Tongue-tie Care System for Promotes Breast Feeding at Maharat Nakhon Ratchasima Hospital - การพัฒนาระบบดูแลทารกลิ้นติดเพื่อส่งเสริม การเลี้ยงลูกด้วยนมแม่ โรงพยาบาลมหาราชนครราชสีมา

Abstract

         Ankyloglossia, also known as tongue-tie in infants is one of many factors that can affect the breast feeding. Tongue-tie has been found to increase breast feeding difficulties. Previously, Maharat Nakhon Ratchasima Hospital had no explicit system to deal with this problem. This current study is therefore interested in developing a clear system to take care of newborn with ankyloglossia using the knowledge management (KM) approach. The objectives of this study were to develop a system to take care of newborn with ankyloglossia in order to promote breast feeding and explore the effectiveness of the developed system. A research and development was carried out in three phases. The first phase began with purposively selection of Doctor, nurses19 participants to discuss about existing system and to develop a treatment system for tongue-tie in newborn in Maharat Nakhon Ratchasima Hospital. This phase was performed using the KM approach. Second, test system from first phase in newborn care. Forty two infants
were found to have tongue tie (around 1.1%) and forty one of these were treated. In addition, it was found that the screening system was ineffective and the access to treatment was hindered by the complexity of hospital processes. Therefore, the developed system was improved by the Lean concept to minimize the treatment processes enhancing access to treatment of mothers and their infants. These lean systems were found to have tongue tie 265 (around 2.7%). After being treated, infants showed improvement of latching onto or staying onto the mother’s breast. Mothers reported less nipple pain. Moreover, a 1 month follow up showed that infants were breastfed around 87.8%. In conclusion, this study demonstrated the effectiveness of the developed treatment system for tongue-tie in newborn.
Key words: tongue-tie, knowledge management, lean