Goodchild Louise, Hussey Lee, McPhee Andrew J, Lizarondo Lucylynn, Gillis Jennifer, Collins Carmel T
Department Of Neonatal Medicine, Women's and Children's Hospital, Adelaide, Australia.
Healthy Mothers, Babies and Children, South Australian Health and Medical Research Institute, Adelaide, Australia.
JBI Database System Rev Implement Rep. 2018 Oct;16(10):2027-2037. doi: 10.11124/JBISRIR-2017-003534.
The aim of this implementation project was to optimize lactation success in mothers of preterm infants by ensuring early (as soon as possible and within six hours) and frequent (eight to 12 times/day) milk expression.
Evidence suggests that breast milk improves enteral feeding tolerance and neurodevelopmental outcomes and decreases the risk of necrotising enterocolitis and late onset sepsis in preterm infants. It is widely accepted that breast milk expression should commence as soon as possible and within six hours of delivery.
Following implementation of the breast milk expression information pack and staff education program, compliance to clinical guideline recommendations improved considerably. An increase from 5/20 (25%) to 17/20 (85%) of women expressing milk within six hours of delivery was observed. The average expression times also increased: from 2.6 (2.0) to 6.1 (2.7) times in the first 24 hours and from 4.6 (1.7) to 7.8 (1.7) times between 24-48 hours. The compliance rate for milk expression within six hours of delivery and expression of eight to 12 times daily in the first 48 hours increased from 1/20 (5%) at baseline to 10/20 (50%) in the follow-up audit.
The implementation of the breast milk information pack and staff education led to improvements in the milk expression practices of mothers who had preterm infants. As a result of this project, the information packs are now routinely given to all women at risk of delivering preterm or who have babies in the neonatal unit. Further audits will be undertaken in the future to determine sustainability of practice changes.
本实施项目的目的是通过确保早产母亲尽早（尽快且在6小时内）和频繁（每天8至12次）挤奶，来优化早产母亲的泌乳成功率。
有证据表明，母乳可提高早产儿的肠内喂养耐受性和神经发育结局，并降低坏死性小肠结肠炎和晚发性败血症的风险。人们普遍认为，应在分娩后尽快且在6小时内开始挤奶。
实施母乳挤奶信息包和员工教育计划后，对临床指南建议的依从性有了显著提高。观察到在分娩后6小时内挤奶的女性比例从5/20（25%）增加到17/20（85%）。平均挤奶次数也有所增加：在最初24小时内从2.6（2.0）次增加到6.1（2.7）次，在24至48小时之间从4.6（1.7）次增加到7.8（1.7）次。分娩后6小时内挤奶且在最初48小时内每天挤奶8至12次的依从率从基线时的1/20（5%）增加到随访审计时的10/20（50%）。
母乳信息包和员工教育的实施使早产母亲的挤奶做法得到了改善。由于该项目，现在会定期向所有有早产风险或新生儿在新生儿病房的女性发放信息包。未来将进行进一步审计，以确定做法改变的可持续性。
