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Description
INNOVATION
Background
The benefits of MBM is well-known in literature, especially for infants admitted to the NICU. There is difficulty in engaging and empowering NICU mothers due to multiple barriers including holding limitations, inability to feed orally, and separation of mother and infant for extended periods. Opportunities for improving MBM utilization throughout admission include oral immune therapy (OIT) and/or oral care with MBM, skin to skin (STS), and non-nutritive attempts at breast. Access to lactation education, support, and resources throughout admission is imperative.
Methodology
Utilization of the plan-do-study-act (PDSA) cycle of quality improvement (QI) has improved our overall lactation processes since January 2023.
- SMART aim: Increase MBM at discharge from 73% to 82% by December 2024.
A literature review and benchmarking were completed in collaboration with the Children’s Hospital Neonatal Consortium (CHNC). Comparing best practice to current practice, it was identified the biggest opportunities included:
- OIT and/or oral care • Lactation Team engagement within 72 hours of all admissions
- Double Electric Breast Pump access
- Provider team engagement and education within 72 hours of admission
- STS within 14 days of admission
Outcomes
MBM at discharge increased from 72% in 2022 to 82% in 2023. In 2024 through July, MBM at discharge is 79%. Comparing patients that go home with MBM versus those that do not, higher rates of the following are seen:
- STS (40% compared to 12%)
- Access to double electric breast pump within 72 hours (91% compared to 64%)
- OIT / Oral Care (62% compared to 38%)
When lactation team is fully staffed and available to provide education and support within 72 hours, the percent of patients discharging home with MBM is higher. There are still multiple barriers to achieve sustainability, including:
- Provider engagement
- Rate of OIT / Oral Care.
- Consistent availability of lactation support< br />
Continued work includes engagement of bedside nurses that are Certified Breastfeeding Counselors, standardized education, and pump access at home.
Publication Date
9-27-2024
Keywords
Innovation, Lactation, NCU, Breastfeeding
Disciplines
Pediatric Nursing
Recommended Citation
Palmer, Rebecca; Tidwell, Jerithea; Hankins, Traci; Hollier, Sharetha; Jenkins, Nicole; Schindler, Dawn; and Gaines, Jeanne, "Improving the Lactation Journey: Empowering Moms’ Utilization of Breast Milk From Admission to Discharge in a Level IV Neonatal Intensive Care Unit" (2024). 2024. 23.
https://scholarlycollection.childrens.com/nursing-anf2024/23
Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-No Derivative Works 4.0 International License.
