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Using quality improvement to increase human milk use for preterm infants.

Margaret G Parker1, Aloka L Patel2

  • 1Department of Pediatrics, Boston Medical Center, Boston University School of Medicine, 88 E Newton St, Vose Hall, 3rd Floor, Boston, MA 02118.

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Summary

This review covers quality improvement strategies to boost human milk use for very low-birth-weight infants. It highlights evidence-based practices, successful lactation programs, and metrics for enhancing mother's own milk and donor milk.

Keywords:
Early initiationHuman milkNeonatal intensive care unitPretermQuality improvement

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Area of Science:

  • Neonatal care
  • Quality improvement science
  • Lactation support

Background:

  • Very low-birth-weight infants have unique nutritional needs.
  • Human milk is crucial for improving outcomes in this vulnerable population.
  • Consistent use of mother's own milk and donor milk presents challenges in hospital settings.

Purpose of the Study:

  • To review quality improvement (QI) methods enhancing human milk use for very low-birth-weight infants (VLBWIs) in hospitals over the past decade.
  • To identify evidence-based practices promoting mother's own milk (MOM) for VLBWIs.
  • To examine exemplary lactation programs, QI collaboratives, and human milk quality metrics.

Main Methods:

  • Comprehensive literature review of QI initiatives focused on human milk for VLBWIs.
  • Analysis of evidence-based practices for increasing MOM provision.
  • Case study review of successful hospital lactation programs and statewide QI collaboratives.
  • Evaluation of current quality metrics for human milk and identification of gaps.

Main Results:

  • Evidence-based practices exist to significantly increase MOM for VLBWIs.
  • Exemplary hospital programs and statewide collaboratives demonstrate successful QI approaches.
  • Gaps in current quality metrics for human milk necessitate further development.
  • Practical QI tools like driver diagrams can guide improvement efforts.

Conclusions:

  • Quality improvement methodologies are effective in increasing human milk utilization for VLBWIs.
  • A multi-faceted approach combining evidence-based practices, strong lactation support, and robust metrics is essential.
  • Further research and implementation of standardized metrics are needed to optimize human milk delivery for VLBWIs.