Sethi Amanpreet, Joshi Meena, Thukral Anu, Singh Dalal Jagjit, Kumar Deorari Ashok
Division of Neonatology, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, 110029, India.
Indian J Pediatr. 2017 Apr;84(4):322-325. doi: 10.1007/s12098-017-2306-4. Epub 2017 Feb 24.
This study is a single center quality improvement (QI) initiative in a tertiary care neonatal intensive care unit which was done with an objective to increase the proportion of neonates receiving mother's own milk (at postnatal age of 7 d) from the current rate of 12.5% to 30% over a period of six weeks. Additional objectives were to evaluate the proportion of mothers' expressing breast milk within 3 h of birth, on day one and three and the amount of expressed breast milk (EBM) on day one and day seven. A team was formulated to evaluate the reasons for inadequate breast milk expression and to plan the steps for promoting the same. Comprehensive postnatal breast feeding counseling (CPNC) to promote early breast milk expression was initiated soon after the birth of a preterm neonate. CPNC was done for next fifteen mothers and their breast feeding support was streamlined. The effect of CPNC and teamwork was discussed amongst the team members every day and adjustments incorporated (Plan-Do-Study-Act cycle). The proportion of neonates receiving mother's only milk (MOM) on day 7 increased to 80% (12/15) after 4 wk of QI. Thus, a simple and feasible CPNC package lead to improved breast milk output in mothers.
本研究是在一家三级护理新生儿重症监护病房开展的单中心质量改进（QI）项目，旨在将接受母亲自身母乳（出生后7天）的新生儿比例在六周内从当前的12.5%提高到30%。其他目标包括评估母亲在出生后3小时内、第1天和第3天挤出母乳的比例，以及第1天和第7天挤出的母乳量（EBM）。组建了一个团队来评估母乳挤出不足的原因，并规划促进母乳挤出的步骤。在早产儿出生后不久就开始了全面的产后母乳喂养咨询（CPNC），以促进早期母乳挤出。对接下来的15位母亲进行了CPNC，并简化了她们的母乳喂养支持。团队成员每天讨论CPNC和团队合作的效果，并进行调整（计划-执行-研究-行动循环）。质量改进4周后，第7天接受纯母乳（MOM）的新生儿比例增至80%（12/15）。因此，一个简单可行的CPNC方案提高了母亲的母乳产量。
