A quality improvement study to increase the breastfeeding rate in very preterm infants in the neonatal intensive care unit

To increase the breastfeeding rate of very preterm infants in the neonatal intensive care unit (NICU).

The baseline period was January to December 2023, during which the breastfeeding rate for very preterm infants in the NICU of Cangzhou People's Hospital was 75%. The quality improvement period was January to December 2024, with a target to increase the rate by 10 percentage points. Effective improvement measures were identified using the plan-do-study-act (PDSA) cycle. Reasons for not receiving breast milk were analyzed, and a key driver diagram was constructed to guide targeted actions. A run chart was used to dynamically monitor monthly breastfeeding rates until the quality improvement goal was achieved.

Seventy very preterm infants were included in the baseline group and 72 in the intervention group. The run chart showed that breastfeeding rate increased to 89% after implementation of the improvement measures, an increase of 14 percentage points from baseline, showing a statistically significant difference (P=0.039). No severe adverse events related to kangaroo care or donor milk-associated infections were reported.

Multidimensional quality improvement strategies based on the PDSA cycle significantly increase the breastfeeding rate of very preterm infants in the NICU.