The Indian Journal of Pediatrics

, Volume 84, Issue 4, pp 322–325 | Cite as

A Quality Improvement Initiative: Improving Exclusive Breastfeeding Rates of Preterm Neonates

  • Amanpreet Sethi
  • Meena Joshi
  • Anu Thukral
  • Jagjit Singh Dalal
  • Ashok Kumar Deorari
Clinical Brief


This study is a single center quality improvement (QI) initiative in a tertiary care neonatal intensive care unit which was done with an objective to increase the proportion of neonates receiving mother’s own milk (at postnatal age of 7 d) from the current rate of 12.5% to 30% over a period of six weeks. Additional objectives were to evaluate the proportion of mothers’ expressing breast milk within 3 h of birth, on day one and three and the amount of expressed breast milk (EBM) on day one and day seven. A team was formulated to evaluate the reasons for inadequate breast milk expression and to plan the steps for promoting the same. Comprehensive postnatal breast feeding counseling (CPNC) to promote early breast milk expression was initiated soon after the birth of a preterm neonate. CPNC was done for next fifteen mothers and their breast feeding support was streamlined. The effect of CPNC and teamwork was discussed amongst the team members every day and adjustments incorporated (Plan-Do-Study-Act cycle). The proportion of neonates receiving mother’s only milk (MOM) on day 7 increased to 80% (12/15) after 4 wk of QI. Thus, a simple and feasible CPNC package lead to improved breast milk output in mothers.


Breast milk Neonate Quality improvement 



The authors acknowledge the contribution by nursing staff (Ms Kiran Singh, Ms. Veena Bahri, Ms. Geeta George, Ms. Sneh Dixon) and Dr. Poonam Joshi (Lecturer, Nursing College, AIIMS) without whom this study would not have been possible.


AS: Primary responsibility for protocol development, study implementation, data management and writing the manuscript; MJ: Primary responsibility for protocol development, supervised implementation of the study and contributed to writing of the manuscript; JSD: Participated in implementation of study and provided inputs in manuscript writing; AT and AKD: Participated in development of the protocol, supervised implementation of the study and contributed to writing of the manuscript. AKD will act as guarantor for the paper.

Compliance with Ethical Standards

Conflict of Interest


Source of Funding



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Copyright information

© Dr. K C Chaudhuri Foundation 2017

Authors and Affiliations

  • Amanpreet Sethi
    • 1
  • Meena Joshi
    • 1
  • Anu Thukral
    • 1
  • Jagjit Singh Dalal
    • 1
  • Ashok Kumar Deorari
    • 1
  1. 1.Division of Neonatology, Department of PediatricsAll India Institute of Medical SciencesNew DelhiIndia

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