Using results from the NNAP annual report to drive improvements in the rates of breast feeding at discharge from neonatal care - a case study for NNAP

The following case study was included in the 2016 National Neonatal Audit Programme (NNAP) annual report to highlight how some neonatal networks and units have used NNAP results as a basis for identifying and undertaking local quality improvement activities.


The Oliver Fisher Neonatal Intensive Care Unit (NICU) is located within the Medway Maritime Hospital in Kent. Each year, around 1,000 babies are looked after in the unit as they need intensive, high dependency, transitional or special care.

The unit is located within the wider South East Coast Neonatal Operational Delivery Network (ODN).

The Oliver Fisher NICU has participated in the NNAP since 2007 with audit results for the unit consistently confirming high standards of care.

The 2015 report on 2014 data however showed a drop in our rates of breast milk feeding at discharge. Furthermore, and for the first time ever, we were identified as a low outlier for this NNAP audit measure with breast feeding rates at discharge of 34% compared to the national average of 60% in babies born at less than 33 weeks gestation.

In this case study we highlight that with a quality improvement approach, and simple but focused interventions, we have been able to achieve a significant improvement in breast milk feeding rates over a relatively short period of time.