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Multi-prong quality improvement approach for increasing mother’s own milk use for very low birth weight infants

Journal of Perinatology (2023)Cite this article

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Abstract

Objective

Evaluate a single center quality improvement (QI) collaborative designed to increase the provision of mother’s own milk (MOM) at discharge to premature infants through evidence-based practices while targeting perinatal health disparities.

Design

This QI initiative was designed for preterm infants admitted to a single-center NICU within 24 h of life. Interventions were implemented between March 2022 and June 2022. MOM provision rates were compared between baseline (August 2021–February 2022), and after interventions (March 2022–December 2022).

Results

The percentage of mothers who discontinued pumping during the infant hospitalization decreased from 49% to 35% (p < 0.01). Infant discharge diet with MOM improved from 36% to 58% (p < 0.001). Pump frequency at two weeks increased from 4.0 ± 2.6 to 5.1 ± 2.4 (p = 0.026).

Conclusion

Our collaborative increased the percentage of preterm infants receiving MOM at discharge and reduced the number of mothers who discontinue pumping during the NICU hospitalization.

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Fig. 1: Process control charts of primary divers and secondary outcome.
Fig. 2: Process control charts of primary outcomes.

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Data availability

The dataset generated and analyzed during the study are available from the corresponding author on reasonable request.

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Acknowledgements

The authors would like to acknowledge MUSC IBCLCs (Jeanne Barreira, Sarah Brunson, Miranda Conrad, Margaret Fontaine, Ellen Linder, Amy Pizzuti Brown, and Dorothy Winters) for their dedication to high-quality lactation support; Other members of the Low Country Milk Club (Erika Drexler, RN, Lisa Kidd, RN, and Dr. Alexandra Rowin); Christy Shelton whose insight in providing MOM for her son in the NICU was invaluable; MUSC interpreting services and April Martinez, NNP for assistance translating materials to Spanish; Sallyanne Koontz for coordinating media outreach and publications; Lowcountry WIC staff (Kristin Pillion, Caroline Madsen, Courtney Smith, and Nancy Kate Pippin Suchecki); and Dr. John Baatz for critically reviewing this manuscript.

Funding

This project was funded in part by the David and Laura Stone Endowment for Advancement in Neonatal Medicine, Division of Neonatology, Medical University of South Carolina (MUSC) (NSB, KEC). Additional funding sources provided by the Clinical Component Core of the MUSC Digestive Disease Research Core Center (P30 DK123704) (KEC), COBRE Digestive Liver Disease Center (KEC), and the National Center for Advancing Translational Sciences of the National Institutes of Health under Award Numbers KL2TR001452 (KEC) and UL1TR001450 (MJG). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

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Authors and Affiliations

  1. Division of Neonatology, Department of Pediatrics, Shawn Jenkins Children’s Hospital, Medical University of South Carolina, Charleston, SC, USA

    Neal Boone, Beth Bohara, Kimberly Lee, Carol L. Wagner & Katherine Chetta

  2. Department of Clinical Nutrition, Shawn Jenkins Children’s Hospital, Medical University of South Carolina, Charleston, SC, USA

    Allison Rohrer

  3. Department of Lactation Services, Medical University of South Carolina, Charleston, SC, USA

    Molly Gros

  4. Department of Public Health Sciences, College of Medicine, Medical University of South Carolina, Charleston, SC, USA

    Mathew J. Gregoski

  5. Darby Children’s Research Institute, Medical University of South Carolina, Charleston, SC, USA

    Carol L. Wagner & Katherine Chetta

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  1. Neal Boone
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Contributions

NSB, KEC: conceptualized manuscript. NSB: original draft preparation. NSB, BLB, AR, KEC, MJG: collected data. KEC, MJG, NSB, CLW: data analysis. All authors reviewed, edited, and approved the final manuscript. Funding is provided by KEC, MJG, and NSB. KEC, KGL, AR: supervised quality interventions, data collection, and data analysis.

Corresponding author

Correspondence to Neal Boone.

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Competing interests

All physical materials are copyrighted MUSC 2022© and are original material crafted for this QI effort. The authors have no financial interest to declare in relation to the content of this article.

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Boone, N., Bohara, B., Rohrer, A. et al. Multi-prong quality improvement approach for increasing mother’s own milk use for very low birth weight infants. J Perinatol (2023). https://doi.org/10.1038/s41372-023-01835-w

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  • DOI: https://doi.org/10.1038/s41372-023-01835-w

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