Introduction: Early colostrum feeds and skin to skin have shown to increase duration of breast milk feeds in newborns. Despite the known benefits of breast milk feeds for high risk preterm infants, many barriers still remain for the preterm infants to receive mother’s own breast milk. We initiated a quality improvement project to support NICU mothers to improve the duration of breast milk feeding in their preterm infants. Methods: Infants with birth weight ≤1500g born and admitted to Santa Clara Valley Medical Center NICU from January 2013 to December 2015 who were discharged home and eligible to breastfeed were included in this study. An ongoing family centered, multi-disciplinary approach was used to improve mother’s own breast milk feeds in all eligible infants. This included education to nursing staff on the science of human milk, lactation, and breastfeeding; 5 day lactation educator certification course offered to all maternal child health staff including nurses and providers; comfortable reclining chairs for NICU mothers to hold their infant skin to skin; and optimal clinical documentation of skin to skin practice in the infant’s electronic health record. The primary outcome was any breast milk feeding at discharge and the process measures were timing of initiation of colostrum, skin to skin, and breastfeeding. Data was collected by chart review. We compared the primary outcome using logistic regression and the gestational age, birth weight, and process measures using non-parametric Kruskal-Wallis test. Results: In the 100 infants included in this study, the time to first skin to skin improved significantly from our baseline of 6.4 days in 2013 to 2.7 days in 2015 (Table 1). The median birth weight of infants in 2013 (990g) was significantly lower than those in 2015 (1280g). In a sub-group analysis for babies with birth weight < 1000g and >1000g, we saw a similar trend towards improvement of time to first skin to skin, although not statistically significant. Conclusions: With our family centered, multi-disciplinary approach, we were able to improve our skin to skin practice. Our future goals include initiating colostrum within 1 hour after birth to improve milk volume production. We will also be introducing earlier initiation of breastfeeding with the goal at 32 weeks so that the first feed should be at breast.
Early Initiation of Colostrum and Skin to Skin to Establish Successful Breast Milk Feeding in Very Preterm Infants
- Views Icon Views
- Share Icon Share
- Search Site
Alganesh Kifle, Sudha Rani Narasimhan, Robin Wu, Angela Huang, Matthew Nudelman, Priya Jegatheesan; Early Initiation of Colostrum and Skin to Skin to Establish Successful Breast Milk Feeding in Very Preterm Infants. Pediatrics January 2018; 141 (1_MeetingAbstract): 287. 10.1542/peds.141.1MA3.287
Download citation file: