Ward Laura P, Williamson Susan, Burke Stephanie, Crawford-Hemphill Ruby, Thompson Amy M
Perinatal Institute, Division of Neonatology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio;
Women's Health Services and.
Pediatrics. 2017 Feb;139(2). doi: 10.1542/peds.2016-0344. Epub 2017 Jan 4.
Breastfeeding has many well-established health benefits for infants and mothers. There is greater risk reduction in health outcomes with exclusive breastfeeding (EBF). Our urban academic facility has had long-standing low EBF rates, serving a population with breastfeeding disparities. We sought to improve EBF rates through a Learning Collaborative model by participating in the Best Fed Beginnings project.
Formal improvement science methods were used, including the development of a key driver diagram and plan-do-study-act cycles. Improvement activities followed the Ten Steps to Successful Breastfeeding.
We demonstrated significant improvement in the median adherence to 2 process measures, rooming in and skin-to-skin after delivery. Subsequently, the proportion of infants exclusively breastfed at hospital discharge in our facility increased from 37% to 59%. We demonstrated an increase in sustained breastfeeding in a subset of patients at a postpartum follow-up visit. These improvements led to Baby-Friendly designation at our facility.
This quality improvement initiative resulted in a higher number of infants exclusively breastfed in our patient population at "high risk not to breastfeed." Other hospitals can use these described methods and techniques to improve their EBF rates.
母乳喂养对婴儿和母亲有诸多已被充分证实的健康益处。纯母乳喂养（EBF）能更大程度降低健康问题的风险。我们的城市学术机构长期以来纯母乳喂养率较低，服务对象存在母乳喂养差异。我们试图通过参与“最佳喂养开端”项目，采用学习协作模式来提高纯母乳喂养率。
运用了正规的改进科学方法，包括制定关键驱动因素图和计划-执行-研究-改进循环。改进活动遵循成功母乳喂养的十个步骤。
我们在两项过程指标（母婴同室和产后肌肤接触）的中位数依从性方面取得了显著改善。随后，我们机构出院时纯母乳喂养婴儿的比例从37%增至59%。在产后随访中，我们发现一部分患者持续母乳喂养的情况有所增加。这些改进使我们的机构获得了爱婴医院称号。
这项质量改进举措使我们“母乳喂养高危”患者群体中纯母乳喂养的婴儿数量增加。其他医院可以采用上述方法和技巧来提高其纯母乳喂养率。
