Improving Breastfeeding Establishment by Reducing the Use of Bottles and Artificial Nipples with Medically Needed Supplementation in Full-Term Breastfed Infants: A Quality Improvement Project

Background: Breastfeeding has long been strongly recommended by national and international organizations as a prevention of many common and chronic diseases. Baby-Friendly Hospital Initiative (BFHI) was developed to motivate hospitals to protect, promote, and support breastfeeding. This Quality Improvement (QI) project aims at supporting the continuation of the Baby-Friendly designation at the organization is being implemented, by focusing on reducing the use of bottles and artificial nipples for medically necessary supplementation for full-term breastfed newborns. Methods: The Plan-Do-Study-Act (PDSA) framework was utilized to guide this quality improvement project. Intervention: Educational posters on the interference of the use of bottles in breastfed infants in relation to breastfeeding establishment were prepared and affixed in common areas that nursing staff frequented often to increase access and readability of the material. Results: The project goal of a reduction of 15% use of bottles and artificial nipples was not met during this rapid change cycle; however, the collected data showed that bottles were used less by 9.5% than the pre-intervention period, and an increase of 9.5% in the use of alternative feeding methods was seen. Conclusion: A colored chart comparison highlighted a reduction of 9.5% in the use of bottles and artificial nipples in the post-intervention period, indicating a positive effect from the educational posters was obtained in this QI project