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

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

Full description

Saved in:
Bibliographic Details
Published in:Pediatrics (Evanston) 2012-12, Vol.130 (6), p.e1679-e1687
Main Authors: Lee, Henry C, Kurtin, Paul S, Wight, Nancy E, Chance, Kathy, Cucinotta-Fobes, Tracey, Hanson-Timpson, Tara A, Nisbet, Courtney C, Rhine, William D, Risingsun, Kate, Wood, Matthew, Danielsen, Beate H, Sharek, Paul J
Format: Article
Language:English
Subjects:
Adult
Babies
Birth weight
Birth weight, Low
Breast feeding
Breastfeeding & lactation
California
Care and treatment
Collaboration
Cooperative Behavior
Enterocolitis, Necrotizing - prevention & control
Enterocolitis, Neonatal necrotizing
Enterocolitis, Pseudomembranous
Evidence-Based Medicine
Female
Food and nutrition
Humans
Infant, Newborn
Infant, Very Low Birth Weight
Infants (Premature)
Intensive Care Units, Neonatal
Length of Stay - statistics & numerical data
Low birth weight
Male
Milk, Human
Necrotizing enterocolitis
Outcome Assessment (Health Care)
Patient outcomes
Pediatrics
Perinatal care
Premature infants
Quality Improvement
Quality of care
Quality Report
Statistics
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:To evaluate a multihospital collaborative designed to increase breast milk feeding in premature infants. 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. 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. 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.
ISSN:0031-4005
1098-4275
DOI:10.1542/peds.2012-0547