Authors (including presenting author) :
Shiu WY, Li YK, Chan KY, Leung SK, Wan OM
Affiliation :
Department of Obstetrics & Gynaecology, United Christian Hospital
Keyword 1: :
Breastfeeding
Keyword 2: :
Baby-friendly
Keyword 3: :
quality improvement
Keyword 5: :
feeding choice
Keyword 6: :
personal care
Introduction :
Breastfeeding is an essential public health priority for maternal and neonatal health. Despite achieving Baby-Friendly Hospital certification in 2023, a decrease in breastfeeding rates upon discharge was noted by the end of 2024. To address the clinical decline in breastfeeding rates, it is critical to analyze the underlying factors that influence a mother's feeding choice during hospitalization.
Objectives :
The aim of this quality improvement project was to investigate mothers’ perspectives and obstacles they encounter when breastfeeding, with the goal of optimizing clinical support during the early postpartum period and raising the breastfeeding on discharge rate.
Methodology :
The PDCA (Plan-Do-Check-Act) framework served as a structured methodology to direct the continuous improvement initiative from January to September of 2025. This includes identifying root causes through methods such as maternal survey, implementing focused interventions, monitoring outcomes using data-driven audits, and modifying strategies based on results, thereby improving outcomes and operational efficiency.
Result & Outcome :
The maternal survey revealed that policy misunderstandings were the primary barriers, especially the incorrect assumption among many women that essential formula would be denied to breastfeeding mothers. Additionally, the challenges of breastfeeding after a caesarean section, including postoperative pain management and the importance of postpartum rest for recovery were recognized. In response, targeted initiatives were implemented, including proactive prenatal counselling to correct misconceptions, the assistance of skin-to-skin contact following surgery, and the development of a customized rest care plan for new mothers. Staff training to emphasize the importance of attentively listening to mothers’ needs. Performance was evaluated through monthly audits and feedback, resulting in the refinement of strategies and the establishment of new initiatives on pain management to further improve maternal recovery. The PDCA cycle resulted in a significant and sustainable improvement in the breastfeeding rate at discharge, increasing from a baseline of 67% in January 2025 to an outstanding 93% by September 2025. Notably, enhanced guidance and bonding techniques effectively assisted 48% of mothers who initially relied on formula in transitioning to breastfeeding. Continuous improvement is essential to meet the changing needs of mothers. By integrating "listening to mothers" into the PDCA cycle, the strategies successfully addressed misconceptions and physical barriers for breastfeeding. The findings indicate that personalized support and practical help with rest and pain management are essential for achieving optimal breastfeeding outcomes.
