419 - Increasing Maternal Breast Milk Production Through Successful Implementation of Kangaroo Care Program in a Level IV NICU

Poster Number: 419
Publication Number: 419.301

Rachel L. Schaus, Wayne State University, Dearborn, MI, United States; Leanne Nantais-Smith, Wayne State Univeristy College of Nursing, Detroit, MI, United States; Nithi Fernandes, Children's Hospital of Michigan, Northville, MI, United States

Background: Although donor milk has become a valuable resource, mother’s own milk (MOM) remains the best source of nutrition in the Neonatal Intensive Care Unit (NICU). However, many mothers have difficulty establishing a milk supply. Kangaroo care (KC) is known to be an effective method of increasing MOM production. Our NICU did not have existing KC practices and previous data showed < 40% of infants were discharged on MOM.

Objective: Our objective was to develop and implement a KC program in a Level IV NICU to evaluate its impact on the percentage of infants who were discharged on MOM: 1) By training 80% of nurses, improve the post-test average score by 20%, and achieve the global benchmark of 5,000 minutes of KC during the two-week Kangaroo-a-Thon; and 2) To increase the percentage of infants discharged home on MOM to 50% during a six-month period.

Design/Methods: Education of nurses was initiated with multiple sources of information (Table 1) with various committees and leadership involved to monitor for completion. Throughout the project, to monitor MOM, each pumping session was tracked for volumes produced before and after KC. Tracking sheets were at the bedside and given to take home for consistent monitoring. The percent of infants discharged on MOM was averaged on a monthly basis.

Results: Of the 109 staff nurses, 95 (87%) attended an educational seminar and completed the pre-test. After implementation of education, the post-test score average increased by 61%. Confidence in understanding the physiology and initiating KC increased by 133% and 89%, respectively. The Kangaroo-a-Thon achieved 7,535 total minutes. Post-KC pumped MOM volumes increased by 24% compared to pre-KC volumes. The percent of eligible infants that received KC each week increased from 2.5% to 24%. The number of infants who were discharged home on MOM had a slight decrease due to a lack of lactation coordinators as a result of the pandemic. However, subsequent months saw a progressive increase with sustained education and awareness, surpassing the goal of 50% of discharge on MOM.Conclusion(s): Nurse education and confidence are vital to establish and maintain KC practice in a NICU. KC resulted in an increase in MOM, which is vital for the health of these vulnerable neonates. Our unit will sustain the modules as part of all new-hire orientation and plan to establish an annual Kangaroo-a-Thon each year. On-going efforts are in place to the MOM pumped volume increase after KC and the percentage of infants discharged on MOM is tracked each month.
Educational Resources for Kangaroo CareTable 1. Various sources of education were offered to new and current staff, implemented, and monitored by nursing leadership.
Figure 1.Timeline of educational efforts and tracking of improvement in MOM