Current issues surrounding donor human milk (DHM) banking include the Covid burden and safe supply, new aspects on pasteurisation procedures, donor screening and the nutrient variability of DHM. It’s unlikely Covid is transmitted via breastmilk and WHO recommends no change of practice. However, supply of DHM has decreased due to donors avoiding hospitals and with the closure of transport infrastructures. The percentage of breastfeeding mothers increased during lockdown as there was less distraction and disruption, which helped with bonding and getting the milk flow going. In DHM the macronutrient content is variable and not balanced and the protein content is low, especially for preterms. Donor pooling and additional supplementation of protein may help with avoiding macronutrient depletion. In this video, Christopher Fusch talks about the safety, efficacy and new methodologies in donor milk banking.