A Quality Improvement Project to Improve LATCH Score in Healthy Preterm Neonates

Abstract

Background

The World Health Organization recommends exclusive breastfeeding for six months. Even though exclusive breastfeeding is emphasized universally, some mother-infant dyad face problems in initial postnatal days. LATCH score was developed in 1994 to assess breastfeeding and to identify mothers at risk for failure of exclusive breastfeeding. In our unit, only 19% of late preterm neonates had a LATCH score of more than 7. Hence, the effects of various QI interventions were studied to improve LATCH scores in late preterm neonates.

Objective

To improve the LATCH score of more than 7 in late preterm neonates admitted in the postnatal ward.

Methods

This is a QI project where the average LATCH scores in healthy late preterm neonates (34 weeks to 36⁺⁶ weeks) at 48 hours of life from the postnatal ward were studied. The baseline data was collected from May 2023 to June 2023 and the implementation phase was conducted from July 2023 to August 2023. QI team included staff nurses from the postnatal ward, head staff nurses, resident doctors, and consultants. Potential barriers were listed using the fishbone analysis. Various interventions were identified and a priority matrix was formed to decide the sequence of introduction of multiple PDSA cycles.

Outcome Indicator

Improvement in LATCH score to more than 7 recorded by the postnatal team daily.

Results

A total of 80 late preterm neonates were enrolled. At the end of the study, LATCH score was improved to more than 7 in 75% of late preterm neonates. The intervention that was most helpful in achieving the goal was admission of the late preterm neonates in the M-NICU. We were able to sustain the improvement at the end of 6 months.

Conclusion

Sequential QI interventions helped to improve LATCH scores to more than 7 from 19% neonates to 75% neonates thus ensuring successful breastfeeding.