Improving Early Initiation of Breastfeeding in Newborns Delivered at a Tertiary Care Hospital: A Quality Improvement Study

Abstract

Introduction Neonatal mortality is the major contributor for under five mortality. WHO and UNICEF have mentioned that it is vital to initiate breastfeeding within the first hour of birth for reducing mortality. In India, it has been reported that only 42.7% babies receive breastfeeding within 1 hour of birth, and at our institute, we noticed only 61% of stable babies delivered vaginally received breastfeeding within 1 hour of birth. So, we planned a quality improvement study at our hospital using POCQI (point of care quality improvement). Aims and Objectives To increase the early initiation of breastfeeding (EIBF) practice in neonates born through vaginal delivery at or above 36 weeks of gestation from the observed baseline of 61% to >85% over 3 months period. Methods The study was conducted in Labor Room of a tertiary care hospital over a period of three months (Dec 2022–Feb 2023) and a sustenance phase from April 2023 to June 2023. A root-cause analysis was done using the fishbone framework focusing on various barriers related to mothers, hospital staff, policy, place, and practices. Based on this, a comprehensive early breastfeeding initiation intervention was planned utilizing Plan-Do-Study-Act (PDSA) cycles. Results At the end of the 3 months, we were able to achieve 100% compliance in EIBF from baseline of 61% and same compliance was maintained during sustenance phase. Run charts used for interpretation showed increase in compliance and reduction in time of initiation of breastfeeding. Conclusion This study brought out various hurdles to EIBF and demonstrated that it can be improved by using simple quality improvement model.