What is Rooming-In?
As defined by the World Health Organization and United Nations Children’s Fund, rooming-in is a “hospital practice where postnatal mothers and normal infants stay together in the same room for 24 hours a day from the time they arrive in their room after delivery”. (1) The Centers for Disease Control and Prevention, in 2013, operationalized this process to have mothers and infants stay together 23 out of 24 hours each day. Initially, rooming-in was begun to promote and encourage early and frequent breastfeeding. Crenshaw (2007) recommended rooming in as a healthy birth practice. (2)
Step 7 of the Ten Steps to Successful Breastfeeding states, “Practice rooming-in – allow mothers and infants to remain together 24 hours a day.” (3) Although this is the US-based BFHI criteria, you should access your region, state, or country’s Baby Friendly website for differences designed for your area.
1.) Rooming-In helps to alleviate postnatal parental concerns
For mothers, rooming-in provides them with a healthier mental state after giving birth. Rooming-in has been linked to :
- Increased satisfaction in the birth experience.
- Increased maternal confidence in assessing early feeding and other cues from their newborn.
- Less parental stress when necessary procedures are performed in the room with teaching given about the reason for the procedure and how it is accomplished.
- An overall better quality of sleep for both mother and infant.
2.) Rooming-In influences the physical development and upbringing of the infant
In addition to supporting postpartum mothers, Rooming-in leads to less infant crying and it influences the physical development and upbringing of the child. Some other benefits of rooming-in include:
- Less issues with neonatal hypoglycemia, respiratory concerns, and low body temperature with mothers providing unlimited skin-to-skin care.
- Better infant weight gain and decreased time to a copious maternal milk supply.
- Research suggests other long-term benefits such as decreased rates of postnatal parental hostility, child abuse, neglect, and abandonment.
3.) Rooming-in initiates and enhances the relationship between mother and child
The works of Mary Ainsworth, John Bowlby, Marshall Klaus, and many others gave rise to the theories of attachment and bonding. Although the terms are frequently used interchangeably, there is a distinct difference between them and a difference between when they are used prenatally and postnatally. In an editorial of the Journal of Reproductive and Infant Psychology, Redshaw and Martin discuss these differences and their influence on current policies for maternity care although, “…there is no doubt that early contact can be very enjoyable for both parents, especially as many babies for several hours after birth have a prolonged period of alertness when face-to-face interaction is possible. Skin-to-skin contact at this time has been found to facilitate initiation and continued breastfeeding, although in terms of long-term relationship benefits the evidence is less that substantial,” (2).
In a compilation of research, Lamaze International published a study in 2001 (1) that addressed other postnatal parental concerns and it proved that:
- Rooming-in mothers looked at and talked more to their infants.
- Rooming-in mothers touched…the infant’s face and head more than when compared to a minimal contact group.
- Rooming-in mothers scored significantly higher in interactive processes on postpartum day 3 and 28 than mothers and infants who were separated after birth.
- At one year, mothers who roomed-in during the postpartum stay displayed more empathy toward their infants and held them close more often.
- Rooming-in mothers scored higher on maternal attachment tests than those who were separated by choice or by circumstances.
- Human infants recognize physical separation from their mothers and start to cry; crying stops at reunion.
- Researchers found that 34-36-week preterm infants recover from birth related fatigue as demonstrated by physiologic and behavioral responses when placed skin-to-skin on their mother’s chest sooner than those infants taken to the NICU.
The link to this article is below and there are many additional studies analyzed. This is a great compilation of information. If you found this post informative then you may also learn from my previous post with 3 things to know about pacifier use in newborns.
The option of rooming-in is also more cost effective and easy for your facility to implement. So does your facility practice a full rooming-in policy? Are infants removed from the room for procedures as simple as a blood draw? Why not offer a parent the opportunity to hold or even breastfeed during the procedure? How are you addressing other postnatal parental concerns? It only involves a bit of education for the staff performing the procedure and assistance to the parents during the time the procedure takes. Fear of the unknown is usually greater than seeing that the baby does better in the arms of its parents.
Stay safe and keep up the great work.
Kathy
Referrences
- Theo, L.O. and Drake, E. (2017). Rooming-in: Creating a better experience. J Perinatal Education; 26(2): 79-84. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6353266/
- Crenshaw, J. (2007). Care Practice #6: No separation of mother and baby, with unlimited opportunities for breastfeeding. J Perinatal Education; 16(3): 39-43. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6353266/
- Baby-Friendly USA, Inc. (2020). The Baby-Friendly Hospital Initiative: Interim guidelines and evaluation criteria for facilities seeking and sustaining Baby-Friendly designation. Downloaded from: https://www.babyfriendlyusa.org/news/bfusa-releases-interim-guidelines-and-evaluation-criteria/
- Mathew, L., Phillips, K.F., and Sandanapitchai, P. (2018). Interventions to reduce postpartum fatigue: An integrative review of the literature. Global J of Health Science & Nursing; 1: 113-119. https://pdfs.semanticscholar.org/decc/05c75dd04614e39f95f6887cafdad83717f1.pdf
- Baumgartel, K.L. and Facco, F. (2018). An integrative review of the sleep experiences of mothers of hospitalized preterm infants. Nurs Womens Health; 22(4): 310-326. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6157631/
- Redshaw, M. and Martin, C. (2013). Babies, ‘bonding’ and ideas about parental ‘attachment’. J Reproductive and Infant Psychology; 31(3): 219-221. https://www.tandfonline.com/doi/full/10.1080/02646838.2013.830383Lamaze International. (2001). Supporting early postpartum attachment: Selecting a birthing environment that clearly supports the infant-parent attachment process. J Perinatal Education; 10(4): 35-50. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1595086/
