Fostering the practice of rooming-in in newborn care

© 2013 Saurabh R. Shrivastava et al.; licensee University of Sarajevo Faculty of Health Studies. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. UNIVERSITY OF SARAJEVO FACULTY OF HEALTH STUDIES ABSTRACT

Fostering the practice of rooming-in in newborn care.
Saurabh R. Shrivastava, Prateek S. Shrivastava, Jegadeesh Ramasamy Department of Community Medicine, Shri Sathya Sai Medical College & Research Institute, Kancheepuram, India Th e beginning of 20th century witnessed a rise in the number of institutional deliveries among pregnant women which was associated with a subsequent increase in nursery-based newborn care.One of the signifi cant consequences of such practice was an ascent in the incidence of cross-infections among neonates (1).Th is then led to adoption of rooming-in in diff erent hospitals and maternity homes.Practice of rooming-in meant that baby and mother stayed together in the same room day and night in the hospital, right from the time of delivery till the time of discharge (2).Rooming-in off ers multiple benefi ts to the newborn, mother as well as mother & child as a unit in terms of -successful initiation of breastfeeding helps prevent hypoglycemia (1); direct skin-to-skin contact with the mother's chest aids in thermoregulation in newborn (1); reduces risk of infections / cross-infections (2,3); off ers emotional stability (4); makes mother more confi dent in taking care of her child (1); reduces anxiety (5); aids mother in understanding baby's natural physiology (3); and facilitates mother-child bonding (3).Rooming-in has also been found to be useful in early diagnosis of the hearing loss (6); and in reducing the need of treatment of opiate withdrawal in the newborn (7).In

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Open Access addition, rooming-in is a cost-eff ective approach where fewer instruments are required and spares additional manpower (1,3).Rooming-in endeavors the opportunity to contribute signifi cantly in the child's growth, development and survival by assisting in timely initiation of breastfeeding (2).Th is attracts further attention as despite the proven advantages of exclusive breastfeeding, only 35% of infants (0-6 months) are exclusively breastfed globally (2).Rooming-in can act as a stepping-stone in saving the lives of an additional 1.5 million under-fi ve children annually (2).
In a study to assess the utility of rooming-in among pre-term infants, it was concluded that rooming-in not only accelerated weight gain in pre-term babies but also cut-down maternal anxiety associated with birth of a pre-term child (5).However, adopting the practice of rooming-in universally, in a blind-folded manner has its own limitations.Conditions such as maternal diseases of the postpartum period, neonatal complications, maternal pain and discomfort immediately after delivery (3); hospital associated factors -inadequately trained healthcare and nursing staff (8); dearth of family members support ( 9); can be the potential barriers in adopting rooming-in.
To ensure universal application of rooming-in in hospitals, a comprehensive and technically sound strategy should be formulated and implemented with active participation of trained healthcare professionals.Measures such as advocating institutional delivery through outreach awareness activities; adoption of baby-friendly hospital initiative (1); inculcating a sense of ownership among health professionals (10); training of nursing staff to facilitate rooming-in (10); counseling sessions by the medical social workers to encourage family support (1,2); and establishment of grading/accreditation standards for acknowledging the hospitals off ering better healthcare services in neonatal care; can be strategically enforced for better maternal and child health related outcomes.
To conclude, multiple health as well as psychological benefi ts in relation to maternal and child health have been attributed to the practice of rooming-in.Healthcare institutes should assume the responsibility of training their healthcare professionals in establishing the practice of rooming-in thereby reducing a signifi cant proportion of neonatal morbidity and mortality.