Article Text
Abstract
To improve the postdischarge growth of exclusively breastfed preterm infants, born weighing ≤1.8 kg, by using breast milk fortifier (BMF) supplements postdischarge until 48 weeks’ gestational age. A quality improvement (QI) project involving plan–do–study–act (PDSA) cycles. A tertiary surgical neonatal unit. Preterm infants weighing ≤1.8 kg at birth. We completed four PDSA cycles to develop and improve an electronic patient information sheet to promote the use BMF beyond discharge. Safety, feasibility and attitudes of parents to home BMF were assessed using questionnaires. A retrospective audit (July 2015–September 2017) was completed investigating the effects of home BMF on growth up to 1 year of age. Change in SD scores for weight for age, length for age and head circumference of age at various time points compared with those at birth were calculated. Compared with baseline measurements (infants born October 2012–November 2013), the QI project resulted in improved growth (measured as the change in SD score from birth, cSDS) at discharge for weight (cSDS −0.7), head circumference (cSDS 0.4) and length (cSDS-0.8), and at 1 year for weight (cSDS 0.9) and length (cSDS 0.8). Home BMF appeared to be safe, and parents found its use acceptable. QI methods facilitated the successful integration of BMF into routine clinical care after discharge, improving the growth trajectory of exclusively breastfed preterm infants discharged home, as well as supporting breast feeding in this vulnerable population group.
- quality improvement
- breast milk fortifier
- preterm infants
- nutrition
- growth
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Footnotes
Contributors All authors have made substantial contributions to all of the following areas of this manuscript: all authors participated in the design of the study. CF and LVM carried out the data collection. LVM and CF developed the parent information sheets. LVM and MJJ completed the data and statistical analyses and drafted the manuscript. All authors edited, read and approved the final manuscript.
Funding This work is also part of independent research completed by CF as part of a Health Education Wessex Clinical Academic Training Internships and LVM arising from a Health Education England/NIHR Clinical Lectureship (ICA-CL-2016-02-001) supported by the National Institute for Health Research. MJJ is supported by the National Institute for Health Research through the NIHR Southampton Biomedical Research Centre.
Disclaimer The views expressed in this publication are those of the author(s) and not necessarily those of the NHS, the National Institute for Health Research, Health Education England or the Department of Health.
Competing interests None declared.
Patient consent Not required.
Provenance and peer review Not commissioned; externally peer reviewed.