Enhancing Milk Supplies for Mothers of NICU Babies Through “Pump Early, Pump Often”

Abstract

This project was a quality initiative project in the women’s services department of Piedmont Fayette Hospital in Georgia. To encourage mothers who were separated from their newborns to pump within 1 hour of birth through comprehensive education of the staff. An additional objective was to increase breast milk available to NICU infants. The evidence used to support this initiative were current recommendations in UpToDate, as well as randomized pilot studies. The initiative began by gathering a group of staff members representing lactation, labor and delivery unit, family care center, NICU, and leadership. Evidence was also collected before the initiative started on the lapsed time between birth and mother’s pumping, how many mothers were providing milk to their newborns at the time of discharge from the NICU, and the length of time mothers were able to provide milk to their NICU neonates. Staff was then educated on the importance of timing, breast milk production, how to use the breast pump, the baseline data on pumping timelines and on NICU infants discharged receiving human milk, the targeted population, and the established nursing roles for each department. One month after the initiative started, 29% of mothers were reaching the 1-hr target versus 0 mothers in the preinitiative data collection. The mothers who pumped within the first hour, compared with those who did not, averaged 1.9 ml of milk on the day of delivery compared with 0; 28.4 ml on Day 1 compared with 13.3 ml; and on Day 3 averaged 68 ml of milk compared with 21 for those who did not pump in the first hour. The project was successful, with several recommendations for improvement. Suggestions included the following: make it easier to do the right thing, find a better way to track milk volume after women are discharged, assign responsibility for making supply buckets, be aware of outliers, and speak with one voice.