Improving expressed breast milk (EBM) provision in the neonatal unit: A rapid and effective quality improvement (QI) intervention

Breast milk is associated with a range of benefits in babies who are born preterm and/or sick. However, not all women may choose to initiate expression, and of those that do continued provision of breast milk may be challenging because of associated maternal anxiety and practical difficulties with expression. We aimed to improve both our initiation rates and the numbers still expressing at day 14 (D14) and discharge from the neonatal unit. A quality improvement (QI) program was designed and led by a single member of nursing staff. This identified potentially remediable factors and sought to improve them. Initiation rates increased from 76% to 90% and were maintained for the following 12 month period. D14 rates increased from ∼45% to ∼90% (of those initiating) and discharge rates from 30% to 54%. A QI program can result in dramatic improvements in provision of breast milk within a relatively short period and is likely to be associated with a range of improved baby, maternal and health care benefits.