Improving Colostrum Administration to Newborns Within the First 6 Hours of Life in the Neonatal Intensive Care Unit
Gonca Karataş Baran1, Kadriye Kiziltepe2, Elif Yildizhan2
1Yuksek Ihtisas University, Faculty of Health Sciences, Department of Midwifery, Ankara, Turkey.
Insights
Implementing the Apollo Root Cause Analysis (ARCA) method significantly increased early colostrum administration in the NICU. This quality improvement initiative improved newborn nutrition and breastfeeding outcomes.
Area of Science:
- Neonatal care
- Quality improvement science
- Lactation support
Background:
- Colostrum provides critical nutrition, immunity, and growth factors for newborns.
- Early administration of colostrum is vital for healthy infant development.
- Barriers exist to timely colostrum delivery in Neonatal Intensive Care Units (NICUs).
Purpose of the Study:
- To reduce barriers and increase colostrum administration within 6 hours for all NICU newborns.
- To utilize the Apollo Root Cause Analysis (ARCA) method for process optimization.
- To enhance early-life nutrition and health outcomes for infants.
Main Methods:
- A pre-post quality improvement study conducted in a maternity hospital NICU.
- Involved 301 newborns over a one-year period (July 2022-July 2023).
- Applied the ARCA method to identify and address barriers to colostrum administration.
Main Results:
- Identified barriers included lack of awareness, knowledge gaps, and logistical issues in colostrum handling.
- Interventions led to 93.6% of mothers expressing colostrum.
- Achieved 74.4% of newborns receiving colostrum within 6 hours and 85.8% discharged with exclusive breastfeeding.
Conclusions:
- The ARCA method quadrupled the rate of early colostrum administration in the NICU.
- Nurses can effectively use problem-solving techniques to optimize breast milk delivery.
- Improved colostrum delivery significantly impacts newborn health and promotes breastfeeding success.
Background And Aim:
Colostrum, given to newborns early in extrauterine life, provides essential nutrition, immunity, and growth support, offering a strong start for healthy development. This study aims to reduce barriers to colostrum administration and increase colostrum administration for all newborns in the Neonatal Intensive Care Unit (NICU) within the first 6 hours of life, using the Apollo Root Cause Analysis (ARCA) method.
Methods:
A pre-post quality improvement study was done prospectively in the NICU of a maternity hospital from July 15, 2022 to July 15, 2023. The study group consisted of 301 newborns. The ARCA method (systematic analysis and intervention guidance method) was used to identify the reasons for barriers to colostrum administration to newborns in the NICU and to optimize the solution processes.
Results:
The reasons for the inadequate rate of colostrum given to newborns in the first 6 hours of life were classified as lack of awareness, knowledge and skills about colostrum and disruptions in expressing colostrum, delivering it to the newborn, and applying it. With the interventions, it was determined that 93.6% of the mothers expressed their colostrum, 74.4% of the newborns received colostrum within the first 6 hours, and 85.8% were discharged with only breastfeeding.
Conclusion:
With the ARCA method, a gradual increase of up to four times the mean rate of giving colostrum to newborns in the first 6 hours of life was achieved. Nurses can use problem-solving techniques to ensure optimal delivery of breast milk, which has an important impact on newborn health.
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