title: The human milk project: a quality improvement initiative to increase human milk consumption in very low birth weight infants.
abstract: OBJECTIVE
  Human milk has well-established health benefits for preterm infants. We conducted a multidisciplinary quality improvement effort aimed at providing at least 500 mL of human milk/kg in the first 14 days of life to very low birth weight (VLBW) (< 1,500 g) infants in the neonatal intensive care unit.
  
  
  METHODS
  Improvement activities included antenatal consults with at-risk mothers, staff and parent education, a breast pump loaner program for uninsured/underinsured mothers, pump logs, establishment of a donor milk program, and twice-daily physician evaluation of infants' ability to tolerate feedings.
  
  
  RESULTS
  The number of infants receiving at least 500 mL of human milk/kg in their first 14 days of life increased from 50% to 80% within 11 months of implementation, and this increase has been sustained for 4 years. Infants who met the feeding goal because they received donor milk increased each year. Since September 2007, infants have received, on average, 1,111 mL of human milk/kg. Approximately 4% of infants did not receive any human milk. Respiratory instability was the most frequent physiological reason given by clinicians for not initiating or advancing feedings in the first 14 days of life.
  
  
  CONCLUSIONS
  Our quality improvement initiative resulted in a higher consumption of human milk in VLBW infants in the first 14 days of life. Other clinicians can use these described quality improvement methods and techniques to improve their VLBW babies' consumption of human milk.
authors.affiliation: Division of Neonatology and Pulmonary Biology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.
authors.forename: Laura
authors.initials: L
authors.lastname: Ward
authors.forename: Christine
authors.initials: C
authors.lastname: Auer
authors.forename: Carrie
authors.initials: C
authors.lastname: Smith
authors.forename: Pamela J
authors.initials: PJ
authors.lastname: Schoettker
authors.forename: Raymond
authors.initials: R
authors.lastname: Pruett
authors.forename: Nilesh Y
authors.initials: NY
authors.lastname: Shah
authors.forename: Uma R
authors.initials: UR
authors.lastname: Kotagal
mesh_terms: D001942:Breast Feeding / Q000379:methods / Q000523:psychology / Q000706:statistics & numerical data; D003376:Counseling; D005260:Female; D006801:Humans; D007227:Infant Nutritional Physiological Phenomena; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000453:epidemiology / Q000517:prevention & control*; D019102:Infant, Very Low Birth Weight; D007363:Intensive Care Units, Neonatal / Q000706:statistics & numerical data; D015931:Intensive Care, Neonatal / Q000706:statistics & numerical data*; D008895:Milk, Human; D009035:Mothers / Q000523:psychology; D011247:Pregnancy; D058996:Quality Improvement