A Quality Improvement Project to Increase Mother's Milk Use in an Inner-City NICU

Area of Science:

• Neonatal care
• Quality improvement initiatives
• Infant nutrition

Background:

• Mother's milk is crucial for preterm infants' health.
• High initiation rates of milk production by mothers of preterm infants were observed.
• Sustained milk consumption until discharge remained a challenge.

Purpose of the Study:

• To increase mother's milk use in preterm infants before discharge.
• To promote exclusive mother's milk consumption.
• To reduce racial/ethnic disparities in milk utilization.

Main Methods:

• A quality improvement project was implemented from 2015 to 2017.
• Interventions included prenatal education, early milk expression, and skin-to-skin care.
• Data were collected on 202 preterm infants and analyzed using run and control charts.

Main Results:

• First milk expression within 6 hours and skin-to-skin care rates improved.
• Rates of any or exclusive mother's milk use at discharge did not increase.
• 85% of mothers initiated milk production, but only 55% provided milk at discharge.

Conclusions:

• The quality improvement project enhanced early care practices for preterm infants.
• Despite improvements in early interventions, mother's milk use at discharge was not increased.
• Further strategies are needed to sustain milk provision for preterm infants.