Supporting Breastfeeding in Infants Hospitalized for Jaundice

Area of Science:

• Neonatal care
• Pediatric gastroenterology
• Lactation support

Background:

• Infants readmitted for neonatal hyperbilirubinemia requiring phototherapy show lower rates of exclusive breastfeeding.
• Neonatal hyperbilirubinemia poses a risk to successful breastfeeding initiation and maintenance.

Purpose of the Study:

• To implement and evaluate an intervention to increase exclusive breastfeeding (EB) rates in infants admitted for neonatal hyperbilirubinemia.
• To improve the percentage of infants exclusively breastfeeding during phototherapy hospitalization from 30% to 80% within 12 months.

Main Methods:

• A Model for Improvement framework was used, involving three plan-do-study-act cycles.
• Interventions included staff education, automated lactation consultation orders, and use of bilirubin blankets.
• Data analysis utilized run charts and statistical process control, monitoring EB, lactation consultations, weight loss, bilirubin encephalopathy, readmissions, and length of stay.

Main Results:

• Exclusive breastfeeding (EB) improved from 30% to 60% post-intervention.
• Lactation consultations increased from 60% to 90% after implementing automated orders.
• Infants receiving early lactation support were 4 times more likely to achieve EB during hospitalization (OR 3.8).

Conclusions:

• Early and safe involvement of lactation consultants significantly enhances exclusive breastfeeding rates in hospitalized infants with neonatal hyperbilirubinemia.
• Automated lactation consultations are effective in improving breastfeeding outcomes for jaundiced infants.
• The intervention demonstrated safety, with no adverse events such as excessive weight loss or readmissions.