174 - From policy to practice: a quality improvement project in an italian well-baby nursery within a widestate collaborative initiative aimed to boost exclusive breastfeeding
Sunday, April 26, 2026
9:30am - 11:30am ET
Publication Number: 3168.174
Silvia Bonato, Ospedale San Bortolo, Vicenza, Veneto, Italy; Valentina Dal Cengio, Hospital of Vicenza, Vicenza, Veneto, Italy; Valentina Vanzo, Ulss 8 Vicenza, Padova, Veneto, Italy; federico Pece, ULSS8, Vicenza, Veneto, Italy; Luca Pegoraro, Ospedale San Bortolo - Vicenza, Padova, Veneto, Italy; Grazia Giunta, Ospedale san Bortolo, Vicenza, Veneto, Italy; Genny Gottardi, San Bortolo Hospital, Vicenza, Veneto, Italy; Federica Bertuola, AULSS 8, San Bortolo Hospital, Vicenza, Veneto, Italy; Enrico Franchetti, Aulss 8 Berica, Vicenza, Veneto, Italy; alessandra grison, Aulss8, Creazzo, Veneto, Italy; francesca parata, San Bortolo hospital, Vicenza, Veneto, Italy; Anna trivillin, San Bortolo Hospital, Vicenza, Veneto, Italy; Marta Rotella, Ospedale San Bortolo, Vicenza, Vicenza, Veneto, Italy; Serena Calgaro, Ospedale San Bortolo Vicenza, Vicenza, Veneto, Italy; Stefania Vedovato, San Bortolo Hospital, Vicenza, Veneto, Italy; Massimo Bellettato, Ospedale San Bortolo Vicenya, vicenza, Veneto, Italy
Neonatologist Ospedale San Bortolo, Vicenza, Italy Vicenza, Veneto, Italy
Background: In Italy, the rate of exclusive breast milk feeding among hospitalized healthy term newborns remains lower than desirable. The Baby-Friendly Hospital Initiative represents the gold standard for supporting successful breastfeeding; however, only a few hospitals in Italy have this designation, and our center is not among them. Our hospital manages approximately 2,200 deliveries per year. From January to December 2023, the median exclusive breastfeeding rate in our well-baby nursery was 67%. In 2023, we joined a statewide collaborative initiative aimed at improving in hospital breastfeeding support. Objective: To increase the exclusive breast milk feeding rate among term infants by 10% by June 2025. Design/Methods: A multidisciplinary team established working groups to identify primary drivers and change ideas within a Quality Improvement project (Fig 1). Planned interventions included developing a written hospital infant feeding policy and breastfeeding procedures, providing staff education, and monitoring skin-to-skin contact, breast milk feeding, and rooming-in rates. The primary outcome measure was the exclusive breast milk feeding rate among term newborns. We setted as the baseline before interventions the exclusive breastfeeding rate from January to December 2023. Process measures included skin to skin , rooming-in rates and compliance with the creation of policy and breastfeeding procedures. Prospective data were collected from January 2024 to September 2025. Run charts were used to monitor monthly changes in breast milk feeding and rooming-in rates, shared with staff. Results: The baseline exclusive breast milk feeding rate among term infants was 67%. Following the implementation of QI interventions, this rate increased to 73%, achieving and sustaining the project’s aim. The written policy was approved by hospital management in October 2024 and disseminated to both staff and parents during 2025. The proportion of trained staff increased from 37% to 90% by the end of the initiative. The percentage of breastfeeding procedures accomplished was 95%. The rate of skin-to-skin contact for at least one hour after birth rose from 78% to 93%, and extensive rooming-in (≥20 hours per 24-h period) increased significantly from a median of 65% to 88%.
Conclusion(s): Quality Improvement interventions including the development of written policies and breastfeeding procedures, staff education, and systematic monitoring of skin-to-skin contact, breastfeeding, and rooming-in led to a measurable improvement in the exclusive breast milk feeding rate among hospitalized term infants within a statewide collaborative initiative.
