A quality improvement initiative to improve the quantity of expressed breast milk among mothers whose neonates were admitted in the neonatal intensive care unit

Abstract

Introduction:The importance of breast milk (BM) is unquestionable for any neonate. Our neonatal intensive care unit (NICU) does not have a human milk bank and depends entirely on the availability of mothers' own milk. Hence this quality improvement (QI) initiative was designed to improve expressed breast milk (EBM) usage.Objective: To increase the quantity of EBM in postnatal mothers, whose neonates were admitted in NICU on day-3 of life, from the baseline of 15ml per day to 60ml per day over an 8-week-period. Method:In our neonatal unit, we found many challenges faced by mothers in initiation and maintenance of breast feeding. This study involved systematic implementation utilizing QI strategies; baseline data were collected in the initial weeks and the important causes for less usage of BM were found using a fish bone analysis. Plan-do-study-act cycles were conducted to test change of ideas like counselling sessions and methods of milk expression with help of pamphlets, charts and videos. This series of changes led to increase in BM expression.Results: There were 48 deliveries during the study period of which 26 were included in study. Baseline data collection revealed that the average quantity of expressed mothers' milk intake per day was 15 ml, and use of other mothers' milk and formula feeds was 50%. Within the 8-week-period of implementation, average quantity of EBM improved _________________________________________ 1