Aims The Small Wonders Change Programme (SWCP) is a complex intervention designed by the charity Best Beginnings to improve family-centred practices in neonatal care. The main component of SWCP is a series of films on a DVD supported by a staff training package. The aim of this study was to evaluate the impact of SWCP on staff knowledge and attitudes, parental knowledge and experience and preterm feeding outcomes.

Methods A mixed methods evaluation was performed in two NICUs. Measurements made on cohorts of staff, parents and babies recruited in a period before the intervention (pre) and after the intervention had been embedded (post) were compared.

Results Staff – Knowledge and confidence were assessed in 182 (pre) and 63 (post) staff. Knowledge scores increased from a mean (SD) of 25.71 (3.74) to 28.65 (2.95), p < 0.001. Confidence scores increased from a mean (SD) of 63.93 (13.01) to 74.70 (9.37), p < 0.001. Qualitative analysis of semi-structured interviews revealed that clinicians valued the evidence-based programme and were motivated to integrate their knowledge into practice

Parents – 110 (pre) and 64 (post) parents were surveyed. There were several significant improvements in relation to information received, infant feeding intentions and practices (Table 1). 85.7% of mothers had received a DVD. Only 45.2% watched it. 78.9% of those rated it as either ‘very helpful’ or ‘helpful’. All fathers rated it as either ‘helpful’ or ‘very helpful’.

Clinical outcomes – Clinical outcomes of 617 (pre) and 590 (post) preterm babies were compared. The proportion of babies receiving breast milk at discharge increased from 42.4% to 49% (p = 0.02). The days on which breast milk was used as a proportion of days on which any enteral feeding occurred increased from 57.2% to 62.8% (p < 0.0001). There were no differences in any other clinical outcome.

Conclusions SWCP improved staff knowledge and confidence in supporting preterm breast feeding and family centred care, parental experience and the amount of breast milk received by preterm babies.