Improving Milk Donation at a Comprehensive Lactation Management Center and its Implications on Post-natal and Post-operative Ward Neonates – A Quality Improvement Project

Objectives To improve monthly milk donation by 30% from 25.4 L to 33 L over 17 months in a comprehensive lactation management center (CLMC) and to study its implications on postnatal and postoperative ward neonates. Material and Methods This is a quality improvement (QI) project, conducted from Jan 2022 to May 2024 in three phases: Baseline (Jan-Dec 2022), Intervention (Jan-Dec 2023), and sustenance (Jan-May 2024). A QI team was formed and factors for reduced milk donation were identified. Interventions were planned in two PDSA (Plan Do study Act) cycles to improve awareness among mothers and staff nurses of postnatal (PN)-Postop ward regarding benefits of breastmilk, human milk bank, PDHM, increasing nutrition of mothers and to improve milk collection facilities. The monthly outcome measures were number of donors, average volume of milk collected, volume of milk disbursed, number of beneficiaries, the rate of exclusive breastfeeding, morbidities & mortality in PN-Postoperative ward. Study variables of all three phases were analyzed using QI macros 2020. Results The mean (SD) monthly donated milk volume increased from 25.4L (2.5) in baseline to 40.0 L(2.4) and 39.3L (1.03) in intervention and sustenance phase respectively ( P < 0.0001). Milk disbursed to PN-Postop ward increased from 6.4L (1.1) in baseline phase to 13.1L(3.8) and 14.5L (0.54) in subsequent phases. Beneficiaries increased from 43(35-49.7) to 68(56.7-77) and 110 (105-120). Exclusive breastfeeding rates improved from 70% to 97% and 99%. Postnatal admissions due to sepsis, feed intolerance, or dehydration decreased from 25.5(23.7-26) to 5(4-6.2) and 5(5-5) after intervention ( P < 0.001). Mortality decreased from 0.049% in baseline to 0.016% in intervention phase. However, there were no deaths in sustenance phase ( P = 0.011). Conclusion QI measures help to motivate more mothers to donate more milk. This improves number of beneficiaries and volume of milk disbursed to neonates in postnatal & postoperative ward which improves their outcomes.