Background and Objective: When vulnerable infants are admitted to the neonatal intensive care unit (NICU), they often encounter barriers to breastfeeding that make the transition to oral feeding difficult. To increase the rate of early breast milk expression rate among mothers of infants admitted to the NICU, we have launched a Quality Improvement (QI) project.
Methods: A QI study with a quasi-experimental pre- and post-test design was conducted in the NICU between June 2020 and November 2021 at Niloufer Hospital in Hyderabad, India. All mothers who gave birth to babies younger than 35 weeks or 2 kg participated in the study. Mothers with certain health conditions, mastitis, or cytomegalovirus infection were not included. The rate of early breast milk expression within six hours of birth and the rate of exclusive breastfeeding at discharge were the main outcome indicators. Mothers and birth attendants were counseled immediately after delivery, posters were displayed in the maternity wards, and breast pumps and milk containers were distributed. A fishbone analysis was used to investigate the potential barriers to early expression of breast milk.
Findings: A total of 1359 mother-baby pairs were included in the study. During the study period, the rate of exclusive breastfeeding at the time of discharge increased (63% to 85%), and the expression of breast milk within 6 hours improved (29.7% to 74.39%).
Conclusion: Simple QI initiatives like lactation counseling, tags, posters, breast pumps, and provision of milk containers can promote early expression of breast milk and exclusive breastfeeding rates at discharge.