Wee Nuzzle: A QI Initiative to Promote Nonnutritive Breastfeeding for Preterm Infants

Area of Science:

• Neonatal care
• Pediatric nutrition
• Quality improvement initiatives

Background:

• Nonnutritive breastfeeding (NNBF) offers benefits to preterm infants but is often delayed for those on respiratory support.
• Preterm infants under 34 weeks gestational age (GA) require specialized feeding strategies.
• Optimizing feeding practices in neonatal intensive care units (NICUs) is crucial for infant development.

Purpose of the Study:

• To reduce the mean time to NNBF by 50% in preterm infants (30-34 weeks GA) within 12 months.
• To increase the overall provision of human milk at discharge for eligible infants.
• To improve feeding outcomes for vulnerable preterm neonates.

Main Methods:

• A 1-year quality improvement (QI) initiative utilizing a multidisciplinary team.
• Implementation of "Wee Nuzzle" guidelines through Plan-Do-Study-Act cycles.
• Integration of NNBF protocols into electronic medical records (EMR) and clinical workflows.

Main Results:

• Achieved a 66% reduction in the mean time to first NNBF, from 12.0 to 4.1 days.
• Increased human milk provision at discharge from 59% to 72%.
• Demonstrated the effectiveness of QI methods in optimizing infant feeding practices.

Conclusions:

• The QI initiative successfully decreased the time to NNBF initiation and enhanced human milk utilization.
• Sustained efforts are needed to monitor human milk exposure post-NICU discharge.
• Early NNBF initiation is a feasible and beneficial practice for preterm infants.