Title | A quality improvement project to increase breast milk use in very low birth weight infants. |
Publication Type | Journal Article |
Year of Publication | 2012 |
Authors | Lee HC, Kurtin PS, Wight NE, Chance K, Cucinotta-Fobes T, Hanson-Timpson TA, Nisbet CC, Rhine WD, Risingsun K, Wood M, Danielsen BH, Sharek PJ |
Journal | Pediatrics |
Volume | 130 |
Issue | 6 |
Pagination | e1679-87 |
Date Published | 2012 Dec |
ISSN | 1098-4275 |
Keywords | Adult, California, Cooperative Behavior, Enterocolitis, Necrotizing, Evidence-Based Medicine, Female, Humans, Infant, Newborn, Infant, Very Low Birth Weight, Intensive Care Units, Neonatal, Length of Stay, Male, Milk, Human, Outcome Assessment (Health Care), Quality Improvement |
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. |
DOI | 10.1542/peds.2012-0547 |
Alternate Journal | Pediatrics |
PubMed ID | 23129071 |
PubMed Central ID | PMC3507251 |
Grant List | K23 HD068400 / HD / NICHD NIH HHS / United States K23HD068400 / HD / NICHD NIH HHS / United States |