Milk is Medicine: Early Exposure to Mother's Milk with Oral Immune Therapy

PURPOSE The purpose of this project was to improve early Oral Immune Therapy (OIT) initiation by implementing a nursing intervention bundle for infants weighing less than 1500 grams at birth. BACKGROUND Premature infants face nutritional challenges due to immature digestive systems and delayed oral feeding. Drops of maternal breast milk in the buccal mucosa as OIT expose infants to immune factors, positively impacting their microbiome, supports immune function and enhances health outcomes for very low birth weight (VLBW) infants. METHODOLOGY Using the Institute for Healthcare Improvement (IHI) Model for Improvement with a multi-disciplinary team, interventions included provision of a colostrum collection kit, initial lactation visit with targeted education, and initiation of maternal milk expression within six hours of delivery. Data analysis involved collecting quantitative data on the percentage of infants receiving OIT within 24 hours and three days of life, and the percentage of mothers receiving all bundle elements within six hours of delivery. Compliance ratios and changes pre- and post-intervention were evaluated using descriptive statistics. RESULTS The primary objective was to raise the initial OIT administration to over 55% within 24 hours and over 90% within three days of life. OIT administration within 24 hours increased to 56% (18% rise) and within three days to 89% (21% rise) compared to the pre-intervention group. IMPLICATIONS Early exposure to MOM through OIT can positively affect health outcomes for premature infants. This standardized nursing bundle may benefit other NICUs aiming to enhance outcomes for VLBW infants.