A Quality Improvement Project to Increase Breastfeeding Rates in the NICU.
Leesa L Strickland1, Lindsey C Young2, Lindsey Garfield3
1Marcella Niehoff School of Nursing, Loyola University Chicago, Maywood, IL, USA lstrickland1@luc.edu.
Neonatal Network : NN
|April 30, 2026
Summary
Implementing a multimodal approach, including a NICU-specific policy and nurse coaching, increased nurse-assisted breastfeeding attempts. This supports improved breastfeeding rates in the neonatal intensive care unit (NICU).
Area of Science:
- Neonatal care
- Public health
- Nursing education
Background:
- The Baby-Friendly Hospital Initiative aims to boost exclusive breastfeeding.
- Neonatal intensive care unit (NICU) nurses' support is crucial for breastfeeding success.
- A needs assessment revealed a NICU lacked a specific breastfeeding policy and nurse assistance in electronic health records (EHR).
Purpose of the Study:
- To implement and assess a quality improvement project focused on enhancing breastfeeding support by NICU nurses.
- To evaluate the impact of a NICU-specific breastfeeding policy and nurse education on breastfeeding assistance.
- To determine if nurses' breastfeeding knowledge and EHR documentation of assistance improved post-intervention.
Main Methods:
- Developed a NICU-specific breastfeeding policy and conducted educational inservices with real-time coaching for nurses.
- Administered pre-post questionnaires to assess nurses' breastfeeding knowledge.
- Reviewed the NICU electronic health record (EHR) to quantify nurse-assisted breastfeeding attempts before and after the project.
Main Results:
- Eighty percent of nurses attended the inservice; 63% had adequate baseline knowledge.
- No statistically significant difference was found in nurses' knowledge pre- and post-intervention (t = 0.48, p = 0.32).
- Eleven nurse-assisted breastfeeding attempts were documented in the EHR post-implementation, compared to zero prior to the project.
Conclusions:
- A multimodal approach, including policy development and targeted nurse support, may increase breastfeeding assistance in the NICU.
- Ensuring nurses possess adequate knowledge and skills is vital for promoting breastfeeding.
- Quality improvement initiatives can positively impact breastfeeding support within the NICU setting.
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