537 - Increase Rate of Breastfeeding in NICU by encouraging early pumping within 4 hours of birth and continue pumping every 3 hours
Saturday, April 26, 2025
2:30pm – 4:45pm HST
Publication Number: 537.5152
Sharadha Polam, Childrens Hospital of Philadelphia, MONMOUTH JUNCTION, NJ, United States; Marilyn Giorgi, Childrens Hospital of Philadelphia, Princeton, NJ, United States; Sharath Chowdawarapu, CHOP Newborn care, Plainsboro, NJ, United States; Thomas Habib, Children’s Hospital of Philadelphia, Princeton, NJ, United States; catherine muhumuza, CHOP Newborn care Network, morganville, NJ, United States; Elizabeth Pleickhardt, Childrens Hospital of Philadelphia, Warren, NJ, United States; John Chuo, Perelman School of Medicine, University of Pennsylvania, Doylestown, PA, United States; Cherlisse Javier, Penn Medicine Princeton Health, Freehold, NJ, United States; Katelyn Brennan, Childrens Hospital of Philadelphia, Plainsboro, NJ, United States; Alyssa K. Salerno, Penn Medicine Princeton Health, Flemington, NJ, United States; Laura Rivera, University Medical Center of Princeton at Plainsboro, Yardley, PA, United States; Allyson M.. Freda, Penn Med Princeton, Hamilton, NJ, United States; Christine Kelly, Childrens Hospital of Philadelphia, Kendall Park, NJ, United States; Sheena Mathew, Penn Medicine Princeton Health, Allentown, NJ, United States; Kelliann Keirns, Childrens Hospital of Philadelphia, Pemberton, NJ, United States; Mary Ellen Spencer, Penn Medicine Princeton Health, Dresher, PA, United States; Susan Straszynski, Penn Medicine, Langhorne, PA, United States
Attending Neonatologist Childrens Hospital of Philadelphia MONMOUTH JUNCTION, New Jersey, United States
Background: Breast milk is ideal form of nutrition for infants. Newborns benefit from decreased bacterial infections, inflammatory bowel disease, and obesity, and improved neurodevelopment. AAP recommends exclusive breastfeeding for 2 full years of age due to well documented benefits of breast milk for both newborns and mothers. Objective: Our SMART aim is to initiate first breastfeeding or pumping within 4 hours of birth. To improve breastfeeding rates in NICU of ALL infants at the time of discharge from 21% in Year 2021 to 30% by December 2025. To improve breastfeeding rates in NICU of VLBW infants at the time of discharge from 0% in Year 2021 to 40% by December 2025. Design/Methods: A multi-disciplinary team composed of Neonatologists, Lactation Consultants, and Nurses developed a policy in Nov 2021 to start initiation of early breast pumping within 4 hours on all mothers with NICU babies at PMPMC. Staff (Neonatologists, NICU & Maternal Child Health Nurses) and parents were educated regarding benefits of breastfeeding and early pumping by Lactation Consultants. The new breast pump policy and pumping log were part of the nurses’ clipboards which were distributed to all mothers to records time of first pump, latch, or hand expression. Breast pumps in every room were equipped with QR Codes to scan and watch videos which explained benefits of breastfeeding and pumping. Data was collected from EHR, pumping logs, and lactation consultant notes. Outcome and process measures were breastfeeding rate and early pumping, respectively. These metrics were ascertained using a retrospective chart review extending 6-months prior to implementing the new breast pumping policy, followed by a prospective data collection process after implementing the new breast pumping policy. Data was visualized in a run chart to identify special cause signals using health care rules for detecting special cause signals. Results: In pre-intervention period from June 2021 to Nov 2021, the average pumping initiation time was 8.15 hours. Breastfeeding rate was 21% and 0% for all infants and VLBW respectively. In post-intervention period from Jan 2022 to Aug 2024, a special cause signal was detected starting August 2022 allowing a centerline shift bringing down the average pumping initiation time to 3.4 hours. Exclusive breastfeeding rate was increased to 34% and 67% in all infants and VLBW infants respectively and sustained in 2024.
Conclusion(s): Target goals for breastfeeding rates in all infants and VLBW sub cohorts at PMPMC NICU were reached. This improvement was associated with a parallel improvement (decrease) in pumping initiation below 4 hours.
