Improving direct breastfeeding at discharge in a Level II Neonatal ICU

Area of Science:

• Neonatal care
• Quality Improvement Science
• Breastfeeding research

Background:

• Direct breastfeeding (DBF) offers numerous benefits for infants, particularly those admitted to the Neonatal Intensive Care Unit (NICU).
• Optimizing feeding practices in the NICU is crucial for infant health outcomes.
• Quality improvement (QI) initiatives can enhance clinical practices in neonatal care.

Purpose of the Study:

• To implement and evaluate a quality improvement project aimed at increasing direct breastfeeding (DBF) rates at discharge.
• To assess the feasibility of supporting breastfeeding among premature infants in a community hospital level II NICU.

Main Methods:

• A single-center, time-series QI study utilizing serial plan-do-study-act (PDSA) cycles over 12 months.
• Data collected over 3.5 years, with the primary outcome measure being successful breast milk transfer within 48 hours of discharge.
• Balancing measures included the provision of own human milk and gestational age at discharge.

Main Results:

• Direct breastfeeding (DBF) at discharge increased from 34% to 79% following the QI intervention (p < 0.01).
• No significant change was observed in the overall provision of own human milk at discharge.
• Gestational age at discharge showed a slight increase from 37.2 to 37.7 weeks (p = 0.05).

Conclusions:

• QI interventions effectively increased direct breastfeeding (DBF) rates in the NICU setting.
• The findings support the feasibility of promoting and achieving breastfeeding among premature infants prior to NICU discharge.
• This study highlights the success of targeted QI efforts in improving infant feeding practices in neonatal care.