"This project was driven by bedside nurses, who carried out a goal of systematically integrating evidence-based lactation support and education as part of standard nursing care," said Spatz. Edwards and Spatz note in their study that Children's Hospital strongly supports breast-feeding, but for these medically fragile newborns, mothers may have to wait days or weeks before they are able to even hold their babies.
Therefore, the nurses followed a step-wise system called the Transition to Breast Pathway, which begins with the mother learning to pump breast milk shortly after delivery. Before the baby is able to nurse at the breast, mothers learn to provide mouth caresupplying the infant with a bit of human milk on a cotton swab or a pacifier. Nurses also teach skin-to-skin care, letting the mother hold the child close to her body. The skin-to-skin contact reduces stress in both child and mother, increases the mother's milk supply, and nurtures the mother-infant bond.
Although not all the mothers were willing or able to transition to breast-feeding, 58 of the 80 infants were breast-feeding before they were discharged. For each step of the pathway, success rates improved in the second nine months of the project compared to the first six months.
"This CQI project demonstrates that even the most vulnerable infants can transition to at-breast feeds prior to discharge," said Spatz. "This pathway can be replicated in intensive-care nurseries throughout the world, allowing infants to achieve improved health outcomes, and their mothers to have the opportunity to follow the natural path of bonding that breastfeeding allows for."
|Contact: John Ascenzi|
Children's Hospital of Philadelphia