Assessment of Hospital Rooming-in Practice in Abu Dhabi, United Arab Emirates: A Cross-Sectional Multi-Center Study.

The World Health Organization (WHO) recommends rooming-in to reduce infant mortality rates. Little research has been done to assess practices such as rooming-in and its relation to breastfeeding in the United Arab Emirates (UAE). The aim of this study was to examine the prevalence of rooming-in during hospital stay among mothers with infants six months old and below, in addition to other associated factors in Abu Dhabi, UAE. This study utilized a sub-sample extracted from a dataset based on a convenience sample of mothers who were recruited from governmental maternal and child health centers as well as from the community. The purpose of the original research was to evaluate infant and young children's feeding practices. A pre-tested questionnaire was used during interviews with mothers once ethical clearance was in place. Multivariable logistic regression was conducted to describe the results. The original sample included 1822 participants, of which 804 infants met the inclusion criteria. The mean age for mothers and infants was 30.3 years and 3.5 months, respectively. The rate of rooming-in during hospital stay was 97.5%. Multivariable logistic regression analysis indicated factors associated with not rooming-in were low maternal age (Adjusted Odds Ratios (AOR) = 1.15, 95% confidence interval (CI): 1.03, 1.30), low gestational age (GA) (AOR = 1.90, 95% CI: 1.52, 2.36), abnormal pre-pregnancy body mass index (BMI) (AOR = 3.77, 95 % CI: 1.22, 11.76), and delayed initiation of breastfeeding (AOR = 4.47, 95 % CI: 1.08, 18.48). In the context of the high rate of rooming-in revealed in this study, there should be a focus on those groups who do not room-in (i.e., younger women and those with babies of a younger gestational age). Rooming-in practice provides self-confidence in taking care of a baby, knowledge about breastfeeding, and stimulates early-phase lactation.

Exclusive Breastfeeding, 24-Hour Rooming-In, and the Importance of Women's Informed Choices.

OBJECTIVE: To measure the relationship between exclusive breastfeeding and 24-hour rooming-in for low-risk primiparous women with uncomplicated vaginal births at term. DESIGN: Descriptive correlational design with a qualitative component. SETTING: The Labor & Delivery and Mother/Baby units of a community hospital with more than 2,300 births annually. PARTICIPANTS: A convenience sample of 89 women. INTERVENTION/MEASUREMENTS: Participants completed a demographic questionnaire, the Iowa Infant Feeding Attitude Scale, which measures attitudes toward breastfeeding, and a four-item questionnaire at 2, 6, and 12 weeks postpartum to assess breastfeeding status. RESULTS: Iowa Infant Feeding Attitude Scale scores suggest that most of the sample had positive attitudes toward breastfeeding. The average separation time for women and newborns was 3 hours 40 minutes. No statistically significant differences were found regarding maternal attitudes toward breastfeeding or mother-newborn separation during the postpartum period between newborns who were exclusively breastfeeding or formula-feeding at 12 weeks. CONCLUSION: Success with exclusive breastfeeding in the immediate postpartum period is not necessarily dependent on 24-hour rooming in, and it is important for women to have the ability to make informed choices regarding newborn separation in the hospital.

Expansion of the baby-friendly hospital initiative ten steps to successful breastfeeding into neonatal intensive care: expert group recommendations.

In the World Health Organization/United Nations Children's Fund document Baby-Friendly Hospital Initiative: Revised, Updated and Expanded for Integrated Care, neonatal care is mentioned as 1 area that would benefit from expansion of the original Ten Steps to Successful Breastfeeding. The different situations faced by preterm and sick infants and their mothers, compared to healthy infants and their mothers, necessitate a specific breastfeeding policy for neonatal intensive care and require that health care professionals have knowledge and skills in lactation and breastfeeding support, including provision of antenatal information, that are specific to neonatal care. Facilitation of early, continuous, and prolonged skin-to-skin contact (kangaroo mother care), early initiation of breastfeeding, and mothers' access to breastfeeding support during the infants' whole hospital stay are important. Mother's own milk or donor milk (when available) is the optimal nutrition. Efforts should be made to minimize parent-infant separation and facilitate parents' unrestricted presence with their infants. The initiation and continuation of breastfeeding should be guided only by infant competence and stability, using a semi-demand feeding regimen during the transition to exclusive breastfeeding. Pacifiers are appropriate during tube-feeding, for pain relief, and for calming infants. Nipple shields can be used for facilitating establishment of breastfeeding, but only after qualified support and attempts at the breast. Alternatives to bottles should be used until breastfeeding is well established. The discharge program should include adequate preparation of parents, information about access to lactation and breastfeeding support, both professional and peer support, and a plan for continued follow-up.

Keeping mothers and newborns together after cesarean: how one hospital made the change.

Keeping mothers and newborns together during the time immediately following delivery has several benefits, including the promotion of maternal-infant bonding and breastfeeding, which are essential components of care. A new care delivery model was instituted at a large women's health hospital so that women who delivered by cesarean were able to recover with their infants. The change was the result of a multi-department collaborative effort, and the outcome has been very positive, with increased satisfaction reported by nurses, physicians and patients, as well as the observation of the promotion of breastfeeding and maternal-infant bonding.

An evaluation of hospital breastfeeding policies in the Philadelphia metropolitan area 1994-2009: a comparison with the baby-friendly hospital initiative ten steps.

OBJECTIVE: The purpose of this study was to describe current breastfeeding policies and practices among Philadelphia, PA metropolitan hospitals and changes in their policies and practices over time. METHODS: In-person group interviews were conducted to obtain a composite picture of actual breastfeeding policies and practices. One questionnaire per hospital was completed based on responses from group consensus. Twenty-five hospitals providing maternity care were contacted. Information was obtained from personnel representing different areas of maternity services. Hospitals were classified according to the degree to which they were implementing the Ten Steps to Successful Breastfeeding. RESULTS: Mean breastfeeding rates at suburban hospitals were significantly higher than urban hospitals (72% vs. 49%, p = 0.015). Most hospitals were classified as high or moderately high implementers on six of the Ten Steps, including staff training (67%), printed information distributed to breastfeeding mothers (94%), breastfeeding initiation (61%), oral breastfeeding instruction given to mothers (83%), infant feeding schedules (89%), and hospital postpartum support (83%). Most hospitals reported partial or low implementation on two maternity practices: infant formula supplementation (61%) and rooming-in (72%). CONCLUSIONS: In the past 15 years, hospitals in the Philadelphia area have an increased awareness about breastfeeding and enhanced support of breastfeeding by healthcare professionals. In spite of an increase in overall breastfeeding rates, formula supplementation in hospitals and contact time between mothers and their newborns continue to be areas of concern.

[A survey among pregnant women about their expectations towards the maternity clinic to inform internal quality improvement procedures]. / Eine Befragung von Schwangeren zu Erwartungen an die Geburtsklinik für klinikinterne Massnahmen zur Qualitätsförderung.

INTRODUCTION: Transparent and effective quality management is an essential marketing tool for maternity clinics. Procedures for quality assurance in maternity clinics differ from those in other medical professions. Apart from evidence-based health care the pregnant woman's choice of maternity services providers is increasingly influenced by a number of other factors as well, such as, for example, the response to individual needs or the staff. Hence, the facilities need to present their services and quality of care according to the needs of the target group. METHODS: In order to identify these needs, a survey was performed among 152 pregnant women during the "Baby Fair", which took place in Berlin in 2006. The objective of the survey was to find out about the preferences and expectations of pregnant women towards the maternity clinic and breastfeeding and their current criteria for the choice of a maternity clinic. The questionnaire contained questions about expectations towards the maternity clinic staff, traditional medicine and alternative medicine, premises, courses offered, rooming-in and expectations towards breastfeeding. RESULTS: The findings from the survey show that the pregnant women's ratings for personal contact, expertise and kindness of the staff were twice as high as for premises, comfort and service. The provision of traditional versus alternative medicine was rated equally. More than 90% of the respondents do see a demand for specific public relations campaigns by maternity clinics concerning information about the particular institution, its range of activities and the impact and process of rooming-in. Only 20% of the respondents felt sufficiently informed about breastfeeding. CONCLUSION: Besides medical and technical factors, staff factors play a key role in the assessment of maternity clinics. In addition to evidence-based medical information communication strategies should also include information on the staff employed. In particular, information is lacking on rooming-in and breastfeeding, which emphasises the necessity for the timely provision of scientifically based information to pregnant women.

Aleitamento materno exclusivo e uso de chupeta nos primeiros quatro meses de vida

A Organização Mundial de Saúde recomenda a amamentação exclusiva até os seis meses de vida e sabe-se sobre sua importância tanto para a mãe quanto para o bebê. Na alimentação do recém-nascido a sucção tem grande valor, contribuindo para o desenvolvimento global dos órgãosfonoarticulatórios. A harmonia facial do recém-nascido implica a normalização do “retrognatismo” e esta se dá através da amamentação. Alguns fatores, entre os quais o hábito inadequado de sucção, podem desencadear ou estar associados à desordem miofuncional oral, provocando a sua ocorrência e/ou permanência. A sucção de chupetas muito precocemente e seu uso freqüente podem interferir naamamentação, pela “confusão de bicos”, podendo contribuir para o desmame precoce. A Iniciativa Hospital Amigo da Criança (IHAC) propõe 10 passos que constituem em rotinas voltadas para a amamentação, entre as quais o não uso de bicos e chupetas. Existem poucos estudos sobre a avaliação do impacto do uso da chupeta sobre o desmame. Este estudo propõe-se analisar fatores que levam a interrupção do aleitamento materno exclusivo, a descrever o aleitamento materno exclusivo associado ao uso de chupeta ou não, e identificar o início do uso e fatores que levaram a esta decisão. A metodologia adotada é coorteprospectiva, em 89 díades em hospital de grande porte credenciado como HAC. A coleta dos dados foi feita de três formas – entrevista no hospital, telefonemas de acompanhamento realizado na 1ª semana e quinzenal e busca no domicílio nos casos de insucessos Os resultadosmostraram que o desmame foi maior conforme uso de chupeta ocorrido na primeira semana de vida (p<0,000) com RR=3,75 (IC 95%: 1,91-7,34). A amamentação noturna (p<0,000) e ter irmão menor de cinco anos de idade (p<0,000) foram considerados fatores de proteção ao desmame. É preciso intensificar ações de promoção e apoio à amamentação paragarantir o aleitamento materno exclusivo até o período preconizado pela OMS. A chupeta é um fator de risco para...

Aleitamento materno exclusivo e uso de chupeta nos primeiros quatro meses de vida / Exclusive Breast-feeding and pacifier use in the first four months of life

A Organização Mundial de Saúde recomenda a amamentação exclusiva até os seis meses de vida e sabe-se sobre sua importância tanto para a mãe quanto para o bebê. Na alimentação do recém-nascido a sucção tem grande valor, contribuindo para o desenvolvimento global dos órgãosfonoarticulatórios. A harmonia facial do recém-nascido implica a normalização do retrognatismo e esta se dá através da amamentação. Alguns fatores, entre os quais o hábito inadequado de sucção, podem desencadear ou estar associados à desordem miofuncional oral, provocando a sua ocorrência e/ou permanência. A sucção de chupetas muito precocemente e seu uso freqüente podem interferir naamamentação, pela confusão de bicos, podendo contribuir para o desmame precoce. A Iniciativa Hospital Amigo da Criança (IHAC) propõe 10 passos que constituem em rotinas voltadas para a amamentação, entre as quais o não uso de bicos e chupetas. Existem poucos estudos sobre a avaliação do impacto do uso da chupeta sobre o desmame. Este estudo propõe-se analisar fatores que levam a interrupção do aleitamento materno exclusivo, a descrever o aleitamento materno exclusivo associado ao uso de chupeta ou não, e identificar o início do uso e fatores que levaram a esta decisão. A metodologia adotada é coorteprospectiva, em 89 díades em hospital de grande porte credenciado como HAC. A coleta dos dados foi feita de três formas – entrevista no hospital, telefonemas de acompanhamento realizado na 1ª semana e quinzenal e busca no domicílio nos casos de insucessos Os resultadosmostraram que o desmame foi maior conforme uso de chupeta ocorrido na primeira semana de vida (p<0,000) com RR=3,75 (IC 95%: 1,91-7,34). A amamentação noturna (p<0,000) e ter irmão menor de cinco anos de idade (p<0,000) foram considerados fatores de proteção ao desmame. É preciso intensificar ações de promoção e apoio à amamentação paragarantir o aleitamento materno exclusivo até o período preconizado pela OMS. A chupeta é um fator de risco para interrupção do aleitamento materno exclusivo, mesmo em crianças nascidas em hospital credenciado como Amigo da Criança. Esforços devem ser realizados para que não sejam introduzidas precocemente

Mother-baby inpatient psychiatric care in different countries: data collection and issues - introduction.

The material was presented during a symposium on "Mother-Baby joint admission for mental health care in different countries" at the Marcé Society International Biennial Scientific Meeting in Sydney (Australia) in 2002 (25-27 September 2002). The introduction stresses the main contribution of each of the six papers. It discusses the general context of perinatal psychiatry and offers guidelines for perinatal health care.

[Assessment of social and professional support offered to patients during their stay in a rooming-in at a maternity ward]. / Ocena wsparcia spolecznego i udzielanego przez profesjonalistów w czasie pobytu kobiety na oddziale polozniczym w systemie matka-dziecko.

UNLABELLED: The improvement of quality of care on maternity wards concerns not only the medical activities. Professional activities minimalizing the occurrence of difficult situations of woman in puerperal period are of great importance as well. The aims of the study were: 1) to evaluate the accessible social support and the need of professional support in women during their staying on maternity ward in rooming-in system; 2) to establish the correlation between accessible social support the need of professional one. Studies were conducted at one of maternity wards in Szczecin working in rooming-in system. Studied group were primiparas (n = 100), reference group consisted of multiparous females (n = 100). The following tools were introduced into the study: Modified Social Support Scale and Author's questionnaire on Demand for Support in maternity ward in rooming-in system. The results of investigations show, that the need of professional support was more often expressed in the study group (p < 0.001). It reached an average--high level. There was no significant difference concerning an accessible social support in both groups. No correlation was showed between accessible social and professional support. CONCLUSIONS: 1. Primiparas require special puerperal care and professional support as well. 2. High, accessible social support has no influence on need of professional support in women during their stay on maternity ward in rooming-in system.

[Evaluation of the rooming-in system at the D. Francisca Cintra Silva Maternity Department, Santa Casa Hospital at the Sao Carlos municipality]. / Avaliação do sistema de alojamento conjunto na maternidade D. Francisca Cintra Silva da Santa Casa de São Carlos-SP.

The rooming-in was implemented at a maternity at the municipality of São Carlos in 1997. This study analyzes the acceptance of the system by mothers and how nursing participates in this work. Results showed that mothers are satisfied. However, the nursing team does not agree with this evaluation, confirming the need of increasing the number of workers as well as qualifying them.