in a level III neonatal intensive care unit.

Main outcome measures Perceptions of mothers whose premature infants received donor human milk.

Results Mothers described their experience as a journey of acceptance with three sequential themes. ‘Resistance to receiving somebody else’s milk’ was a process of overcoming initial hesitation and concerns. ‘Recognising maternal limitations and baby’s needs’ depicted the mothers’ struggles in reconciling their infant’s milk demand and their low milk supply. ‘Embracing benefits of donor human milk and acceptance with gratitude’ illustrated the mothers’ joy and gratitude to milk donors as they embraced benefits of donor human milk usage. Although participants had agreed to use of donor human milk after counselling, many still struggled with negative emotions of anxiety and guilt. Mothers of Muslim faith had additional concerns about milk kinship and religious permissibility of donor human milk.

Conclusion Mothers undergo a spectrum of complex emotions from initial hesitation to acceptance with gratitude, when their premature infants receive donor human milk. Some continue to struggle with negative emotions and require more support. By recognising their emotional responses, healthcare providers can support mothers in their breastfeeding journey with targeted counselling.