A Quality Improvement Initiative: Improving First-hour Breastfeeding Initiation Rate among Healthy Newborns

Abstract

Introduction: “No matter where a newborn takes his or her first breath, the desire to give that baby the best start in life is universal.” The best gift a mother can give her baby is the gift of health. The gift of health can be given to the baby through early and adequate breastfeeding. Globally, only 2 out of 5 newborns are put to the breast within the first hour of life. Therefore, initiating breastfeeding is an evidence-based intervention for improving neonatal survival. Methods: We aimed to improve the first-hour breastfeeding initiation rate from the existing 12%–80% over 3 months through a quality improvement (QI) process. The setting was antenatal, perinatal, and postnatal wards of the Maharishi Markandeshwar Institute of Medical Sciences And Research Hospital. The participants were postpartum mothers with stable newborns 35 weeks and older of gestation born by normal vaginal delivery. Procedure for QI: A team of nurses and obstetricians was formed; we analyzed possible reasons for delayed initiation of breastfeeding by process cycle matrix chart and Fishbone analysis. Various change ideas were tested through sequential Plan-Do-Study-Act cycles. The outcome measure is the proportion of eligible babies breastfed within 1 hour of delivery. Results: After 3 months, the first-hour initiation of breastfeeding increased from 12% to 80%, without additional resources. Conclusions: A QI approach achieved an improvement in first-hour breastfeeding rates after normal vaginal delivery.

Quality Improvement Interventions in the Delivery Room to Improve the Early Initiation of Breastfeeding in Healthy Neonates: A Tertiary Hospital-Based Study

“…21 The present QI study reiterates the findings from earlier studies that breastfeeding a newborn immediately after birth is feasible and possible by providing immediate SSC after birth. 22 Studies on the effect of QI projects to improve breastfeeding have shown positive results. 23,24 In contrast to the common notion that LSCS is a barrier to EIBF, 10 this QI study did not find any statistical difference between the rate of EIBF among the LSCS group and the NVD group.…”

Early Initiation of Breastfeeding Among Adolescent Mothers: A Quality Improvement Study

“…A QI initiative conducted to improve early breastfeeding among newborns delivered in a secondary care hospital in Northern India increased the prevalence of EIBF from 52% to 97% [ 7 ]. Another QI initiative to improve the rate of first-hour breastfeeding of newborns also proved effective by increasing its prevalence from 12% to 80% [ 8 ]. The prevalence of first-hour breastfeeding among postnatal mothers in another study conducted in a tertiary care hospital in India was 21.5% [ 9 ].…”

Implementation of a quality improvement initiative for standardising essential newborn care in a teaching public hospital in rural central India

“…Literature similar to our study: Two studies reported improvement in initiation of breast feeding from 12% to 80% and 55% to 95% through implementation of QI projects. 13 14 Patodia et al in their QI study on reducing admission hypothermia in newborns at tertiary care NICU reported the Open access preintervention incidence of hypothermia to be 82% which dropped to 45% over a period of 6 months. 15 Similarly study reported decline in incidence of hypothermia from 39% to 0% over 8 weeks through three PDSA.…”