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One hundred and seventy-two low-income women were interviewed prenatally to determine risk for later mistreatment of their children. High-risk and low-risk women were then randomly assigned at delivery to either limited or extended postpartum contact with their newborns over the first two days after birth. Mother-infant interaction observations were performed at 48 hours and at one, three, six, twelve and eighteen months postpartum. Infants were tested at nine months with the Bayley Scales of Infant Development. Results indicated that outcome following extended mother-infant postpartum contact varies with maternal risk status and measures employed for evaluation. Low-risk extended-contact mother-infant pairs differed from low-risk controls in observed interaction while high-risk extended-contact and controls did not differ from each other in interaction. High-risk extended-contact infants were more advanced in motor development than control infants at nine months, however, while low-risk extended contact and control infants did not differ in development.

In 1981 a questionnaire administered to mothers in Ujung province in INdonesia indicated that only 41% supported having newborns stay in the same room with them. Most of them were educated preferred bottle feeding and of a high socioeconomic status. To learn more about the advantages of rooming in (RI) researchers conducted a study to compare both RI and separate nursing (SN) from September 1986-February 1987. They chose 414 mothers at a hospital in Ujung Pandang. The infants matched in terms of birth weight and sex distribution. The age and parity of the mothers did not match however. 61% of the mothers chose to have their newborns with them. On average the breasts produced milk by 1.85 days for mothers of RIs as opposed to 3.07 days for mothers of SNs (p .05). A significant difference in the incidence of jaundice occurred between RIs (13.44%) and SNs (26.09) however. Further SNs lost an average of 80.06 gm as compared to 21.42 gm for RIs (p

Com o objetivo de oferecer subsídios às enfermeiras de unidades que permitem a presença da mãe junto a seu filho doente, a autora analisa e comenta os critérios utilizados pelas enfermeiras de uma unidade pediátrica, para decidir quais as mães que poderão acompanhar seus filhos durante a hospitalização, fazendo também algumas considerações sobre as acomodações oferecidas às mães em sistema de internação conjunta mãe-filho. Pediatric nurses for decision making about wich mothers may accompany their sick children during hospitalization, in a unit that allows rooming-in, are analized by the author. Some considerations are also made about accomodations offered to these mothers.

Nearly all maternity wards offer the rooming-in system (RI) today. The good experiences made with it may bring up the opinion that only a “bad mother” would refuse RI. In order to ascertain whether RI can be recommended generally or whether certain personality structures might not be suitable for it, studies were made. A hundred and ten women received questionnaires for psychometric and standardized personality tests.Sixty percent of the puerperae decided in favor of RI and the negative group formed the control group.

As a La Leche League (LLL) Leader, having worked with mothers for 13 years, I have learned many things, but if I were asked to put it in one sentence I would say: prevention is better than cure. A well-informed and confident mother is the key to a problem-free and smooth nursing experience.

Communal nurseries for neonates are commonly associated with an &creased risk of cross-infection, but few studies have compared this system with that of ‘rooming-in’ of mother and baby. During an observation period of 4.5 years, Seidemann & Eisenhoff (1956) found no infections in 527 newborn babies in a rooming-in system, but 16 infections occurred in 527 neonates in a system using communal nurseries (centralized system). The nursing staff from the centralized system had no contact with mothers, children or staff from the rooming-in system. Mortimer, Wolinsky 8z Hines (1966) found that the rate of colonization of nose, throat and umbilical cord with staphylococci was 27% in 75 neonates in the rooming-in system prior to discharge, and 34% in 224 neonates in the centralized system, a difference which was not statistically significant. Cretius et al. (1968) also found that there was no essential difference in the rate of staphylococcal colonization of nose and throat in mothers and children between the rooming-in and centralized system. Furthermore, there was no statistically significant difference in bacterial counts in the air, or in staphylococcal contamination of the environment, between rooming-in and the centralized system. The rate of staphylococcal colonization of 9515 neonates between 1971 and 1976 in a centralized system was analyzed by Czarlinsky et al. (1979). From 1971 to 1974 the rate remained steady at 14%. However, in 1975 it was 29% and in 1976 it was 25%, with 74% of the neonates colonized with the same phage type of Staphylococcus aureus. The higher colonization rate did not result in a higher infection rate. The noses and throats of mothers and nursing staff, as well as the inanimate environment, were excluded as reservoirs of the organism. It was assumed that the most important mode of transmission of staphylococci from child-to-child was the hands of nursing staff. However, Lagercrantz, NystrGm & Wretlind (1973) found no difference between the centralized and mixed systems in the rate of staphylococcal colonization and infection in mothers and children. In a retrospective study conducted on 1188 mothers and babies in 1976 and 1977, the infection rate in neonates in the rooming-in system was 0.6% vs. 0.4% in the centralized system (Schurz, 1980). Bishop et al. (1979), on the other hand, found considerable differences in the frequency of rotavirus infections in the rooming-in system (2%), neonatal intensive care unit (36%), and centralized system (19O/,).

Maternal-child relationship is a process that begins during pregnancy and grows from the birth of the child on. An effective means of enhancing bonding is the practice of rooming-in. To study attitudes toward rooming-in 25 obstetricians and 24 hospitals were solicited through the mail. Thirty-five nurses employed by the above hospitals were surveyed. Twenty-four expectant mothers, who ranged in age from 21 to 33 yr. and were enrolled in birth preparation classes, were also surveyed. Only 2 ( 7 % ) of these women were multiparous. All participants were from metropolitan Philadelphia. Questionnaires requested data pertaining to delivery of rooming-in information by those groups giving services, encouragement of the rooming-in practice by those groups delivering services, and the incidence of rooming-in. Responses were tallied. Twelve (50%) of the expectant mothers felt they received adequate rooming-in information. However, resources for information came not from doctors, nurses, and hospitals, but from friends and books. Six ( 2 5 % ) of the expectant mothers stated they had discussed rooming-in with their obstetricians. Of this group, 5 (83%) stated they initiated the topic. Twelve (48%) of the obstetricians, 18 (75%) of the hospitals, and 29 (82%) of the nurses stated they would encourage patients to elect rooming-in. Yet the doctors and hospitals reported that only 20% and 27%, respectively, of their patients elect rooming-in. Encouragement toward rooming-in may be given to expectant mothers by obstetricians, nurses, and hospitals. It is possible, however, that expectant mothers are not perceiving or receiving this message. They do not view these groups as a resource for rooming-in information, thus insufficient discussion of rooming-in practices exists among groups who deliver obstetrical services. The responsibility rests with those who deliver services to the expectant mothers to provide information and support. Only then can expectant mothers clearly have options.

A review of the literature and an analysis of the changing conditions which have identified coagulase-positive hemolytic Staphylococcus aureus as the primary endemic and epidemic menace in hospital environments has been presented. A detailed description has been provided of the six different physical environments in which newborn infants reside in the patient-care areas of the newly constructed (1959) Rooming-In Maternity of the Evanston Hospital. A comprehensive, 2 year analysis of the microbiological environments of these six infant care areas and of the related nurseries is detailed in which a total of 2,222 bacteriological samples, both human and environmental, were processed.

A study of first mothers Rooming-in with their newborns in a Swedish hospital was completed by comparing fifty Rooming-in mothers with fifty Non-Rooming-in mothers. There was complete randomization in the selection procedure. Rooming-in mothers judged themselves to be more confident and competent in baby care, thought they would need less help in caring for their infants at home, and could attribute more to their babies' cries than the Non-Rooming-in mothers.

For general practitioners, who handle more than 85 per cent of all pediatric care, POSTGRADUATE MEDICINE here presents authoritative, up-to-date summaries, prepared by specialists in pediatric problems.

A system of baby care by the mother, in which some 1,018 babies, ward and semiprivate, have been housed with the mother, has been presented. This system has satisfied the requirements for which it was set up, i.e., there have been no ill babies among these housed-in babies, and there have been no epidemics among the newborn. The care of the baby has also been simplified and there has been no addition of nursing hours. The babies have seemed to be contented and happy under this arrangement, have gained rapidly in weight, and the percentage of breast feeding has increased. The mothers have in general enjoyed having their babies with them. They have learned to take care of the baby from the first postpartum day on and have left the hospital quite capable of managing the ordinary problems of infant care. The arrangement of housing baby with mother has been found to depend for its success to some degree upon early ambulation and breast feeding, and, in turn, the housing-in arrangement aids in involution and encourages breast feeding. The plan also seems to work particularly well in small wards where mothers can watch each other, teach each other, and can be under the frequent observation of the nursing personnel. The question of how well this plan will work in the private and small semiprivate rooms has not been adequately answered. However, we see no reasons why the plan will not work there, too, if the proper modifications and adjustments are made.

SUMMARY Infections and colonization with Staphylococcus aureus were studied in 159 mothers and their newborns. The patients were observed when in hospital, and the mothers were given questionnaires to report symptoms of infection in themselves or their babies during the first weeks after discharge from the hospital. The infection rate measured in this way was high, 27% among the children and 16% among the mothers. Interviews with mothers and reports from child welfare centres that were attended by all children showed, however, that anxious and insecure mothers over-reported infection symptoms. Such a re-evaluation reduced the infection rates to 8% among the children and 7% among the mothers. No differences were observed in infection rates and in staphylococcal colonization rates between a ward with a partisal rooming-in system and a similar ward with conventional care. A less than total rooming-in system thus does not seem to reduce the infection rate.

Background Breastfeeding is the preferred method of feeding for the infant. The present study aimed at investigating the different infant feeding practices and the influencing factors in the United Arab Emirates (UAE). Methods A convenient sample of 593 Emirati mothers who had infants up to 2 years of age was interviewed. The interviews included a detailed questionnaire and conducted in the Maternal and Child Health Centers (MCH) and Primary Health Centers (PHC) in three cities. Results Almost all the mothers in the study had initiated breastfeeding (98%). The mean duration of breastfeeding was 8.6 months. The initiation and duration of breastfeeding rates were influenced by mother’s age (P

Background: The importance of rooming-in in promoting breastfeeding initiation and continuation within the 10 Steps for Successful Breastfeeding is widely acknowledged. However, adherence to this practice by healthcare facilities is lower than that of other Steps. A deeper knowledge of maternal rooming-in experience has been advocated to identify the most effective rooming-in policies, thus enabling mothers to have a positive experience when practicing it in the postpartum period. Aim: To investigate maternal knowledge of rooming-in and the most frequently encountered barriers and possible facilitators of adherence to the practice, according to their experience. Study Design and Methods: We enrolled mothers who delivered healthy term or late preterm infants during the month of January 2019 in a tertiary referral center for neonatal care in Milan, Italy. At discharge, a structured interview about mothers' rooming-in experience was administered by healthcare professionals. Basic subjects' characteristics and mode of feeding were recorded. Results: The enrolled population included 328 mothers and 333 neonates. The great majority of mothers knew of rooming-in and 48.2% practiced it continuously. The 86.3% of mothers was aware of the beneficial effects of rooming-in; promotion of mother-infant bonding, increased confidence in taking care of the baby and ability to recognize baby's feeding cues were the most frequently cited, whereas improving breastfeeding was reported by a limited number of mothers, unless they were asked a specific question about it. The main reported obstacles were fatigue (40.5%) and cesarean section related difficulties (15.5%); night was the most critical time of the day for rooming-in. Strategies suggested by mothers for improving rooming-in were increased assistance to the dyad, organizational and structural changes and the possibility to have a family member during the night. Additionally, mothers who adhered to rooming-in practice continuously during hospital stay had a higher exclusive breastfeeding rate at discharge compared to mothers who did not. Conclusions: Our study contributes to a deeper knowledge of maternal rooming-in experience in an Italian tertiary maternity. We underline the importance of providing a tailored support to the mother-infant dyad in order to overcome rooming-in barriers perceived by mothers and promote a positive rooming-in experience.

IT IS necessary to provide convenient and practical methods of infant handling in adopting the principle of rooming-in and selective feeding procedures. This is important, since the mother plays a prominent role in the daily care of her infant. The infant must be available to her for a greater part of the day. She deserves consideration in the ease with which she can handle her infant. The carriage for the newborn infant, therefore, becomes an all important link in this service. The bassinet in use on the maternity service at the George Washington University Hospital fills most of these requirements. In the over-all planning of this service, the bassinet was designed to fulfill the following demands: 1. simplicity; 2. ease of cleaning; 3. mobility—to move to and from the mother's room; 4. drawers and compartments to store bedside and nursery equipment sufficient for complete care of the infant; 5. foolproof attachment to the mother's bed in adjustable positions; 6. moveable bassinet on top of the cabinet for convenient and easy lifting-out and replacing the infant; 7. clear plastic bassinet for observation of the infant by nurse and mother. The cabinet-bassinet is easily moveable and is provided with 5 inch casters. The cabinet is 19 inches wide, 28½ inches long and 30 inches deep (legs included) surmounted by the bassinet held in a frame which can be pulled laterally for a distance of 18 inches, just clearing the top of the mother's bed. This places the infant in such a position that, without strain or awkwardness, he can be lifted out by the mother.

Maximum serum bilirubin (SB) levels and feeding methods were analyzed in 2388 infants (99% white) admitted to our well baby nursery in 1976-1980. The vast majority of breast feeding mothers had 24 hour rooming in and fed their babies on demand. Virtually all infants with SB>13 mg/dl received phototherapy which may have depressed the upper percentiles. The clear differences (for whatever reason) between these populations imply that our standards for non-physiologic jaundice should be modified. SB>13mg/dl might require evaluation in a bottle fed baby whereas SB>15.5mg/dl would be necessary to arouse similar concerns in a breast fed infant. This approach would save money, if nothing else.

A two-group design was used to compare the state behavior of newborns who roomed-in with their mothers at night with those who were cared for by the traditional nursery-at-night method. Twenty-one full-term, low-risk newborns comprised the study sample. Data were collected using a sleep monitor bassinet for two consecutive nights after delivery. Comparison of the nursery environment with the mother's postpartum room at night revealed greater light and sound levels in the nursery setting. Regarding caregiving practices, rooming-in infants received more contact with the caregiver and care that was more often related to their state behavior. Infants in the mother's room had significantly, p less than .001, more quiet sleep (33% vs. 25.4%), less indeterminate (4.8% vs. 11.2%), and less crying (0.6% vs. 7.5%) states than infants who remained in the nursery.

Every hospital nursery is faced with the danger of an epidemic of infectious diarrhea of the newborn. During the past 10 years, these epidemics have been numerous and the mortality has been high.1In spite of every precaution to prevent cross infections and to maintain isolation, a nursery is a source of danger, even though it is subdivided into smaller units.2It was not until Moloney introduced his Cornelian Corner program that there was a solution to the dilemma.3He recommended that infants should be kept with their mothers immediately after delivery to improve the psychological relationships between the mother and infant. We adopted this plan of rooming-in not primarily for its psychological advantages but in order to avoid the possibility of nursery epidemics. We had not had an epidemic, but the only obvious way to avoid one was to abolish the nursery. A year was required

onstrations. Through her casual contact with patients it is sometimes possible for the public health nurse to glean valuable information for the medical student or resident. For instance, in talking with a pregnant patient, I discovered that her husband had a diagnosis of tuberculosis although he was not under medical supervision. After this was reported to her doctor, it was possible to get her husband to come to the clinic for x-ray and sputum examinations. Subsequently, a BCG vaccination was given their newborn baby as a protective measure. The public health nurse had helped the doctor see the patient as a member of a family rather than as an isolated patient. The students and the patients are not the only ones who benefit from the public health nurse's teaching in the outpatient clinic. The alert public health nurse constantly helps other clinic and hospital personnel understand public health services. Many nurses who are employed in clinics have no formal public health nursing background, and the public health nurse has the opportunity to interpret some of the principles of public health nursing to them. As the public health nurse in our clinic, I have a close working relationship with the local health department and its nurses, and I act as liaison between the departments. As a member of the staff of the visiting nurse service, it is easy for me to have such a relationship. As a coordinator of the health services I am responsible for keeping the channels of cormmunication open, arranging joint conferences to consider the needs of certain families, and interpreting the work of the clinic to the local health services.

Breast milk is the preferred feeding for all infants. Unfortunately, late preterm infants (LPIs) have a lower rate of feeding at-breast and lower expressed breast milk intake than other infants. [1] In fact, literature documents an increased risk of morbidity and even mortality of LPIs, often related to feeding problems, possibly due to an inadequate support of the breastfeeding. [2] Born with low energy stores and high energy demands, LPIs may be sleepier and have more difficulty with latch, suck, and swallow. They are at risk for hypothermia, hypoglycemia, excessive weight loss, dehydration, failure to thrive, kernicterus, and breastfeeding failure. Establishing breastfeeding in LPIs is problematic, due to neonatal physiological, neurological immaturity and due to maternal risk factors leading to delayed lactogenesis II. Mothers may be obese, experienced a cesarean delivery, have pregnancy induced hypertension, diabetes, or been treated for preterm labor. They easily experience anxiety about milk insufficiency and about separation from their babies for medical problems. Sanitary staff has to encourage the immediate and extended skin-to-skin contact to improve postpartum stabilization of heart rate, respiratory effort, temperature control, metabolic stability, and early breastfeeding, possibly within 1 hour after birth. If the infant is healthy, it’s important to allow rooming in and free access to the breast. It may be necessary to wake the baby up if he/she does not indicate hunger cues, which is not unusual in LPIs. The infant should be breastfed (even with expressed milk) 8 to 12 times/day. It is important observing the baby feeding at breast and showing the mother techniques to facilitate effective latch and adequate support of the neonate’s head. A nipple shield could be recommended. Pre- post-feeding weight may be helpful to assess milk transfer, because a supplementation with small quantities of maternal expressed milk, donor human milk, or formula may be necessary. If supplementing, the mother should pump milk after breastfeeding, 6 to 8 times/day to establish and maintain milk supply. [3] LPIs developing complications are often discharged early, after successful transition to extra-uterine environment, but before lactogenesis II is fully established. Before discharge, adequate milk intake should be documented by feeding volume or by thriving. One/2 days after discharge, a follow up to check weight, feeding ability and jaundice is recommended. In conclusion we may say that breastfeeding LPIs is possible, but to achieve this target, an adequate maternal support and a regular neonatal monitoring is required. [4]