Breast milk is medicine for babies born very low birth weight (under 1,500 grams). For these high risk infants, being fed human milk improves gastrointestinal maturity and visual development, reduces the risk of life-threatening infections such as sepsis and necrotizing enterocolitis, and reduces length of stay and health care costs. When a very low birth weight (VLBW) infant receives its own mother’s milk, both mother and infant benefit.
But only 45.7% of very low birth weight infants cared for in Florida neonatal intensive care units (NICUs) in 2013 received any breast milk before leaving the hospital.
In order to improve feeding rates of mother’s own milk in Florida’s NICUs, the Florida Perinatal Quality Collaborative (FPQC) launched an evidence-based statewide collaborative NICU quality improvement initiative to determine and remove barriers to mother’s own milk use for these at-risk infants. Launched at a kick-off event in May in Orlando, FL, 25 hospital teams are signed up to participate in the Mother’s Own Milk (MOM) Initiative until December 2017. This initiative will focus on mother’s intention to provide her own milk, establishing milk supply, maintaining milk supply, and transitioning to the breast.
Nearly 100 nurses, physicians, and lactation consultants from the participating NICUs attended the kick-off training. The meeting featured presentations and trainings led by members of the FPQC’s Mother’s Own Milk Initiative Advisory Committee. Topics included background and significance of human milk for very low birth weight infants with Dr. Douglas Hardy, and the Florida Toolkit to improve the use of MOM in the NICU with Dr. Ivonne Hernandez.
FPQC Quality Director Dr. Maya Balakrishnan presented on implementation challenges and how to use plan, do, study, act cycles to make change. Dr. Kara del Valle and Juana Rodriguez led a hands-on session on skin-to-skin and other practical elements of the initiative. Jessica Realin, Volunteer Lactation Peer Counselor at Winnie Palmer Hospital, presented a parent’s perspective to providing MOM in the NICU.
Attendees were extremely passionate about the topic of improving the use of MOM and were highly engaged in the sessions. Team members have also been engaged in the monthly learning sessions held online once a month for MOM hospitals to collaborative and share challenges and successes.
Special Opportunity for Nurses
In addition to the kick-off training, participating Florida MOM hospitals were also offered the opportunity to send nurses to attend Breastfeeding Resource Nurse Master trainings led by Dr. Diane Spatz from the Children’s Hospital of Philadelphia. Nurses were trained in Dr. Spatz’s 10 Steps for Promoting and Protecting Human Milk and Breastfeeding in Vulnerable Infants and provided resources for them to return to their institutions and train their colleagues to become Breastfeeding Resource Nurses (BRN).
120 nurses attended one of three BRN Master training events held throughout the state in August 2016. The nurses who attended were very motivated to increasing MOM in the NICU, and they rated the training very highly. Dr. Spatz created video modules the nurses are able to use to review key clinical pearls and for guidance in teaching and applying her 10 steps, including the most up-to-date research findings for human milk in the NICU setting.
Hospitals enrolled in the MOM Initiative have access to an online Toolbox for hospital implementation and receive monthly data quality reports to track their progress in implementing change. As part of the MOM project, the FPQC also provides a website full of resources for Mother’s Own Milk and Breastfeeding for mother’s and families in the NICU, as well as physicians and nurses.
For more information on the FPQC’s MOM Initiative, visit our “Current Projects” page at FPQC.org.
Written by Emily A. Bronson