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Semin Perinatol. 2017 Apr;41(3):175-186. doi: 10.1053/j.semperi.2017.03.007. Epub 2017 May 23.

Using quality improvement to increase human milk use for preterm infants.

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Department of Pediatrics, Boston Medical Center, Boston University School of Medicine, 88 E Newton St, Vose Hall, 3rd Floor, Boston, MA 02118. Electronic address:
Department of Pediatrics, Rush University Medical Center, Chicago, IL.


This review will provide an overview of quality improvement methods that have been used to improve human milk use (mother's own milk and donor milk) for very low-birth-weight infants in the hospital setting in the last decade. We will review the following: (1) evidence-based practices known to increase mother's own milk for very low-birth-weight infants; (2) individual hospitals with exemplary lactation programs and past and current US-based statewide quality improvement collaboratives focused on increasing mother's own milk; and (3) existing quality metrics for human milk and gaps in metrics. Finally, we will provide practical examples of key driver diagrams and change concepts that may be used to inform quality improvement for mother's own milk for very low-birth-weight infants.


Early initiation; Human milk; Neonatal intensive care unit; Preterm; Quality improvement

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