Optimizing human milk provision: Review of QI best practices

This review examines how Quality Improvement (QI) methodology bridges the gap between evidence-based research and bedside practice to optimize human milk provision. Even though data shows significant improved clinical outcomes, support for neurodevelopment, and reduces comorbidities with breast milk provision to NICU patients, there remains varying breast milk utilization and discharge rates. Successful initiatives apply QI framework including multidisciplinary stakeholders' engagement, plan-do-study-act cycles, collaboration, guideline, education to implement strategies for successful outcomes and across neonatal care continuum: antenatal education, peripartum initiation, and postpartum maintenance. Key interventions include early pumping initiation, oral immune therapy, skin-to-skin care, lactation support, and standardized feeding protocols. This review highlights impactful projects which improved the provision of breast milk. Furthermore, targeted QI efforts in diverse populations have shown success clinically and with hospital resource utilization. Ultimately, systematic QI efforts that address cultural barriers and redefine provider roles are essential to decreasing institutional variation and ensuring the most vulnerable infants receive optimal nutrition.