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Impact of mother-baby friendly initiative plus approach on improving human milk feeding for neonates in hospital: a quality improvement before-and-after uncontrolled study.
Eur J Pediatr. 2022 Jan; 181(1):107-116.EJ

Abstract

Breastfeeding, use of pasteurised donor human milk when mother's own milk is unavailable and kangaroo mother care have independently proven benefits in improving survival of vulnerable sick babies. A triangulated approach called the Mother Baby Friendly Initiative Plus (MBFI+) model, bringing together the combined benefits of these proven interventions, was used to improve exclusive human milk feeding at health facilities through quality improvement and system strengthening approach. This quality improvement before-and-after uncontrolled study enrolled 5343 term and 278 very low birth weight (VLBW) mother-infant dyads. Pre- and post-intervention data were compared to evaluate effect on feeding-related healthcare processes and outcomes. Primary outcome which was incidence of exclusive human milk feeding during hospital stay, improved from 44 to 64.8% (RR 1.47, 95% CI: 1.40-1.55) among term and from 60.5 to 80.7% (RR: 1.33; 95% CI: 1.12-1.59) among VLBW neonates. Neonates receiving extended KMC improved from 43 to 71.1% (RR: 1.65; 95% CI: 1.30-2.10).Conclusion: MBFI+ approach improved exclusive human milk feeding among term and preterm VLBW neonates. What is Known: • Breastfeeding has immense health benefits to sick preterm neonates admitted in NICU. What is New: • Quality improvement approach can lead to system strengthening and can help overcome hindrances to achieve increased breastfeeding rates.

Authors+Show Affiliations

Department of Neonatology, Lokmanya Tilak Municipal Medical College and Lokmanya Tilak Municipal General Hospital, Sion, Mumbai, 400022, India.Department of Neonatology, Government Medical College and Hospital, Chandigarh, 160 030, India.Nutrition Lead, India Country office, Bill and Melinda Gates Foundation, Seattle, USA.Department of Neonatology, Lokmanya Tilak Municipal Medical College and Lokmanya Tilak Municipal General Hospital, Sion, Mumbai, 400022, India. drswatimanerkar@gmail.com.Lokmanya Tilak Municipal Medical College and Lokmanya Tilak Municipal General Hospital, Sion, Mumbai, 400022, India.Lokmanya Tilak Municipal Medical College and Lokmanya Tilak Municipal General Hospital, Sion, Mumbai, 400022, India.Seth V C Gandhi and M.A. Vora Municipal General Hospital, Rajawadi, Ghatkopar East, Mumbai, 400077, India.Seth V C Gandhi and M.A. Vora Municipal General Hospital, Rajawadi, Ghatkopar East, Mumbai, 400077, India.Seth V C Gandhi and M.A. Vora Municipal General Hospital, Rajawadi, Ghatkopar East, Mumbai, 400077, India.Maternal, Newborn and Child Health and Nutrition Program, PATH, Seattle, WA, 98121, USA.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

34216269

Citation

Mondkar, Jayashree, et al. "Impact of Mother-baby Friendly Initiative Plus Approach On Improving Human Milk Feeding for Neonates in Hospital: a Quality Improvement Before-and-after Uncontrolled Study." European Journal of Pediatrics, vol. 181, no. 1, 2022, pp. 107-116.
Mondkar J, Chawla D, Sachdeva RC, et al. Impact of mother-baby friendly initiative plus approach on improving human milk feeding for neonates in hospital: a quality improvement before-and-after uncontrolled study. Eur J Pediatr. 2022;181(1):107-116.
Mondkar, J., Chawla, D., Sachdeva, R. C., Manerkar, S., Shanbhag, S., Khan, A., Manuhar, M., Wankhede, M. G., Thakur, V., & Israel-Ballard, K. (2022). Impact of mother-baby friendly initiative plus approach on improving human milk feeding for neonates in hospital: a quality improvement before-and-after uncontrolled study. European Journal of Pediatrics, 181(1), 107-116. https://doi.org/10.1007/s00431-021-04141-9
Mondkar J, et al. Impact of Mother-baby Friendly Initiative Plus Approach On Improving Human Milk Feeding for Neonates in Hospital: a Quality Improvement Before-and-after Uncontrolled Study. Eur J Pediatr. 2022;181(1):107-116. PubMed PMID: 34216269.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Impact of mother-baby friendly initiative plus approach on improving human milk feeding for neonates in hospital: a quality improvement before-and-after uncontrolled study. AU - Mondkar,Jayashree, AU - Chawla,Deepak, AU - Sachdeva,Ruchika Chugh, AU - Manerkar,Swati, AU - Shanbhag,Sunita, AU - Khan,Aisha, AU - Manuhar,Minu, AU - Wankhede,Maya Ganesh, AU - Thakur,Vidya, AU - Israel-Ballard,Kiersten, Y1 - 2021/07/03/ PY - 2021/04/01/received PY - 2021/05/31/accepted PY - 2021/05/27/revised PY - 2021/7/4/pubmed PY - 2022/1/19/medline PY - 2021/7/3/entrez KW - Breastfeeding support KW - Human milk banking KW - Kangaroo mother care KW - MBFI plus KW - Pasteurised donor human milk KW - Quality improvement SP - 107 EP - 116 JF - European journal of pediatrics JO - Eur J Pediatr VL - 181 IS - 1 N2 - Breastfeeding, use of pasteurised donor human milk when mother's own milk is unavailable and kangaroo mother care have independently proven benefits in improving survival of vulnerable sick babies. A triangulated approach called the Mother Baby Friendly Initiative Plus (MBFI+) model, bringing together the combined benefits of these proven interventions, was used to improve exclusive human milk feeding at health facilities through quality improvement and system strengthening approach. This quality improvement before-and-after uncontrolled study enrolled 5343 term and 278 very low birth weight (VLBW) mother-infant dyads. Pre- and post-intervention data were compared to evaluate effect on feeding-related healthcare processes and outcomes. Primary outcome which was incidence of exclusive human milk feeding during hospital stay, improved from 44 to 64.8% (RR 1.47, 95% CI: 1.40-1.55) among term and from 60.5 to 80.7% (RR: 1.33; 95% CI: 1.12-1.59) among VLBW neonates. Neonates receiving extended KMC improved from 43 to 71.1% (RR: 1.65; 95% CI: 1.30-2.10).Conclusion: MBFI+ approach improved exclusive human milk feeding among term and preterm VLBW neonates. What is Known: • Breastfeeding has immense health benefits to sick preterm neonates admitted in NICU. What is New: • Quality improvement approach can lead to system strengthening and can help overcome hindrances to achieve increased breastfeeding rates. SN - 1432-1076 UR - https://www.unboundmedicine.com/medline/citation/34216269/Impact_of_mother_baby_friendly_initiative_plus_approach_on_improving_human_milk_feeding_for_neonates_in_hospital:_a_quality_improvement_before_and_after_uncontrolled_study_ L2 - https://dx.doi.org/10.1007/s00431-021-04141-9 DB - PRIME DP - Unbound Medicine ER -