Twelve experts, seven countries: inside the IMAGINE-HMB EU Forum of Experts

Harmonised European guidelines for donor human milk only carry weight if the people who write them are the right people, chosen in a way anyone can inspect. That principle shaped the IMAGINE-HMB EU Forum of Experts from the outset.

The Forum was given a demanding brief: to evaluate the evidence base for human milk banking practice across Europe, and to draft two complementary sets of guidelines — technical standards for the handling, processing and use of donor human milk, and oversight requirements for the authorities that authorise and supervise human milk banking establishments. Both sit against a hard deadline. Under the EU Regulation on standards of quality and safety for substances of human origin (SoHO), human milk banks must be registered as SoHO entities or establishments by August 2027, and be fully compliant by August 2028.

An open call, openly judged

The Steering Committee began by defining the expertise the Forum would need, rather than the individuals it wanted. That list spanned human milk banking professionals — managers, doctors, nurses and dieticians — alongside neonatologists and specialists in lactation science, human milk biochemistry, microbiology, food technology, blood and tissue banking, and quality and safety management.

Including people who run human milk banks day to day was a deliberate choice. It kept the operational and clinical realities in the room during drafting, and it guarded against guidelines written in language only guideline developers can read.

The call for experts opened on 10 November 2024 and closed on 30 November, published on the project website and circulated through EMBA’s social channels and direct outreach to professional networks. Applicants submitted a CV and a declaration of conflicts of interest, and were required to comply with the WHO Code.

Fifty-one applications arrived, from fifteen countries. The largest groups came from Poland (10), Belgium (8), Italy (7) and Spain (6), with applications also received from the United Kingdom, France, Norway, Germany, Greece, Austria, Croatia, Czechia, Ireland, the Netherlands and Serbia.

Conflicts of interest, assessed first

Before any academic assessment took place, applications were screened for conflicts of interest. Eight were excluded at this stage, on conflict-of-interest grounds or because the submission was incomplete. Candidates with major conflicts, financial or non-financial, could not be appointed at all; minor conflicts were managed at individual level, for example by restricting participation in particular parts of a Forum meeting. Any subsequent change in a member’s declared interests must be reported to the Steering Committee.

A scoring system published in advance

The remaining candidates were ranked on a 100-point scale, applied consistently across every application:

•    Publications and research impact — total and field-specific peer-reviewed output, h-index and citation counts drawn from Scopus, and authorship of guidelines or recommendations (up to 50 points)

•    Participation in research projects — role, scale and the collaborative or interdisciplinary nature of the work (up to 10 points)

•    Invited talks — keynote and invited presentations, weighted by the standing of the conference (up to 20 points)

•    Engagement in scientific and regulatory committees — active memberships, roles held and duration of involvement (up to 20 points)

The Steering Committee then reviewed the highest-scoring candidates as a group, checking that the appointed Forum covered every required area of expertise rather than simply taking the twelve highest totals. Members were appointed for a term of twelve months and signed an agreement accepting the Forum’s statute, its activities and its deliverable timeframes.

Strong applicants who were not appointed were not lost to the project. Many were invited onto the IMAGINE-HMB Advisory Board, which broadened the project’s national coverage well beyond the countries represented in the Forum itself.

Meet the EU Forum of Experts

The twelve appointed members, listed alphabetically:

•    Prof. Enrico Bertino, MD  —  Italy

•    Agnieszka Bzikowska-Jura, PhD  —  Poland

•    Veerle Cossey, MD, PhD  —  Belgium

•    Freya Couvin, MSc  —  Belgium

•    Prof. Christoph Fusch, MD  —  Germany

•    Marzia Giribaldi, PhD  —  Italy

•    Anne Grovslien, LC  —  Norway

•    Anna Michalska-Falkowska, PhD, MSc  —  Poland

•    Prof. Guido E. Moro, MD  —  Italy

•    Prof. Jean-Charles Picaud, MD  —  France

•    Prof. Juan Rodriguez, VMD, PhD  —  Spain

•    Patricia Sagre, MSc  —  Spain

Seven countries are represented: Italy (3 members), Belgium, Poland and Spain (2 each), and France, Germany and Norway (1 each).