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Pediatrics. 2012 Dec;130(6):e1679-87. doi: 10.1542/peds.2012-0547. Epub 2012 Nov 5.

A quality improvement project to increase breast milk use in very low birth weight infants.

Author information

1
Division of Neonatology, Department of Pediatrics, University of California, San Francisco, San Francisco, CA 94143-0734, USA. hank45@gmail.com

Abstract

OBJECTIVE:

To evaluate a multihospital collaborative designed to increase breast milk feeding in premature infants.

METHODS:

Eleven NICUs in the California Perinatal Quality of Care Collaborative participated in an Institute for Healthcare Improvement-style collaborative to increase NICU breast milk feeding rates. Multiple interventions were recommended with participating sites implementing a self-selected combination of these interventions. Breast milk feeding rates were compared between baseline (October 2008-September 2009), implementation (October 2009-September 2010), and sustainability periods (October 2010-March 2011). Secondary outcome measures included necrotizing enterocolitis (NEC) rates and lengths of stay. California Perinatal Quality of Care Collaborative hospitals not participating in the project served as a control population.

RESULTS:

The breast milk feeding rate in the intervention sites improved from baseline (54.6%) to intervention period (61.7%; P = .005) with sustained improvement over 6 months postintervention (64.0%; P = .003). NEC rates decreased from baseline (7.0%) to intervention period (4.3%; P = .022) to sustainability period (2.4%; P < .0001). Length of stay increased during the intervention but returned to baseline levels in the sustainability period. Control hospitals had higher rates of breast milk feeding at baseline (64.2% control vs 54.6% participants, P < .0001), but over the course of the implementation (65.7% vs 61.7%, P = .049) and sustainability periods (67.7% vs 64.0%, P = .199), participants improved to similar rates as the control group.

CONCLUSIONS:

Implementation of a breast milk/nutrition change package by an 11-site collaborative resulted in an increase in breast milk feeding and decrease in NEC that was sustained over an 18-month period.

PMID:
23129071
PMCID:
PMC3507251
DOI:
10.1542/peds.2012-0547
[Indexed for MEDLINE]
Free PMC Article

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