The practices and support for delivery of Neonatal Enteral Nutrition (EN) in Northern Ireland were audited against standards derived from the NICE Quality Standards for Specialist Neonatal Care.
Method The records of the first 40 babies consecutively admitted to 5 neonatal units in Northern Ireland after 1st April 2012 were audited (~10% of all NI admissions).
All units have breastfeeding policies and 80% EN progression guidelines
Infant characteristics were gestation median (range) 34 (24–41) weeks; birthweight median (range) 2.24 (0.6–4.97) kg.
EN commencement median (range) was 1 (0–74) days. Full EN was reached median (range) 4 (0–21) days.
Initial milk used was; 48% expressed breast milk (EBM), 35% formula, 14% donor EBM (DEBM) and 3% never received EN.
63% of all babies received some EBM; 27% received DEBM.
Milk at full EN was; 36% formula, 30% EBM, 14% EBM + formula, 9% DEBM, 7% none.
On discharge 55% were on formula, 28% EBM.
Median (range) of corrected age at discharge was 37 (28–44) weeks with weight median (range) 2.47 (0.8–4.97) kg.
Patient outcomes; 75% home, 19% transferred, 4% postnatal ward, 2% died.
Conclusion Despite increasing evidence of the benefits of maternal breast milk for preterm infants, rates of EBM use fell from 48% on initiation to 28% at discharge. Only 63% of neonatal admissions in Northern Ireland ever received maternal breastmilk. A Quality Improvement Initiative should commence supporting mothers breastfeeding and expressing milk for their infants.
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