Background:Early Initiation of Breastfeeding (within 1st hour) will improve the success with latch/suckling in first days ,timely switch from colostrum to milk production , Improved milk volume at 4 days , 4 weeks, 4 months.Delayed initiation , results in failure to breastfeed leading to faulty IYCF practices and later in life leads to Severemalnutrition. The present rates of early initiation of breastfeeding is 21 % in our setup so there is a need of Quality improvement in this subject.Objectives: To Increase the rate of early initiation of breastfeeding in normal babies (i.e, babies with birthweight> 1800 grams with no perinatal complications) in a very busy Government Hospital from existing 21% to 60% by 30 days.Design: Quality improvement study. Setting: Labor Room, Operation Theatre and PNWs and Post-Ceaserian wards of a very busy tertiary care Government hospital.Procedure: A team of Final year Post Graduate students of Obstetrics and Gynecology, Post-Graduate student of Pediatrics, analyzed possible reasons for delayed initiation of breastfeeding by Process flow mapping and Fish bone analysis .Various change ideas were tested through sequential Plan-Do-Study-Act (PDSA) cycles.Outcome measure: Proportion of eligible babiesbreast fed within 1 hour of delivery. Results: The rate of first-hour initiation of breastfeeding increased from 21% to 36.7% over the study period. The result was sustained even after the last PDSA cycle, without any additional resources. The study did not achieve the expected goal because of following reasons
Time given was less and needed more time for PDSA cycle.
Need more training of team members.
Lack of communication among team members.
Perinatology includes the team of Obstetricians, Pediatricians and Anesthetists coordinate and complementation needed.
Conclusion:Proper communication, training, Reinforcements with Posters and Counselling may help in increasing the Early Initiation of Breastfeeding in a busy Government Hospitals.
Keywords: Quality Improvement, Breast Feeding, Plan-Do-Study-Act cycle
