237 - Improving the Rate of Early Breast Milk Expression in Mothers with Premature Infants

Poster Number: 237
Publication Number: 237.128

Amy E. Ng, Cooper Medical School of Rowan University, Harrison, NJ, United States; Kavya Sundar, Cooper Medical School of Rowan University, Philadelphia, PA, United States; Lori Feldman-Winter, Cooper Medical School of Rowan University, Cherry Hill, NJ, United States; Krystal Hunter, Cooper Medical School of Rowan University, Camden, NJ, United States; Alla Kushnir, The Children's Regional Hospital at Cooper, Camden, NJ, United States

Background: The Baby-friendly Hospital Initiative recommends that mothers of preterm infants be assisted to express their milk within the first 6 hours after birth, as these mothers are at an increased risk of delayed lactogenesis. However, one of the many barriers to achieving early expression is the lack of lactation consultant staffing at night to provide assistance and education to mothers.

Objective: To improve the rate of early human milk expression (HME) among all mothers with Neonatal Intensive Care Unit (NICU)-hospitalized infants to 80% over 4-months through standardized documentation of lactation assistance in maternal postpartum flowsheets.

Design/Methods: The rate of early HME among mothers of NICU patients in a tertiary hospital in urban New Jersey was determined by conducting in-person/phone interviews using a survey instrument adapted from a Baby-friendly Hospital Initiative auditing tool. Interviews were conducted for 1 year Pre-Intervention (Pre-I) and 4 months Post-Intervention (Post-I). The intervention entailed additional documentation of whether lactation assistance was provided or offered to the mother on her postpartum flow sheet. The type of lactation support remained the same throughout the intervention, and included an interactive hand expression and pumping tutorial. Women in Pre-I and Post-I were sub-grouped based on whether they delivered between 07:00-19:00 (Day), or 19:00-07:00 (Night). Rates of early initiation of HME ( < 6 hours postpartum) were compared between Pre-I and Post-I groups, and between Day and Night groups, using Chi square tests in SPSS.

Results: Interviews were conducted with 62 mothers of NICU-hospitalized infants. Of 28 Pre-I, 18.5% (5/27) of mothers received lactation assistance within 6 hours of delivery, while of the 34 Post-I, 36.3% (12/33) received appropriate assistance. There was significant improvement in early initiation of HME in Day mothers, from 7.1% (1/14) to 42.9% (6/14) Post-I (p=0.03). There was no improvement in the rate of early initiation of HME among Night mothers (30.8% [4/13] to 31.6% [6/19], p=0.961).Conclusion(s): Standardized documentation of whether lactation assistance is offered can improve rates of early initiation of HME in mothers of NICU-hospitalized infants. Next steps include developing additional interventions to improve nighttime education in order to achieve an 80% rate of early HME initiation.
Amy Ng CVNg, Amy-CV- 12:30:21.pdf