Optimizing human milk provision: Review of QI best practices

Area of Science:

• Neonatal Medicine
• Public Health
• Healthcare Quality Improvement

Background:

• Human milk provision in Neonatal Intensive Care Units (NICUs) is linked to improved clinical outcomes, neurodevelopment, and reduced comorbidities.
• Despite evidence, significant variation exists in breast milk utilization and discharge rates among NICU patients.
• Bridging the gap between evidence-based research and bedside practice for human milk provision remains a challenge.

Purpose of the Study:

• To examine the role of Quality Improvement (QI) methodology in optimizing human milk provision for NICU infants.
• To identify key interventions and strategies for successful implementation of human milk initiatives.
• To highlight the impact of QI efforts on clinical outcomes and resource utilization.

Main Methods:

• Review of successful Quality Improvement (QI) initiatives in human milk provision.
• Application of the QI framework, including multidisciplinary stakeholder engagement and plan-do-study-act cycles.
• Analysis of interventions across the neonatal care continuum: antenatal, peripartum, and postpartum.

Main Results:

• Successful QI initiatives demonstrate improved breast milk utilization and clinical outcomes in NICU populations.
• Key interventions such as early pumping, oral immune therapy, skin-to-skin care, and standardized protocols are effective.
• QI efforts have shown positive impacts on clinical outcomes and hospital resource utilization, particularly in diverse populations.

Conclusions:

• Quality Improvement (QI) methodology is crucial for optimizing human milk provision in the NICU.
• Systematic QI efforts addressing cultural barriers and provider roles are essential to reduce institutional variation.
• Ensuring optimal nutrition for vulnerable infants requires sustained and targeted QI initiatives.