1. Gaynor Jones Geraint Morris

2. Third annual audit of breastmilk use on the Neonatal Unit Audit Questions: 1) Are we starting feeds with EBM/donor EBM during the first 24/48 hrs of life? 2) When during admission do feeding patterns change? 3) What are our breastfeeding rates at discharge? 4) In those less than 33 weeks what percentage are on mothers milk at discharge (NNAP )? 5) Have our interventions improved our breastfeeding rates?

3.  Annual skills days  Posters  Breastfeeding assessment chart  Dedicated Infant Feeding Coordinator appointed  Comprehensive Unit Refurbishment – added cot space  Away day for increasing staff awareness and motivation  Parent feedback – live, questionnaire  Trying to change awareness, culture and attitudes

4. Methods: Prospective Data collection - all babies admitted 01/04/15 to 31/07/2015 (4 months) – Badgernet, Notes, Charts Data collected: commencement of feeding, type of milk and method of feeding, daily for the first week and then weekly until discharge. Findings: 136 admissions 38 were <32 weeks gestation 98 were 32 weeks gestation or more (0f these 7 were 32 – 32+6 weeks)

6. 98 babies (73%) had some breast milk during their stay compared to 69% in 2012 and 76% in 2014. <32 weeks (n=37): 34 babies (92%) had some breastmilk during admission compared to 80% in 2012 and 95% in 2014. Exceptions were all admitted from other units & already on formula.

11.  We are achieving initiation of breast milk feeds within 48 hours for 92% our patients less than 32 weeks gestation.  Our initiation of breast milk is better than in both 2012 and 2014  The total use of breastmilk has increased on the unit during the time of admission  The previous sharp reduction in giving breast milk at around 2 weeks of age has improved  Our use of breastmilk at discharge is below the recommendation from UNICEF of 75%, but above the NNAP UK average

12.  There is scope for reducing our use of formula for babies born at >32 weeks gestation  Still more work to do to: ◦ maintain the momentum of improvement, working towards at least 75% rate of breastfeeding at discharge ◦ target support to mothers of babies staying more than 6 to 8 weeks  BFI accreditation as a neonatal unit  Introduce responsive feeding to staff and parents  Employing non registered staff  Peer support – 3rd sector?