A Quality Improvement Initiative to Increase the Supply of Mother’s Own Milk for Preterm Newborn Admitted in Neonatal Intensive Care Unit of Bangabandhu Sheikh Mujib Medical University

Abstract

Background: Mother’s own milk for preterm infants is a complete nutrition. In NICUs, there is a delay in starting and decreased frequency of breast milk expression leading to inadequate supply of mother’s own milk for preterm babies. There is a lack of knowledge about the importance of mother’s own milk for preterm babies in the general population and a paucity of studies on this topic from Bangladesh. This quality improvement initiative will serve as a baseline study for increasing the use of mother’s own milk for preterm babies in our country. Objectives: To observe the effects of the quality improvement initiative to increase the supply of mother’s own milk for preterm newborns admitted in the NICU. Methods: This QI study was conducted in the Department of Neonatology, in collaboration with the Department of Obstetrics and Gynaecology, Bangabandhu Sheikh Mujib Medical University, Dhaka, over the period of 1 year. Inborn Preterm neonates ≤34 weeks and/or ≤1800 gm and mother dyads, anticipated to stay in NICU for ≥ 7 days, were included in this study. In the observation phase, baseline data were collected. The intervention phase was started with a comprehensive counseling package, the demonstration of breast milk expression, and the early (within 6 h of delivery) and frequent (2 h) expression of breast milk. Results: A total of 96 preterm newborns and mother dyads were enrolled. There was an improvement in the percentage of mothers expressing breast milk within 6 h of birth and on day 1 from 0% to 100% and from 14.5% to 100%, respectively, after implementing the QI initiative. The amount of expressed breast milk on days 1, 3, and 7 in the intervention group was higher than that of the observation group. The percentage of neonates receiving only mother’s own milk on day 1 was increased from 14.5% to 100% after giving intervention. Conclusion: A significant improvement in early expression of breast milk, an increase in total amount of expressed breast milk, and an exclusive mother’s own milk feeding among the preterm neonates admitted in the NICU were observed.