M Arien, R Agarwal.
Neonatal Intensive Care Unit, Royal Oldham Hospital.. |
| Background |
| Breast milk is the best form of nutrition for extremely low birth weight (ELBW) infants but is difficult to sustain throughout the time on NICU due to preterm complications and long admissions. Successful care bundles and evidence-based practices have been developed to promote the use of mothers’ breast milk. This QI study aims to identify strengths and weaknesses in practice on NICU in implementing evidence-based practices around promoting breast milk in ELBW infants. |
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| Methods |
| A retrospective study looked at all ELBW infants born at Royal Oldham and discharged from either Royal Oldham or North Manchester General in 2014. Data was extracted on basic demographics of the infants and the pattern of feeding. A proforma was designed with elements of the care bundle to assess compliance with evidence-based practices during the antenatal, postnatal and neonatal period. Basic statistical and qualitative analysis was performed to assess the level of compliance with each component of care bundle. |
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| Results |
| All 32 infants were started on breast milk. Only 25% were exclusively fed expressed breast milk. At discharge, 44% of infants were fed expressed breast milk exclusively or partially. The unit is following elements of the care bundle but is not reaching the targets for all infants. 100% targets were only met for the skin-to-skin care element of the care bundle. Mothers were given more regular support on the postnatal unit as compared to the neonatal unit. |
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| Conclusions |
| Evidence-based practices are being fulfilled, but targets are not being met. Lack of continuous and detailed documentation on NICU means that the breastfeeding care cannot be monitored accurately. A proforma has been designed for the neonatal nursing notes to make the documentation process more efficient, after which this study should be repeated for more accurate results. |
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