Volume 22 Issue 3

Increasing the First-Hour Breastfeeding Initiation Rate in Neonates Born Through Cesarean Section

Binu Abraham, Sanuja Sarasam Edwin, Gopakumar Atchutha Kumara Pillai, Ajithkrishnan Ananthakrishnan Sarasam, Kiran Narayanan

Abstract

Background: Early initiation of breastfeeding is important to establish mother–neonate bonding, but it is difficult to execute in neonates born through cesarean deliveries.

Aim: To increase the first-hour breastfeeding initiation rate in healthy neonates born through cesarean deliveries

Materials and Methods: Study participants were mother–neonate pairs; only neonates born at > 35 weeks of gestation and through cesarean deliveries were considered. A team of nurses, pediatricians, obstetricians, and anesthetists identified the problem areas using a fishbone analysis and a process flow mapping. Three change ideas were tested through the Plan–Do–Study–Act (PDSA) cycles, followed by a sustainability period of 3 months. The outcome measure was the proportion of eligible neonates breastfed within the first hour of delivery in each phase.

Results: The rate of early initiation of breastfeeding after implementing the PDSA cycles 1, 2, and 3 was 54.5%, 72.7%, and 81.8%, respectively. In the sustainability period, the compliance was 84.6% in phase 1 and 72.7% in phase 2. The compliance increased to 83.3% in phase 3 after addressing the shortcomings.

Conclusion: A quality-improvement drive, with no additional resources, significantly improved the first-hour breastfeeding rate in neonates born through cesarean deliveries.

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