Official publication of Rawalpindi Medical University
Early Breast-Feeding Initiation Using Point of Care Quality Improvement Model at Tertiary Care Hospital in AJK

Supplementary Files

PDF

Keywords

Early Initiation of Breastfeeding, Newborns, AJK, Quality Improvement

How to Cite

1.
Khan AH, Khan MA, Akbar A, Mumtaz S, Abbasi Y, Meraj L. Early Breast-Feeding Initiation Using Point of Care Quality Improvement Model at Tertiary Care Hospital in AJK. JRMC [Internet]. 2023 Apr. 2 [cited 2024 Apr. 16];27(1). Available from: http://www.journalrmc.com/index.php/JRMC/article/view/1950

Abstract

ABSTRACT: Urgency and solely utility of breast feeding for six months is better for the provision of a healthy start to newborn and reduces infant mortality and morbidity. The prevalence of late lactation and other ways to formula or animal milk feeding the neonate in Pakistan is often observed other than the WHO recommendations. Early initiation of breast feeding is one of the indicators to express quality of Care in Maternal, and newborn Health. Among many approaches, point of care Quality improvement initiative (POCQI) is a simplified tool for learning the basics of quality improvement in the health care facilities. This study aimed to assess the prevalence and associated factors of early initiation of breastfeeding among mothers in a tertiary care hospital in AJK, where POCQI has been piloted. 

Methods:A quality improvement, cross sectional study before and after the implementation of POCQI model on two independent samples was carried out from August to November 2019. A total of 100 women (50 before intervention and 50 after intervention) who delivered neonates of 0-7 day’s age were included in study by using non-probability convenience sampling technique. The relevant information was gathered by using questionnaire. Mothers who did not start breast feeding within first hour did not receive any health education during antenatal visits. such women lack knowledge about benefits of colostrum. Hence an intervention was introduced by Researcher jointly in collaboration with POCQI team of the hospital by using Plan-Do-Study-Act (PDSA) cycle. Slogans and health education messages for promotion of early initiation of breast feeding were developed and message was spread to pregnant mothers who visited hospital for antenatal care or came for delivery in labor room. 

Results: A total of 100 women (50 before intervention and 50 after intervention) who delivered newborn babies of 0-7 day’s age were selected purposively. Before POCQI intervention out of fifty only eleven (22 %) women breastfed their new born within one hour after birth. After POCQI intervention, out of fifty, thirty-seven women (74%) exclusive breastfed their new born within one hour. Thus, total increase in term of percentage was 54%. 

CONCLUSION: The study gives evidence for more needs to enhance breastfeeding uptake in AJK. The prevalence of EIBS was low before implementation of POCQI model but it improved significantly after its application

https://doi.org/10.37939/jrmc.v27i1.1950

References

. Tiwari S, Bharadva K, Yadav B, Malik S, Gangal P, Banapurmath CR, et al. Infant and Young Child Feeding Guidelines, 2016. Indian Pediatr. 2016;53:703-13.

WHO, UNICEF. Every Newborn: An Action Plan to End Preventable Deaths. Geneva: World Health Organization; 2014.

WHO. 2017 Message. Available: http://www.who.int/nutrition/topics/2017-world-breastfeeding-week-letter.pdf?ua=1. Accessed: 28 August 2017.

Victora CG, Bahl R, Barros AJD, França GVA, Horton S, Krasevec J, et al. Breastfeeding in the 21st century: Epidemiology, mechanisms, and lifelong effect. Lancet. 2016; 387:475–90. – PubMed

Smith ER, Locks LM, Manji KP, McDonald CM, Kupka R, Kisenge R. ‘Delayed Breastfeeding Initiation Is Associated with Infant Morbidity. J Pediatr. 2017 Dec; 191:57-62.e2. doi: 10.1016/j.jpeds.2017.08.069.6.

Rollins NC, Bhandari N, Hajeebhoy N, Horton S, Lutter CK, Martines JC, et al. Why invest, and what it will take to improve breastfeeding practices? Lancet. 2016; 387:491–504. doi: 10.1016/S0140-6736(15)01044-2. - DOI - PubMed

Hannula, L., Kaunonen, M., & Tarkka, M. (2008). A systematic review of professional support interventions for breastfeeding. Journal of Clinical Nursing, 17(9), 1132- 1143. doi: 10.1111/j.13652702.2007.02239.x

Ching-Man Ku, Susan K Y Chow (2010). Factors influencing the practice of exclusive breastfeeding among Hong Kong Chinese women: a questionnaire survey. J Clin Nurs.2010 Sep;19(17-18):2434-45. doi: 10.1111/j.1365-2702.2010.03302.x.

Otsuka, K., Taguri, M., Dennis, C., Wakutani, K., Awano, M., Yamaguchi, T., & Jimba, M. (2014). Effectiveness of a Breastfeeding Self-Efficacy Intervention: Do hospital practices make a difference? Maternal & Child Health Journal, 18(1), 296-306. doi: 10.1007/s10995-013-1265-2

UNICEF, WHO, the World Bank, United Nations Population Division. Levels and trends in child mortality: report 2013. Estimates developed by the UN inter-agency group for child mortality estimation. New York: United Nations Children’s Fund; 2013.

Jarosz LA. Breast-feeding versus formula: Cost comparison. Hawaii Med J 1993;52(1):14–8

Khan J, Vesel L, Bahl R, Martines JC. Timing of breastfeeding initiation and exclusivity of breastfeeding during the first month of life: Effects on neonatal mortality and morbidity—a systematic review and meta-analysis. Matern Child Nutr. 2015; 19:3.

Grossman X, Chaudhuri J, Feldman-Winter L, Abrams J, Newton KN, Phillipp BL, Merewood A. Hospital Education in Lactation Practices (Project HELP): Does clinician education affect breastfeeding initiation and exclusivity in the hospital? Birth. 2009;36:54–59. doi: 10.1111/j.1523-536X.2008.00295.x.

Schmied V, Beake S, Sheehan A, McCourt C, Dykes F. Women’s perceptions and experiences of breastfeeding support: A meta synthesis. Birth. 2011; 38:49–59. doi: 10.1111/j.1523-536X.2010.00446.x.

Watkins AL, Dodgson JE. Breastfeeding educational interventions for health professionals: A synthesis of intervention studies. Journal for Specialists in Pediatric Nursing. 2010;15:223–232. doi: 10.1111/j.1744-6155.2010.00240.

Otsuka, K., Taguri, M., Dennis, C., Wakutani, K., Awano, M., Yamaguchi, T., & Jimba, M. (2014). Effectiveness of a Breastfeeding Self-Efficacy Intervention: Do hospital practices make a difference? Maternal & Child Health Journal, 18(1), 296-306. doi: 10.1007/s10995-013-1265-2

Thakur A, Kler N, Garg P, Singh A, Gandhi P. Impact of quality improvement program on expressed breastmilk usage in very low birth weight infants. Indian Pediatr 2018; 55:739e43.

Dyson L, McCormick F, Renfrew MJ. Interventions for promoting the initiation of breastfeeding. Cochrane Database Syst Rev. 2005; 2:CD001688.

UNICEF, 2007; Progress for children. A world fit for children. Statistical Review. New York

Creative Commons License

This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.

Copyright (c) 2023 Aftab Hussain Khan, Mumtaz Ahmad Khan, Abrar Akbar, Sehrish Mumtaz, Yasira Abbasi, Lubna Meraj