Thakur, AnupKler, NeelamGarg, PankajSingh, AnitaGandhi, Priya2020-04-232020-04-232018-09Thakur Anup, Kler Neelam, Garg Pankaj, Singh Anita, Gandhi Priya. Impact of Quality Improvement Program on Expressed Breastmilk Usage in Very Low Birth Weight Infants. Indian Pediatrics. 2018 Sep; 55(9): 739-7430974-75590019-6061http://imsear.searo.who.int/handle/123456789/199157Objective: To improve the usage of expressed breast milk invery low birth weight infants admitted in the neonatal intensivecare unit of a tertiary centre in India.Methods: Between April 2015 and August 2016, various Plan-do-act-study cycles were conducted to test change ideas likeantenatal counselling including help of brochure and video, post-natal telephonic reminders within 4-6 hours of birth,standardization of Kangaroo mother care, and non-nutritivesucking protocol. Data was analyzed using statistical processcontrol charts.Results: 156 very low birth weight infants were deliveredduring the study period, of which 31 were excluded due tovarious reasons. Within 6 months of implementation, theproportion of very low birth weight infants who receivedexpressed breast milk within 48 hours improved to 100% from38.7% and this was sustained at 100% for next 8 months. Themean time of availability and volume of expressed breast milkwithin 48 hours, improved gradually from 73.3 h to 20.9 h and 4.7mL to 15.8 mL, respectively. The mean proportion of expressedbreast milk once infant reached a feed volume of 100 mL/kg/dayalso improved from 61.3% to 82.3%.Conclusion: Quality improvement interventions showedpromising results of increased expressed breast milk usage invery low birth weight infants.Antenatal counsellingBreastfeedingCare bundlePDSA cycleJournal ArticleIndiaDepartment of Neonatology, Institute of Child health, Sir Ganga Ram Hospital, Rajinder Nagar, New DelhiDepartment of Neonatology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India