Improving Colostrum Administration to Newborns Within the First 6 Hours of Life in the Neonatal Intensive Care Unit.

Abstract

Background and aim: Colostrum, given to newborns early in extrauterine life, provides essential nutrition, immunity, and growth support, offering a strong start for healthy development. This study aims to reduce barriers to colostrum administration and increase colostrum administration for all newborns in the Neonatal Intensive Care Unit (NICU) within the first 6 hours of life, using the Apollo Root Cause Analysis (ARCA) method.

Methods: A pre-post quality improvement study was done prospectively in the NICU of a maternity hospital from July 15, 2022 to July 15, 2023. The study group consisted of 301 newborns. The ARCA method (systematic analysis and intervention guidance method) was used to identify the reasons for barriers to colostrum administration to newborns in the NICU and to optimize the solution processes.

Results: The reasons for the inadequate rate of colostrum given to newborns in the first 6 hours of life were classified as lack of awareness, knowledge and skills about colostrum and disruptions in expressing colostrum, delivering it to the newborn, and applying it. With the interventions, it was determined that 93.6% of the mothers expressed their colostrum, 74.4% of the newborns received colostrum within the first 6 hours, and 85.8% were discharged with only breastfeeding.

Conclusion: With the ARCA method, a gradual increase of up to four times the mean rate of giving colostrum to newborns in the first 6 hours of life was achieved. Nurses can use problem-solving techniques to ensure optimal delivery of breast milk, which has an important impact on newborn health.