**Background:** Breast milk is essential for infant nutrition and development, yet many infants—particularly those born preterm, via cesarean section, or to mothers with illnesses—lack access to their mother's own milk. The World Health Organization recommends donated breast milk as the next best alternative. Uganda launched its first human milk bank at St. Francis Hospital Nsambya in November 2021, but little is known about how potential users perceive donated breast milk. This study aimed to explore perceptions of mothers, fathers, and health workers toward donated breast milk at Nsambya and Naguru hospitals in central Uganda.
**Methods:** A cross-sectional qualitative descriptive study was conducted from July to October 2020. Data were collected through 8 focus group discussions (FGDs) of 6 participants each (total 48 participants) and 19 key informant interviews (KIIs) at two purposively selected hospitals: St. Francis Hospital Nsambya (private, site of the first milk bank) and China-Uganda Friendship Hospital Naguru (public referral hospital). Participants included pregnant mothers, lactating mothers, grandmothers, fathers, mothers of preterm babies, mothers who had ever used donated breast milk, and health workers (midwives, nurses, paediatricians). All participants were purposively selected. FGDs and KIIs with mothers were conducted in Luganda; interviews with health workers were in English. Data were transcribed verbatim, translated from Luganda to English, and analyzed using thematic analysis following Braun and Clarke's guidelines. Data were managed in Nvivo version 12.0. Saturation determined the number of FGDs and KIIs.
**Key Results:** A total of 67 participants were included. Two main themes emerged: positive perceptions and negative perceptions. Positive perceptions included: (1) donated breast milk is nutritious—participants described it as having "all nutrients the baby needs" and being superior to formula or cow's milk; (2) it helps babies who cannot access their mother's milk, especially orphans, preterm infants, and babies of mothers with insufficient milk; (3) it provides an opportunity to avoid formula or cow milk, with one father stating, "instead of me buying cow's milk when there's human milk, I rather go for human milk"; and (4) it is analogous to blood donation—a lifesaving intervention, as one paediatrician noted: "It's just like how we can use blood transfusion, and you are trying to save a life." Negative perceptions included: (1) disgust—some participants described donated breast milk as "ekyenyinyarwa" (disgusting); (2) fear of inheriting genes and negative traits from the donor, with concerns that a child might "become a thief just because she breastfeeds on another person's breast milk"; (3) safety and quality concerns, including risk of HIV, hepatitis, syphilis, contamination, poor hygiene, improper storage, and distrust in screening procedures; (4) fear that donated breast milk would be expensive; and (5) concern that it would disrupt mother-child bonding and encourage maternal neglect. Participants suggested strategies to address negative perceptions, including sensitization and health education, thorough donor screening, no financial attachment to milk, men's involvement, and standardization of donated milk.
**Clinical Implications:** The study reveals that while there is openness to donated breast milk, significant sociocultural and safety concerns must be addressed for successful implementation of human milk banking in Uganda. Health workers should take extra precautions to ensure safety of donated breast milk. Development of appropriate information and communication programs to sensitize the public—including health workers—about the benefits and safety of donated breast milk is essential. Further research should focus on understanding social-cultural beliefs regarding donated breast milk.