• Adharsh P Ponnapakkam, Christina N Stine, Kaashif A Ahmad, M Cristina Gallup, Andrew J Delle Donne, Charmaine M Kathen, Jacqueline K Wade, Blanca C Molina, Elizabeth A Koslow, and Nicholas R Carr.
• Brooke Army Medical Center, Fort Sam Houston, TX, USA. adharsh.p.ponnapakkam.mil@mail.mil.
• J Perinatol. 2020 Feb 1; 40 (2): 344-351.

ObjectiveEarly feeding, skin-to-skin contact, and dextrose gel have been independently shown to promote breastfeeding and decrease NICU admission for neonatal hypoglycemia. We combined these interventions to decrease NICU admissions for asymptomatic hypoglycemia and increase exclusive breastfeeding rates.Project DesignThe IHI Model for Improvement was used to design a bundle including feeding within 1 h of birth, 1 h of uninterrupted skin-to-skin within 2 h of birth, and administration of buccal 40% dextrose gel for hypoglycemic infants.ResultsUtilization of dextrose gel was 94% following implementation. There were no trends in exclusive breastfeeding at discharge or NICU admissions for asymptomatic hypoglycemia. Post hoc multivariate analysis identified cesarean delivery as an independent risk factor for compliance failure and failure of exclusive breastfeeding but not for NICU admission.ConclusionsDespite high compliance with dextrose gel utilization, there was no change in exclusive breastfeeding at discharge or NICU admission rates for asymptomatic hypoglycemia.

15 keywords...

hide…