A Baby Weigh Station: Continuum of Care for Late Preterm Breastfeeding Infants

Sheppard, Joyce

Sunday, June 24, 2012

Title: A Baby Weigh Station: Continuum of Care for Late Preterm Breastfeeding Infants

Woodrow Wilson (Gaylord National Harbor)

Whitney Lenger Mirvis, BSN, RN, IBCLC , Women's Health Services, Riverside Methodist Hospital, Columbus, OH

Kathleen H. Bright, BSN, RNC, IBCLC , Lactation Education Specialist, Doctors Hospital -Ohiohealth, Columbus, OH

Jane Lamp, MS, RN-BC, CNS , Women's Health Services, Riverside Methodist Hospital, Columbus, OH

Joyce Sheppard, RN, IBCLC , Lactation Education Specialist, Women's Health Services, Riverside Methodist Hospital, Columbus, OH

Discipline: Newborn Care (N)

Learning Objectives:

Recognize the Late Preterm Infant (LPI) as at-risk for post-discharge breastfeeding and weight gain problems.
Report 3 measurements used to set weight gain parameters.
Cite 3 positive outcomes that demonstrate the weigh station to be an effective pathway to ongoing care and support for LPIs.

Submission Description:

Purpose for the program: Breastfeeding Late Preterm Infants (LPI's) are the largest segment of preterm babies. Columbus, Ohio incidence is 9.1 % of live births (2008), and our hospital has 7.7 % of 6456 births/year as LPI’s (2010). LPI’s often appear to be successful breastfeeders during hospitalization, (hence their nickname “the great imposter”), but this may not be sustained following discharge. (Engle,2007) As 1 of 15 sites for the 2010 AWHONN LPI Evidence-Based Practice Guidelines research study, commitment to measure and improve post-discharge care of breastfed LPI's occurred in this hospital’s outpatient setting.

Proposed change: Assure a successful continuum of care for the post-discharge LPI via a community resource where 90% of LPI babies will gain weight, after events of lactation consultation and 1st weight measurement.

Implementation, outcomes and evaluation: Utilize a baby weigh station within a user-friendly lactation support center to offer a community accessible on-site, free service, monitored by approachable staff and expert professionals (IBCLC). Identify LPI’s who return for repeat weight measurement, track weight gain, and generate monthly progress reports. Total number of LPI’s consulted/weighed more than one visit. Numerator – Number of LPI’s who gain weight of >0.5 ounce at > 5 days of age and thereafter, Denominator – Total number of LPI’s consulted/weighed. Outcomes: Over 12 months, 151 individual LPI weights were measured, 116 had repeated weights 99% demonstrated weight gain (monthly averages). Additional benefits included referrals to lactation, pediatrics, pediatric surgery, behavioral services. Evaluation: An accessible weigh station was evaluated to be an effective pathway to ongoing care and support for LPI’s. LPI’s gained weight appropriately while their mothers reported sustained breastfeeding.

Implications for nursing practice: Accessible community service, monitored by approachable staff and expert professionals is an effective means to continue and grow client relationships. Monitor at risk groups for anticipated problems. Provide a portal for continuing care.

Keywords: late, preterm, breastfeeding, weigh