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Aim Methods Results Conclusion To evaluate the effect of couplet care on parent–infant closeness among preterm infants.A comparison study in a Level III neonatal intensive care unit (NICU) before and after the introduction of couplet care, including stabilising infants in the delivery unit for early skin‐to‐skin contact, providing mothers' postpartum care in the infant's room and providing the father's bed in the infant's room. The study included parents of preterm infants born below 35 weeks.Parents of 40 and 66 infants were included before and after couplet care was introduced, respectively. In the linear regression model, the first skin‐to‐skin contact happened significantly earlier after the introduction than before: mean 4.0 vs. 24.0 h after birth and mean difference −18.5 (95% confidence interval −34.8 to −2.1). A larger proportion of infants received their first skin‐to‐skin contact within 2 h after birth after the introduction than before (45.5% vs. 8.6%; odds ratio 13.8 [3.6–62.8]). At least one parent was present in the infant's NICU room longer after the introduction than before (mean 21.2 vs. 10.8 h per day; mean difference 10.8 [9.1–12.4]).Couplet care significantly increased parent–infant closeness during the first weeks of life. [ABSTRACT FROM AUTHOR]

Copyright of Revista Foco (Interdisciplinary Studies Journal) is the property of Revista Foco and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Foco (Interdisciplinary Studies Journal) is the property of Revista Foco and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Abstract Background The 24-h rooming-in policy is crucial to the Baby-Friendly Hospital Initiative (BFHI) for promoting breastfeeding. However, this policy may restrict maternal autonomy. In 2018, to integrate women’s preferences into care decisions, Taiwan’s Baby-Friendly certification included prenatal shared decision-making (SDM) for rooming-in. Prior to 2018, maternal knowledge, considerations, and intentions regarding rooming-in and the impact of prenatal SDM were unknown. Methods A retrospective electronic medical record cohort study was conducted in southern Taiwan. Data on healthy postpartum women eligible for rooming-in and breastfeeding for the years 2017 and 2019, reflecting the periods before and after prenatal SDM was introduced, were gathered. Maternal and newborn characteristics, maternal knowledge, considerations, and prenatal intentions for postpartum rooming-in and breastfeeding during hospitalization were collected. Additionally, data on actual postpartum rooming-in practices during hospitalization and exclusive breastfeeding (EBF) practices from birth to hospital discharge, to 1 month, and to 2 months postpartum were collected. Descriptive and non-parametric statistics were applied to analyze the data. Results A total of 621 women in 2017 and 311 women in 2019 were included. After prenatal SDM was introduced, the rooming-in rate during hospitalization fell from 42.2% in 2017 to 25.6% in 2019 (p

Background: The 24-h rooming-in policy is crucial to the Baby-Friendly Hospital Initiative (BFHI) for promoting breastfeeding. However, this policy may restrict maternal autonomy. In 2018, to integrate women's preferences into care decisions, Taiwan's Baby-Friendly certification included prenatal shared decision-making (SDM) for rooming-in. Prior to 2018, maternal knowledge, considerations, and intentions regarding rooming-in and the impact of prenatal SDM were unknown. Methods: A retrospective electronic medical record cohort study was conducted in southern Taiwan. Data on healthy postpartum women eligible for rooming-in and breastfeeding for the years 2017 and 2019, reflecting the periods before and after prenatal SDM was introduced, were gathered. Maternal and newborn characteristics, maternal knowledge, considerations, and prenatal intentions for postpartum rooming-in and breastfeeding during hospitalization were collected. Additionally, data on actual postpartum rooming-in practices during hospitalization and exclusive breastfeeding (EBF) practices from birth to hospital discharge, to 1 month, and to 2 months postpartum were collected. Descriptive and non-parametric statistics were applied to analyze the data. Results: A total of 621 women in 2017 and 311 women in 2019 were included. After prenatal SDM was introduced, the rooming-in rate during hospitalization fell from 42.2% in 2017 to 25.6% in 2019 (p < 0.001), and the EBF rate declined from 45.9% to 35.7% (p = 0.01). Additionally, the 1-month postpartum EBF rate decreased from 46.4% in 2017 (n = 571) to 44.3% in 2019 (n = 264), and the 2-month postpartum EBF rate dropped from 45.5% in 2017 (n = 591) to 40.2% (n = 308). According to the 2019 Patient Decision Aids responses (n = 236), women demonstrated limited understanding of rooming-in, with only 40.7% expressing an intention toward 24-h rooming-in. Women of older maternal age (p < 0.001), with a graduate degree (p = 0.02), full-time employment (p = 0.04), and concerns about rest disruption (p < 0.001), were more likely to prefer non-24-h rooming-in. Conclusions: Initiatives must promote prenatal SDM to enable healthcare providers to address misconceptions and tailor education, thereby increasing women's intention toward 24-h rooming-in and EBF. Future research should explore women's experiences and unmet needs at BFHI facilities to inform the construction of a baby- and mother-friendly environment. [ABSTRACT FROM AUTHOR]

Quantify and compare reported breastfeeding support practices in the Baby-Friendly Hospital Initiative (BFHI) and non-BFHI facilities. Cross-sectional survey. Regions across the US. Two hundred and eighty-six facilities (110 BFHI and 176 non-BFHI) selected by a stratified (by hospital size) random sample of 50% BFHI and 50% non-BFHI facilities. Emailed survey Fall 2019 through Spring 2020. Reported adherence to the 10 Steps to Successful Breastfeeding. Wilcoxon rank sum test with continuity correction, Pearson chi-square test of independence, and Fisher's exact test. Baby-Friendly Hospital Initiative facilities were more likely to report adherence to the 10 Steps to Successful Breastfeeding. Only 2 of the reported steps were not significantly different: immediate postnatal care and responsive feeding. This research supports breastfeeding support interventions within hospitals as both BFHI and non-BFHI facilities have room for improvement. Interventions targeting non-BFHI facilities are an opportunity to close the disparity in breastfeeding care. [ABSTRACT FROM AUTHOR]

Objectives: To describe how SARS-CoV-2 infection at the time of delivery affected maternal and neonatal outcomes across four major waves of the COVID-19 pandemic in Italy. Methods: This is a large, prospective, nationwide cohort study collecting maternal and neonatal data in case of maternal peripartum SARS-CoV-2 infection between February 2020 and March 2022. Data were stratified across the four observed pandemic waves. Results: Among 5201 COVID-19-positive mothers, the risk of being symptomatic at delivery was significantly higher in the first and third waves (20.8-20.8%) than in the second and fourth (13.2-12.2%). Among their 5284 neonates, the risk of prematurity (gestational age

BackgroundThe effect of COVID-19 in pregnancy on maternal outcomes and its association with preeclampsia and gestational diabetes mellitus have been reported; however, a detailed understanding of the effects of maternal positivity, delivery mode, and perinatal practices on fetal and neonatal outcomes is urgently needed.ObjectiveTo evaluate the impact of COVID-19 on fetal and neonatal outcomes and the role of mode of delivery, breastfeeding, and early neonatal care practices on the risk of mother-to-child transmission.Study designIn this cohort study that took place from March 2020 to March 2021, involving 43 institutions in 18 countries, 2 unmatched, consecutive, unexposed women were concomitantly enrolled immediately after each infected woman was identified, at any stage of pregnancy or delivery, and at the same level of care to minimize bias. Women and neonates were followed up until hospital discharge. COVID-19 in pregnancy was determined by laboratory confirmation and/or radiological pulmonary findings or ≥2 predefined COVID-19 symptoms. The outcome measures were indices of neonatal and perinatal morbidity and mortality, neonatal positivity and its correlation with mode of delivery, breastfeeding, and hospital neonatal care practices.ResultsA total of 586 neonates born to women with COVID-19 diagnosis and 1535 neonates born to women without COVID-19 diagnosis were enrolled. Women with COVID-19 diagnosis had a higher rate of cesarean delivery (52.8% vs 38.5% for those without COVID-19 diagnosis, P14 days). Among neonates born to mothers with COVID-19 diagnosis, birth via cesarean delivery was a risk factor for testing positive for COVID-19 (odds ratio, 2.4; 95% confidence interval, 1.2-4.7), even when severity of maternal conditions was considered and after multivariable logistic analysis. In the subgroup of neonates born to women with COVID-19 diagnosis, the outcomes worsened when the neonate also tested positive, with higher rates of neonatal intensive care unit admission, fever, gastrointestinal and respiratory symptoms, and death, even after adjusting for prematurity. Breastfeeding by mothers with COVID-19 diagnosis and hospital neonatal care practices, including immediate skin-to-skin contact and rooming-in, were not associated with an increased risk of newborn positivity.ConclusionIn this multinational cohort study, COVID-19 in pregnancy was associated with increased maternal and neonatal complications. Cesarean delivery was significantly associated with newborn COVID-19 diagnosis. Vaginal delivery should be considered the safest mode of delivery if obstetrical and health conditions allow it. Mother-to-child skin-to-skin contact, rooming-in, and direct breastfeeding were not risk factors for newborn COVID-19 diagnosis, thus well-established best practices can be continued among women with COVID-19 diagnosis.

• Perinatal SARS-CoV-2 infection of mothers can affect maternal and neonatal outcomes. • Existing perinatal COVID-19 registries do not compare outcomes across pandemic waves. • Maternal outcomes were significantly worse during the first and third waves. • The risk of prematurity was significantly higher during the first and third waves. • Conversely, the postnatal transmission rate significantly increased during the fourth wave. To describe how SARS-CoV-2 infection at the time of delivery affected maternal and neonatal outcomes across four major waves of the COVID-19 pandemic in Italy. This is a large, prospective, nationwide cohort study collecting maternal and neonatal data in case of maternal peripartum SARS-CoV-2 infection between February 2020 and March 2022. Data were stratified across the four observed pandemic waves. Among 5201 COVID-19-positive mothers, the risk of being symptomatic at delivery was significantly higher in the first and third waves (20.8-20.8%) than in the second and fourth (13.2-12.2%). Among their 5284 neonates, the risk of prematurity (gestational age <37 weeks) was significantly higher in the first and third waves (15.6-12.5%). The risk of intrauterine transmission was always very low, while the risk of postnatal transmission during rooming-in was higher and peaked at 4.5% during the fourth wave. A total of 80% of positive neonates were asymptomatic. The risk of adverse maternal and neonatal outcomes was significantly higher during the first and third waves, dominated by unsequenced variants and the Delta variant, respectively. Postnatal transmission accounted for most neonatal infections and was more frequent during the Omicron period. However, the paucity of symptoms in infected neonates should lead us not to separate the dyad. [ABSTRACT FROM AUTHOR]

(1) Background: The ongoing COVID-19 pandemic has led to an increasing number of women giving birth while also grappling with SARS-CoV-2. The objective of this review is to examine the possibility of transmission of the virus from mother to infant through breastfeeding, skin-to-skin contact, and rooming-in and to explore methods for managing COVID-19-positive mother–infant dyads. (2) Methods: A comprehensive search strategy was employed that covered pertinent studies from the Cochrane Library, PubMed Central, and Scopus databases. The Matrix Method and PRISMA guidelines were utilized by the researchers, with the search being updated until 20 December 2021, one year after the initial vaccine delivery. The inclusion criteria for the study involved articles published in English, those employing broad search terms, and those comprising full-text reviews. Additionally, the researchers required that the articles be published from December 2019 onwards. To further analyze the data, a meta-analysis was performed to estimate the rate of infant infection from mothers who engaged in breastfeeding, skin-to-skin contact, and rooming-in practices. (3) Results: Eighteen studies were analyzed in this review, with an infected infant rate of 2.8%. The maternal practices used in these studies ranged from direct separation of the infant to direct skin-to-skin contact, rooming-in, and exclusive breastfeeding. One study investigated the factors associated with positive test results in newborns and found that only the maternal social vulnerability index >90 was a significant predictor. The type of delivery, rooming-in, and the mother's symptom status were not associated with positive neonatal outcomes. (4) Conclusions: According to current data, the incidence of perinatal infection with SARS-CoV-2 is relatively low. It is advised that mothers adhere to several supportive care measures, including engaging in breastfeeding, skin-to-skin contact, and rooming-in. These measures ought to be complemented by diligent hand hygiene, the wearing of masks, and the cleansing of breasts solely when necessary. [ABSTRACT FROM AUTHOR]

Breast milk is the optimal and essential source of nutrients for babies. Many women, however, do not breastfeed or stop early after giving birth, often due to lack of support. For newborns delivered by caesarean section, there is often a delay, or no skin-to-skin contact after birth; thus, early breastfeeding is not achieved. Separation, complementary feeding or pacifier use also limits the mother's ability to breastfeed. A quantitative, cross-sectional study was conducted. Sociodemographic data, the mode of delivery and postpartum circumstances, information on breastfeeding, and the method and duration of feeding were collected (n = 2008). Two-thirds of children born by caesarean section did not have skin-to-skin contact after birth (p < 0.001). Lack of rooming-in placement increased the incidence of more frequent complementary feeding (p < 0.001) and shortened the duration of exclusive breastfeeding (p < 0.001). The duration of breastfeeding may also be negatively affected by scheduled feeding (p = 0.007) and pacifier utilization (p < 0.001). The mode of delivery and postpartum circumstances directly affecting the mother and the newborn can affect the feasibility of breastfeeding and the duration of exclusive and partial breastfeeding. For positive breastfeeding outcomes, skin-to-skin contact immediately after birth, rooming-in and unrestricted, demand breastfeeding, as well as the avoidance of the use of pacifiers, are recommended. [ABSTRACT FROM AUTHOR]

Abstract Background Despite the benefits of breastfeeding, early weaning is a reality, so less than 50% of children worldwide and in Brazil are on exclusive breastfeeding in the sixth month of life. A strategy to counteract this scenario is breastfeeding counseling. This study aims to verify the effectiveness of individualized counseling by nurses trained in breastfeeding counseling, on the duration of exclusive breastfeeding, compared to standard care. Methods Multicenter, randomized, parallel, and open clinical trial, with primiparous women aged over 18 years, hospitalized in rooming-in wards at participating centers and hemodynamically stable, aware, and oriented, who had a single-fetus pregnancy and gave birth, regardless of the type of delivery, with live child, gestational age of 37 to 42 weeks and birth weight greater than 2500 g. The women will be initially approached in rooming-in wards and, upon consent to participate in the study, will be allocated through randomization by blocks composed of eight participants in two groups: intervention and control. The randomization lists will be organized by a central without involvement with the study, which will manage the allocation groups and be prepared in the Randon® program. Women allocated to the intervention group will receive breastfeeding counseling by trained nurses, and those in the control group will receive standard care at the center participating in the study. Discussion The results can contribute to breastfeeding by evidencing possible exclusivity and duration of the counseling trained nurses provide. Trial registration REBEC RBR-4w9v5rq (UTN: U1111-1284–3559) ( https://ensaiosclinicos.gov.br/rg/RBR-4w9v5rq ). Posted on March 20, 2023.

Background: Despite the growing importance given to ensuring high-quality childbirth, perinatal good practices have been rapidly disrupted by SARS-CoV-2 pandemic. This study aimed at describing the childbirth care provided to infected women during two years of COVID-19 emergency in Italy. Methods: A prospective cohort study enrolling all women who gave birth with a confirmed SARS-CoV-2 infection within 7 days from hospital admission in the 218 maternity units active in Italy during the periods February 25, 2020-June 30, 2021, and January 1-May 31, 2022. Perinatal care was assessed by evaluating the prevalence of the following indicators during the pandemic: presence of a labour companion; skin-to-skin; no mother–child separation at birth; rooming-in; breastfeeding. Logistic regression models including women’ socio-demographic, obstetric and medical characteristics, were used to assess the association between the adherence to perinatal practices and different pandemic phases. Results: During the study period, 5,360 SARS-CoV-2 positive women were enrolled. Overall, among those who had a vaginal delivery (n = 3,574; 66.8%), 37.5% had a labour companion, 70.5% of newborns were not separated from their mothers at birth, 88.1% were roomed-in, and 88.0% breastfed. These four indicators showed similar variations in the study period with a negative peak between September 2020 and January 2021 and a gradual increase during the Alpha and Omicron waves. Skin-to-skin (mean value 66.2%) had its lowest level at the beginning of the pandemic and gradually increased throughout the study period. Among women who had a caesarean section (n = 1,777; 33.2%), all the indicators showed notably worse outcomes with similar variations in the study period. Multiple logistic regression analyses confirm the observed variations during the pandemic and show a lower adherence to good practices in southern regions and in maternity units with a higher annual number of births. Conclusions: Despite the rising trend in the studied indicators, we observed concerning substandard childbirth care during the SARS-CoV-2 pandemic. Continued efforts are necessary to underscore the significance of the experience of care as a vital component in enhancing the quality of family-centred care policies. [ABSTRACT FROM AUTHOR]

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Introduction: Practices promoted by the Baby-Friendly Hospital Initiative have become a part of the current mainstream postpartum infant care. However, adherence to rooming-in practice by health-care facilities is lower than that of other steps under this initiative. Objective: The aim of this study was to investigate the experiences in implementing the rooming-in policy among first-time mothers at a postpartum center. Methods: The present study is a qualitative research conducted using the descriptive phenomenological method. This study was performed at a postpartum care center in Southern Taiwan between August 2018 and December 2018. Semi-structured interviews were conducted with 20 postpartum mothers during their postpartum care center stay. Results: Based on interview data, this study identified three main themes about implementing full-time rooming-in experiences: (a) against the rule of taking plenty of rest during the postpartum period, (b) negative experiences and myths regarding implementing rooming-in experience, and (c) postpartum care centers service content affect first-time mothers' willingness to implement rooming-in. Conclusions: In postpartum care centers, first-time mothers' willingness to implement full-time rooming-in significantly decreases due to the effects of the "doing-the-month" culture, postpartum physical recovery status, stress of the rooming-in experience, myths regarding rooming-in practice, trusting professional neonate care services more than own care, and attitude toward payment for services. [ABSTRACT FROM AUTHOR]

Since the first use of methadone to treat OUD in pregnancy in the 1970s, there has been a long, controversial, and confusing history of studies, regulatory actions, and practice changes that have clouded an accurate perception of methadone's use in pregnancy. This review will trace this history with a focus on the effect of methadone exposure during pregnancy on neonatal abstinence syndrome (NAS). A new laboratory measure, the serum methadone/metabolite ratio (MMR), has provided a tool for documenting the profoundly dynamic nature of perinatal metabolism. Continuous induction of metabolic enzymes during pregnancy requires dose adjustments and dose frequency changes. The concept of “fetal methadone dosing” emphasizes that relative stability of methadone levels in the fetus is an important consideration for methadone dosing in pregnancy. Finally, the effects of the societal “war on drugs” on pediatric management of neonatal withdrawal risks will be discussed, as well as the importance of comprehensive services for mother and child including the “rooming-in” approach of neonatal care which has considerably replaced the older NICU care model of maternal/infant separation.

Introduction: Due to the SARS-CoV-2 pandemic, adjustments in patient and visitor traffic were made in hospitals to limit viral exposure. The primary objective of our study was to compare the breastfeeding success of healthy newborns in a maternity ward during the 2020 lockdown period compared with the same period in the previous year. Material and Methods: Single-center comparative study based on prospectively collected data. All neonates born alive, from a single pregnancy, and with a gestational age greater than 36 weeks were considered for this study. Results: 309 infants born in 2020 and 330 born in 2019 were included. Among women who desired to exclusively breastfeed, the rate of exclusive breastfeeding at discharge from the maternity ward was higher in 2020 than in 2019 (85 vs. 79%; p = 0.078). After logistic regression analysis adjusted for potential confounders (i.e., maternal BMI, parity, mode of delivery, gestational age, and size at birth), study period remained significantly and independently associated with exclusive breastfeeding at discharge (OR [95% CI] = 1.645 [1.005; 2.694]; p = 0.046). Newborns born in 2020 were less likely to have weight loss ≥10% than those born in 2019 (OR [95% CI] = 2.596 [1.148; 5.872]; p = 0.017) but had similar need for phototherapy (p = 0.41). Conclusion: The success of exclusive breastfeeding during the 2020 lockdown period was increased compared with the same period in 2019. [ABSTRACT FROM AUTHOR]

Background: Despite the benefits of breastfeeding, early weaning is a reality, so less than 50% of children worldwide and in Brazil are on exclusive breastfeeding in the sixth month of life. A strategy to counteract this scenario is breastfeeding counseling. This study aims to verify the effectiveness of individualized counseling by nurses trained in breastfeeding counseling, on the duration of exclusive breastfeeding, compared to standard care. Methods: Multicenter, randomized, parallel, and open clinical trial, with primiparous women aged over 18 years, hospitalized in rooming-in wards at participating centers and hemodynamically stable, aware, and oriented, who had a single-fetus pregnancy and gave birth, regardless of the type of delivery, with live child, gestational age of 37 to 42 weeks and birth weight greater than 2500 g. The women will be initially approached in rooming-in wards and, upon consent to participate in the study, will be allocated through randomization by blocks composed of eight participants in two groups: intervention and control. The randomization lists will be organized by a central without involvement with the study, which will manage the allocation groups and be prepared in the Randon® program. Women allocated to the intervention group will receive breastfeeding counseling by trained nurses, and those in the control group will receive standard care at the center participating in the study. Discussion: The results can contribute to breastfeeding by evidencing possible exclusivity and duration of the counseling trained nurses provide. Trial registration: REBEC RBR-4w9v5rq (UTN: U1111-1284–3559) (https://ensaiosclinicos.gov.br/rg/RBR-4w9v5rq). Posted on March 20, 2023. [ABSTRACT FROM AUTHOR]

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As the use of opioids and polysubstance by pregnant women has increased over the years, there has also been a sharp increase in cases of neonatal abstinence syndrome (NAS). Classically, infants affected by NAS have been cared for in neonatal intensive care units resulting in an increase of healthcare expenditure and resource utilization as well as separation from the families. Consequently, the Eat, Sleep, and Console (ESC) tool was developed and promoted as a novel method that focuses on maternal/infant dyad during hospital stay while decreasing the use of pharmacological interventions and therefore decreasing the length of stay and healthcare expenditure. Thus, it has been implemented in several hospitals in the United States. Although the training of staff has been proposed and the interventions of sleep, eat, and console are defined, there still exists a lack of standardization of this practice specifically in regard to the type of associated non-pharmacological practices as well as the reports of its short- and long-term outcomes.

Despite the known benefits of exclusive breastfeeding, the value of Baby-Friendly Hospital Interventions in increasing breastfeeding rates has been challenged, particularly the interventions of breastfeeding in the first hour of life and rooming-in. This study aimed to measure the association of breastfeeding in the first hour of life and rooming-in with high breastfeeding intensity of low-income, multi-ethnic mothers intending to breastfeed. A prospective, longitudinal cohort study was performed on 149 postpartum mothers who intended to breastfeed their infants. Structured interviews were performed at birth and one and three months. Breastfeeding intensity was defined as the percentage of all feedings that were breast milk, and high breastfeeding intensity was defined as a breastfeeding intensity >80%. The data were analyzed by chi-square, t-test, binary logistic regression analysis, and multivariate logistic regression analysis. Breastfeeding in the first hour was associated with increased high breastfeeding intensity in the hospital (AOR = 11.6, 95% CI = 4.7–28.6) and at one month (AOR = 3.6, 95% CI = 1.6–7.7), but not at three months. Rooming-in was associated with increased high breastfeeding intensity in the hospital (AOR 9.3, 95% CI = 3.6–23.7) and at one month (AOR = 2.4 (1.1–5.3) and three months (AOR 2.7, 95% CI 1.2–6.3). Breastfeeding in the first hour and rooming-in are associated with increasing breastfeeding and should be incorporated into practice. [ABSTRACT FROM AUTHOR]

Purpose: To describe the social interactions and institutional structures that influence the consistent practice of 24-hour rooming-in of new mothers and newborns in the hospital setting. Study Design and Method: Using an institutional ethnographic design, data were gathered via semistructured interviews and on-unit observations. Data were recorded, transcribed, and analyzed for themes. Study interviews were conducted between February 2020 and June 2021. Results: Seven mother–baby nurses were interviewed, and three on-unit observations of 2 hours each were conducted. Analysis of interview data revealed a consensus that Baby-Friendly does not always feel mother-friendly. Three major themes identifying social interactions were identified: the mother as a patient, managing expectations, and inconsistencies in practice. Three themes identified institutional structures that influenced 24-hour rooming-in: rates of induction of labor and cesarean birth, nurse staffing, and monitoring of nursery use. Clinical Implications: Our findings provide insights about how the everyday work of 24-hour rooming-in is organized and experienced by nurses on the mother–baby units at the study hospital. Themes highlight specific social interactions and institutional structures that affect the practice and can be used by hospital leaders and educators to develop targeted interventions for ensuring consistent 24-hour rooming-in. Mother-baby nurses shared their experiences with 24 hour rooming-in during postpartum hospitalization. Three themes identifying social interactions that affected rooming in included the mother as patient, managing expectations, and inconsistencies in practice, while three themes as institutional structures that influenced rooming-in were high rates of induction of labor and cesarean birth, inadequate nurse staffing, and lack of monitoring of nursery use. There was a consensus that Baby-Friendly is not always mother-friendly. Nurses offered suggestions for how to improve the rooming in experience for new parents. [ABSTRACT FROM AUTHOR]

Introduction: The coronavirus disease 2019 (COVID‐19) pandemic has intensified perinatal anxiety disorders. Psychological flexibility (PF), considered a specific mental toughness, has not been examined with regard to its relationship with anxiety in women after childbirth. We aimed to compare levels of anxiety, PF, and pain in women depending on the mode of birth, parity, and the magnitude of risk of developing an anxiety disorder. We also investigated the association of anxiety with PF and pain. Methods: A total of 187 women after childbirth completed validated questionnaires for anxiety (State‐Trait Anxiety Inventory, Hospital Anxiety and Depression Scale‐Anxiety, Numerical Rating Scale for anxiety [NRS‐A]), PF, and pain (Numerical Rating Scale for pain). Specific postpartum anxieties were assessed with a numerical scale from 0 to 10. The relationship of anxiety with PF and pain was examined. Women at low and high risk of developing anxiety disorder were compared in terms of PF, anxiety, and pain. Results: On the second postpartum day, women after cesarean birth demonstrated significantly greater anxiety on NRS‐A and pain than those after vaginal birth. Primiparous women experienced significantly greater anxieties and pain compared to multiparous women. The higher the PF patients demonstrated, the less anxiety and pain they had. Patients at high risk of developing an anxiety disorder had a lower level of PF (P <.001) and higher levels of anxiety (P <.001) and pain (P <.01) than patients at low risk of developing an anxiety disorder. No difference in the anxiety of getting COVID‐19 was observed between the groups (P >.05). Conclusions: PF is an important psychological construct related to the mental and physical condition of women after childbirth. Increasing PF in women after childbirth may be considered as an important goal of preventive and intervention measures. [ABSTRACT FROM AUTHOR]

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Objective: to assess the Rooming-In Nursing team’s knowledge about mental distress during the puerperium and to offer subsidies for educational actions. Method: a descriptive and quantitative study carried out with 30 Nursing professionals from a public teaching hospital in São Paulo, Brazil. The data were collected between December 2020 and January 2021 using a structured questionnaire and analyzed descriptively. Results: 73.3% of the nursemidwives, nurses, and nursing technicians and assistants were aged ≥40 years old, and 80% had more than five years of working time. There was a predominance of knowledge about the role of Nursing and its respective practices in the assistance provided in cases of mental distress during the puerperium (majority of expected answers in 80% of the questions), in contrast to the knowledge about pathophysiology, symptoms and causes of puerperal blues, depression and psychosis (majority of expected answers in 40% of the questions). Conclusion: the results can support permanent education, aiming to expand the Nursing team’s knowledge and strengthen the care process.

Best practices in postpartum care encourage rooming-in to promote early breastfeeding and mother-newborn bonding. However, when the medical records of mothers and newborns are stored separately in the postpartum ward and the neonatal nursery, respectively, nurses encounter difficulties in accessing complete information about the mother-infant dyad, which results in suboptimal care quality. Accordingly, the authors designed an integrated electronic information (e-information) system linking the medical records of newborns and their mothers and implemented it in April 2022 at a medical center in Taiwan. System effectiveness assessment results indicated that before the implementation of the e-information system, the nursing care completion scored 72.4 out of 100, and the nurse satisfaction scored 80.9 out of 100. After the implementation of the system, the nursing care completion increased to 97.8 (p < .001), while the nurse satisfaction rose to 95.8 (p < .001), demonstrating significant improvements. [ABSTRACT FROM AUTHOR]

In the last two decades, the world faced three epidemics caused by novel coronaviruses, namely, SARS-CoV in 2002, MERS-CoV in 2012, and the ongoing SARS-CoV-2 that started in late 2019. Despite a growing understanding of SARS-CoV-2 virology, epidemiology, and clinical management strategies, other aspects, such as mode of delivery, vertical transmission, and maternal bonding, remain controversial. The question we faced upon the decision to separate the neonates of SARS-CoV-2 positive mother is whether we follow the principle of "do no harm"? This is a quality improvement project that analyzed all cases of SARS-CoV-2 positive pregnancies that delivered at a major health care system from March 1, 2020 to June, 1 2020. The article was prepared following Standards for Quality Improvement Reporting Excellence (SQUIRE) 2.0 guidelines. Data were prospectively collected and entered into the Research Electronic Data Capture (REDCap). Maternal bonding was defined by events such as rooming-in, skin to skin contact (STSC), and breastfeeding. Descriptive analysis was performed using the same software platform. We compared neonatal transmission rates between those neonates who experienced bonding versus those who were separated. A total of 1989 women were screened for SARS-CoV-2, from which 86 tested positive. Out of 31 analyzed pregnancies, five women (16%) were admitted to ICU and required mechanical ventilation. From the remaining 26 (84%), 17 (65%) opted for rooming-in, 12 (46%) for STSC, and 16 (61%) fed the infants with breastmilk (11 direct breastfeedings and five pumped the breast milk). All neonatal tests for SARS-CoV-2 returned negative. Our results have illustrated that maternal bonding appears safe in neonates born to mothers that are SARS-CoV-2 positive. [ABSTRACT FROM AUTHOR]

Background: The Coronavirus disease 2019 (COVID-19) pandemic emerged in December 2019 and spread rapidly worldwide. So far, evidence regarding the breastfeeding and rooming-in management of mothers with COVID-19 and their newborn infants is scarce. Research Aims: 1) To assess the rate of exclusive breastfeeding at discharge among mothers with COVID-19 and their newborn infants managed either using a rooming-in or a separation regimen; and 2) to evaluate different neonatal outcomes, including the need for re-hospitalization related to COVID-19 among newborn infants in the two groups. Method: We conducted a retrospective two-group comparative observational study. The sample was participants with COVID-19 and their newborn infants (N = 155 dyads) between March 1, 2020, and April 30, 2021. Two time periods were outlined resulting from the two different clinical practices of mother–infant separation and rooming-in. Results: Within the sample, 145 (93.5%) were asymptomatic. All neonates had documented Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) test results, and six tested positive by reverse transcriptase polymerase chain reaction within 48 hr of life. The rate of exclusive breastfeeding was significantly higher (p <.0001) within the rooming-in group. Length of hospital stay was significantly lower (p =.001) within the rooming-in group. Conclusions: Protected rooming-in practice has proven to be safe and effective in supporting breastfeeding: None of the infants enrolled were hospitalized due to COVID-19 infection and the rate of exclusive breastfeeding at discharge was increased compared to those infants separated from their mothers. [ABSTRACT FROM AUTHOR]

Zainab Taha,1 Ahmed Ali Hassan,2 Ludmilla Wikkeling-Scott,1 Dimitrios Papandreou1 1Department of Health Sciences, College of Natural and Health Sciences, Zayed University, Abu Dhabi, U.A.E; 2Department of Research, Taami for Agricultural and Animal Production, Khartoum, SudanCorrespondence: Zainab Taha Tel +971-2-5993111Email Zainab.taha@zu.ac.aeIntroduction: Despite the enormous benefits of breastfeeding, working mothers face more challenges to meet the World Health Organization (WHO) recommendations regarding successful breastfeeding practices. Little research has been done to understand the breastfeeding practices among working mothers in the United Arab Emirates (UAE). Thus, the aim of this study was to investigate the prevalence and factors associated with delayed initiation and cessation of breastfeeding among working mothers with children under the age of two years in Abu Dhabi, the UAE.Methods: A cross-sectional multicenter study was conducted from March to September 2017. The study included both Emirati and non-Emirati mothers of children below the age of two years. The data were collected from seven government health care centers in Abu Dhabi as well as from the community. Mothers with young children attending the centers during the study days were approached by trained research assistants, who provided oral and written information about the study.Results: Among the 1610 mother–child pairs with complete data who were included in this study, 606 were working mothers giving an employment rate of 37.6%. The mean (standard deviation) of maternal age and children’s age were 30.9 (5.1) years and 8.6 (6.1) months, respectively. Of the 606 mothers, 217 (35.8%) delayed initiation of breastfeeding, and 359 (59.2%) ceased breastfeeding. In multivariable logistic regression analysis, factors associated with delayed breastfeeding initiation among working mothers were older mother age (adjusted odds ratio [AOR] 1.04, 95% confidence interval [CI]1.01, 1.08), being of non-Arab nationality (AOR 2.24, 95% CI 1.53, 3.27), caesarean section (AOR 2.70, 95% CI 1.84, 3.96), non-rooming-in (AOR 3.85, 95% CI 1.56, 9.51) and mothers with low birth weight children (AOR 2.47, 95% CI 1.23, 4.94). The main factors associated with cessation of breastfeeding were being of non-Arab nationality (AOR 1.59, 95% CI 1.09, 2.31) and mother with high-income rating (AOR 2.79, 95% CI 1.36, 5.75).Conclusion: The study highlighted the need for urgent actions to improve the working mothers’ conditions in order to promote optimal breastfeeding practices, including both early initiation and continuation of breastfeeding among all mothers in the UAE regardless of employment status. Policies to improve EBF rates among professional working mothers should include maternity leave extension to enable mothers to continue breastfeeding.Keywords: working mother, initiation of breastfeeding, cessation of breastfeeding, caesarean section, rooming-in, low birth weight, United Arab Emirates

Abstract Background Since last year, COVID-19, the disease caused by the novel Sars-Cov-2 virus, has been globally spread to all the world. COVID-19 infection among pregnant women has been described. However, transplacental transmission of Sars-Cov-2 virus from infected mother to the newborn is not yet established. The appropriate management of infants born to mothers with confirmed or suspected COVID-19 and the start of early breastfeeding are being debated. Case presentation We report a case of the joint management of a healthy neonate with his mother tested positive for Covid-19 before the delivery and throughout neonatal follow-up. The infection transmission from the mother to her baby is not described, even after a long period of contact between them and breastfeeding. Conclusion It may consider an appropriate practice to keep mother and her newborn infant together in order to facilitate their contact and to encourage breastfeeding, although integration with infection prevention measures is needed.

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BACKGROUND: Perinatal practices such as breast-feeding, kangaroo mother care, rooming-in, and delayed cord clamping have varied by institution during the COVID-19 pandemic. The goal of this systematic review was to examine the success of different practices in preventing viral transmission between SARS-CoV-2 positive mothers and their infants. METHODS: Electronic searches were performed in the Ovid MEDLINE, Ovid Embase, Cochrane Library, EBSCOhost CINAHL Plus, Web of Science, and Scopus databases. Studies involving pregnant or breastfeeding patients who tested positive for SARS-CoV-2 by RT-PCR were included. Infants tested within 48 hours of birth who had two tests before hospital discharge were included. Infants older than one week with a single test were also included. RESULTS: Twenty eight studies were included. In the aggregated data, among 190 breastfeeding infants, 22 tested positive for SARS-CoV-2 (11.5%), while 4 of 152 (2.63%) among bottle-fed (Fisher's exact test p = 0.0006). The positivity rates for roomed in infants (20/103, 19.4%) were significantly higher than those isolated (5/300, 1.67%) (P < 0.0001). There was no significant difference in positivity rate among infants who received kangaroo care (25%vs 9%, p = 0.2170), or delayed cord clamping (3.62%vs 0.9%, p = 0.1116). CONCLUSIONS: Lack of robust studies involving large patient population does not allow meaningful conclusions from this systematic review. Aggregated data showed increased positivity rates of SARS-CoV-2 among infants who were breast fed and roomed-in. There were no differences in SARS-CoV-2 positivity rates in infants received skin to skin care or delayed cord clamping. [ABSTRACT FROM AUTHOR]

Late preterm infants (LPIs) represent a significant percentage of all neonates (6-8%), but there are limited published data on their postnatal management. Our aim was to compare the frequency of neonatal intensive care unit (NICU) admission and the breastfeeding rate of LPIs born at 35+0-36+6 weeks of gestation who were cared for by initial rooming in strategy rather than directly admitted to the special care unit (SCU) and, eventually, to the NICU. We carried out a retrospective study in the perinatal centers of Careggi University Hospital (CUH) and San Giovanni di Dio Hospital in Florence, Italy, where the first and second strategies were applied, respectively. Main outcomes were LPIs admission rate at SCU/NICU and breastfeeding rate at discharge. We studied 190 LPIs born at SGDH and 240 born at CUH. The admission rate in SCU (81 vs. 43%; P < 0.001) and NICU (20 vs. 10%; P = 0.008) was higher in SGDH than in CUH, as was the exclusive breastfeeding rate (36 vs. 22%; P < 0.001). However, infants who were assisted in rooming-in at CUH and infants with similar clinical characteristics at SGDH had similar mixed (60 vs. 69%) and exclusive (35 vs. 31%) breastfeeding rates.  Conclusion: Postnatal assistance of LPIs in rooming-in, eventually followed by admission in SCU/NICU based on their clinical conditions, allowed to safely halve their hospitalization. The assistance of infants in rooming-in did not negatively affect their breastfeeding rate. These results support the possibility of assisting LPIs in rooming-in. What is Known: • Late preterm infants represent a significant percentage of all neonates. • Early rooming-in and breastfeeding is recommended for late preterm infants. What is New: • Postnatal assistance of late preterm infants in rooming-in, followed when necessary by admission in neonatal units based on clinical conditions, allowed to safely avoid about half the number of hospitalizations in comparison with direct admission in neonatal units. • This strategy did not affect breastfeeding rate. Infants who were admitted to SCU/NICU after initial rooming-in had worst breastfeeding rate. [ABSTRACT FROM AUTHOR]

This observational study done during April–December 2020 at a tertiary-care hospital in Haryana (India) enrolled 152 SARS-CoV-2-exposed neonates. Among them, 150 neonates had perinatal SARS-CoV-2 exposure and 2 neonates had late postnatal exposure. Stable infant-mother dyads were roomed-in with precautions to support breastfeeding. Nasopharyngeal swabs collected from neonates were tested for SARS-CoV-2 by reverse transcriptase–polymerase chain reaction (RT-PCR) test. There was a high incidence of prematurity (23%), low birth weight (31%), intrauterine fetal distress (16%), perinatal asphyxia (6%), admission to neonatal intensive care unit (24%), and mortality (1.3%) among neonates with perinatal SARS-CoV-2 exposure. In this sub-group, 20 neonates tested positive for SARS-CoV-2 in nasopharyngeal swab sample(s). A recent official publication by the World Health Organization emphasizes that the perinatal SARS-CoV-2-exposed neonates found RT-PCR positive once in upper respiratory (non-sterile) sample must document viral persistence in another non-sterile sample for confirmation of mother-to-child virus transmission. With this approach, only one neonate was confirmed intrapartum transmission. A telephonic follow-up in discharged neonates at 1 month of age or 1 month postexposure recorded them all to be asymptomatic and doing well. Conclusion: Neonates with perinatal SARS-CoV-2 exposure constitute a high-risk group and it is not uncommon to get a positive RT-PCR report in upper respiratory sample(s) from these babies. Majority of them do not demonstrate viral persistence. Clinical outcomes are favorable in breastfed infants roomed-in with their asymptomatic-mild symptomatic SARS-CoV-2-infected mothers following appropriate safety protocols. What is Known: •Neonates with perinatal exposure suffer a high burden of morbidities and mortality. •Still, an uncertainty exists about rooming-in and breastfeeding among neonates born to SARS-CoV-2 positive mothers. What is New: •With the policy of mother-infant rooming-in and supporting breastfeeding, none of the neonate suffered clinical illness compatible with postnatal SARS-CoV-2 transmission and infection. •Around 13% perinatal exposed neonates demonstrated SARS-CoV-2 RNA in nasopharyngeal swab samples but the majority of them did not demonstrate viral persistence. [ABSTRACT FROM AUTHOR]

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Despite the known benefits of exclusive breastfeeding, the value of Baby-Friendly Hospital Interventions in increasing breastfeeding rates has been challenged, particularly the interventions of breastfeeding in the first hour of life and rooming-in. This study aimed to measure the association of breastfeeding in the first hour of life and rooming-in with high breastfeeding intensity of low-income, multi-ethnic mothers intending to breastfeed. A prospective, longitudinal cohort study was performed on 149 postpartum mothers who intended to breastfeed their infants. Structured interviews were performed at birth and one and three months. Breastfeeding intensity was defined as the percentage of all feedings that were breast milk, and high breastfeeding intensity was defined as a breastfeeding intensity >80%. The data were analyzed by chi-square, t-test, binary logistic regression analysis, and multivariate logistic regression analysis. Breastfeeding in the first hour was associated with increased high breastfeeding intensity in the hospital (AOR = 11.6, 95% CI = 4.7–28.6) and at one month (AOR = 3.6, 95% CI = 1.6–7.7), but not at three months. Rooming-in was associated with increased high breastfeeding intensity in the hospital (AOR 9.3, 95% CI = 3.6–23.7) and at one month (AOR = 2.4 (1.1–5.3) and three months (AOR 2.7, 95% CI 1.2–6.3). Breastfeeding in the first hour and rooming-in are associated with increasing breastfeeding and should be incorporated into practice.

Best practices in postpartum care encourage rooming-in to promote early breastfeeding and mother-newborn bonding. However, when the medical records of mothers and newborns are stored separately in the postpartum ward and the neonatal nursery, respectively, nurses encounter difficulties in accessing complete information about the mother-infant dyad, which results in suboptimal care quality. Accordingly, the authors designed an integrated electronic information (e-information) system linking the medical records of newborns and their mothers and implemented it in April 2022 at a medical center in Taiwan. System effectiveness assessment results indicated that before the implementation of the e-information system, the nursing care completion scored 72.4 out of 100, and the nurse satisfaction scored 80.9 out of 100. After the implementation of the system, the nursing care completion increased to 97.8 (p < .001), while the nurse satisfaction rose to 95.8 (p < .001), demonstrating significant improvements.

Copyright of Journal of Clinical Nursing in Practice is the property of Journal of Clinical Nursing in Practice (Editorial Board, Shanghai Jiao Tong University Press) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

To assess the impact of a rooming-in program for babies at risk of Neonatal Abstinence Syndrome (NAS) in one community hospital centre, in Belleville, Ontario. This retrospective chart review was conducted at Belleville General Hospital. The hospital developed a rooming-in program for newborns at risk of NAS in July 2015. Charts on all infants born to mothers using opioids in the 24 months prior to and after the implementation of our program, who met the inclusion criteria, were examined. The study consisted of 15 babies in the Special Care Nursery (SCN) group and 19 babies in the rooming-in group. Rooming-in is associated with a reduction in the need for treatment with morphine [rooming-in group (1/19, 5.3%), SCN group (14/15, 93.3%), p < 0.01], shorter length of stay in hospital [rooming-in group (days = 5), SCN group (days = 20), p < 0.01], improved exclusive breast and/or breast milk-feeding rates [rooming-in group (17/19,89.5%), SCN group (1/15,6.7%), p < 0.01] and lower total hospital cost [rooming-in group ($6458.00), SCN group ($17,851.00), p < 0.01]. Our study demonstrates that rooming-in programs for babies born to mothers using opioids has benefits in terms of quality of care and health care resource utilization. These findings show that rooming-in can be successfully implemented in a community hospital. • Rooming-in can be successfully implemented in a community hospital • Rooming-in is associated with a reduction in the need for treatment with morphine • Rooming-in is associated with a shorter length of stay in hospital • Rooming-in is associated with improved exclusive breast and/or breast milk-feeding rates • Rooming-in is associated with lower total hospital cost [ABSTRACT FROM AUTHOR]

Although maternal sense of competence is thought to be a multifaceted construct not enough is known about the factors predicting it. We aimed to measure the mediating role of postpartum psychopathology (depression and childbirth PTSD) on the association between insecure (anxious and avoidant) adult attachment styles and maternal sense of competence. Further, we measured the moderating effect of mother-infant rooming-in practices on these associations. The sample included 268 postpartum women (122 (45%) fully rooming-in) who gave birth at a large tertiary health center and were followed as part of a large longitudinal study. Participants responded to questionnaires at 1–4 days postpartum in-person (a demographic questionnaire and the Experiences in Close Relationships Scale [ECR]), at two months using online questionnaires (Edinburgh Postnatal Depression Scale [(EPDS], Birth Trauma Scale (BiTS) and Parental Sense of Competence [PSOC]). Obstetric data was obtained from medical files. Significant direct links were found between insecure adult attachment styles (anxious: B = −0.15, p = 0.0016, and avoidant: B = −0.14, p = 0.0085) and PSOC, while rooming-in mode did not moderate these links. However, for both insecure adult attachment styles (anxious and avoidant) the indirect links through childbirth PTSD general symptoms (anxious: B = −0.05, 95% CI = [−0.11, −0.01], avoidant: B = −0.10, 95% CI = [−0.18, −0.04]) and PPD (anxious: B = −0.10, 95% CI = [−0.17, −0.04], avoidant: B = −0.06, 95% CI = [−0.12, −0.01]) were significant only for women who were in partial rooming-in. Full rooming-in with the baby in the first days may be a promising practice in attenuating the impact of insecure attachment styles on parental sense of competence, among women with some postpartum psychopathology. Highlights: Insecure adult attachment styles were associated with maternal sense of competence. Postpartum psychopathology mediated adult attachment styles association with maternal sense of competence. Rooming-in moderated the indirect links between insecure adult attachment and maternal sense of competence. Full rooming-in may attenuate the impact of insecure adult attachment styles on maternal sense of competence. [ABSTRACT FROM AUTHOR]

Objectives: Although postpartum rooming-in is encouraged by the World Health Organization, independent separated nursery care is still widely adopted in Eastern countries. Our aim is to evaluate the effect of shared decision making (SDM) assisted by patient decision aids on subjective decisional conflict and regret among women who are required to make choices regarding postpartum infant care.Methods: A total of 196 pregnant women who came for routine checkups 1 month before delivery were randomly assigned to the SDM group or the classic group. Before the mothers were discharged after delivery, their decision-making difficulties were evaluated. The primary outcome was the decisional conflict, which was assessed using the SURE (Sure of myself; Understand information; Risk-benefit ratio; Encouragement) scale. The secondary outcome was the decisional regret, which was measured using the Decision Regret scale.Results: Compared with the classic group, SDM group had surer feelings about the choice (P＜.001), felt more confident about knowing the benefits and risks of each option (P＜.001), had a clearer understanding of the benefits and risks (P＜.001), and felt sufficiently supported with enough advice to make a suitable choice (P＜.001). No significant difference was noted in the Decision Regret scores between groups. The choice of 24-hour rooming-in, 12-hour rooming-in, and separated nursery care was not significantly different between groups.Conclusions: SDM reduced the decisional conflict and uncertainty of the mothers. Available choices of postpartum mother-infant care should be provided to mothers through SDM that includes individual values, health goals, and clear knowledge and transparency. [ABSTRACT FROM AUTHOR]

Introduction: Rooming-in is one of the baby-friendly hospital initiative steps. Rooming-in has positive outcomes for mothers and newborns. However, the effect of rooming-in on postpartum fatigue and the difficulty in baby care activities is hardly investigated. Therefore, the purpose of this study is to identify and compare difficulty in baby care activities and postpartum fatigue between rooming-in health care facilities and non- rooming-in facilities. Method: A Quasi-experimental design was used. A total of 152postpartum women were recruited from two hospitals in Jordan. Two self-administered questionnaires were used to collect data. Independent sample t-test was used to analyze the data. Results: The women in the rooming-in group scored significantly higher level of postpartum fatigue than women in the non-rooming-in group. There were no significant differences between study groups related to difficulty in baby care activities. Conclusions: Postpartum rooming-in practice doesn't affect the difficulty in baby care activities, but it influences the level of postpartum fatigue. Therefore, the health care providers should consider the level of postpartum fatigue among the women when implementing rooming-in. [ABSTRACT FROM AUTHOR]

Rooming-in was started in our hospital in 1981 for newborns born normally. After having good results with this in mid 1984 we started rooming-in for babies delivered by caesarean section if they fulfilled a certain criteria. But the facilities for rooming-in for caesaren babies were still limited, so not every baby who fulfilled the criteria could be roomed in with the mother. In the year 1986, 4112 babies were born in our hospital among which 868 were delivered by caesarean section. Of the 868 babies 435 babies fulfilled the criteria but only 269 babies could be roomed in with the mother while 166 babies had to be nursed separately. We compared the data of the rooming-in babies to the babies nursed separately. The study showed that in the rooming-in group more mothers were fully breastfeeding on discharge and incidence of sepsis, enteritis and hyperbilirubinaemia were significantly lower while mortality and the incidence of pneumonia, omfalitis, conjunctivitis and pyodermia did not differ significantly.

A study comparing rooming-in with separate nursing involving 253 and 161 pairs of mothers and their newborns respectively, was carried out in Ujung Pandang General Hospital from September 1985 to February 1987 inclusive. Breastmilk production started earlier in mothers on rooming-in program compared to those with separate nursing. Jaundice was more often seen and physiological body weight loss more obvious in the separate nursing than in the rooming-in group. This study failed to show the differences in the incidence of diarrhea and moniliasis between the two systems, but the overall morbidity of nosocomial infections seemed to be lower in the rooming-in group.

Background: Since last year, COVID-19, the disease caused by the novel Sars-Cov-2 virus, has been globally spread to all the world. COVID-19 infection among pregnant women has been described. However, transplacental transmission of Sars-Cov-2 virus from infected mother to the newborn is not yet established. The appropriate management of infants born to mothers with confirmed or suspected COVID-19 and the start of early breastfeeding are being debated. Case presentation: We report a case of the joint management of a healthy neonate with his mother tested positive for Covid-19 before the delivery and throughout neonatal follow-up. The infection transmission from the mother to her baby is not described, even after a long period of contact between them and breastfeeding. Conclusion: It may consider an appropriate practice to keep mother and her newborn infant together in order to facilitate their contact and to encourage breastfeeding, although integration with infection prevention measures is needed. [ABSTRACT FROM AUTHOR]

The impact of the COVID-19 pandemic upon the health care landscape has prompted many organizations to revise policies in response to ever-changing guidelines and recommendations regarding safe breastfeeding practices. The application of these professional guidelines into clinical practice is fraught with barriers, inconsistencies, and often-minimal evidential support. Key concerns for health care providers and patients include antenatal versus postnatal transmission, milk transmission, and separation care versus rooming-in, including the subsequent impacts upon breastfeeding and bonding. While SARS-CoV-2 is a novel virus, the volume of literature to support best practice for couplet care continues to be developed at a rapid pace. The benefits of breastfeeding are steeped in evidence and outweigh the potential risk of transmission of COVID-19 from mother to newborn. Health care organizations must continue to seek guidance for policy revision within the ever-growing body of evidence for best practice and evaluate current practices for feasibility during and after hospitalization. [ABSTRACT FROM AUTHOR]

Despite decades of research establishing the importance of breastfeeding, skin‐to‐skin contact and mother–infant closeness, the response to the coronavirus disease 2019 (COVID‐19) pandemic has underscored the hidden assumption that these practices can be dispensed with no consequences to mother or child. This article aims to support shared decision‐making process for infant feeding and care with parents and health care providers during the unprecedented times of the pandemic. It proposes a structure and rationale to guide the process that includes (1) discussing with parents evidence‐based information and the different options to feed and care for an infant and young child in the context of the pandemic as well as their potential benefits, risks and scientific uncertainties; (2) helping parents to recognize the sensitive nature of the decisions and to clarify the value they place on the different options to feed and care for their infant or young child; and (3) providing guidance and support needed to make and implement their decisions. A shared decision‐making process will help parents navigate complex feeding and care decisions for their child as we face the different stages of the COVID‐19 pandemic. [ABSTRACT FROM AUTHOR]

Postpartum depression (PPD) is the most common complication of childbearing, and recent studies have attempted to examine risk factors associated with it. The main study hypothesis was that a protective situational factor at a sensitive time period (full rooming‐in postpartum) would moderate the associations between insecure attachment dimensions and PPD. Three hundred twelve women, in either full or partial rooming‐in, participated in a longitudinal study at the maternity ward of a tertiary healthcare center. A Demographic questionnaire and the Experiences in Close Relationships Scale were administered at 1–4 days postpartum, and the Edinburgh Postnatal Depression scale at 2 months postpartum. PPD was significantly associated with both anxious and avoidant attachment dimensions, but not with rooming‐in conditions. In addition, women in partial rooming‐in showed a positive correlation between insecure attachment dimensions and PPD, whereas no such correlation was found for full rooming‐in women. A situational factor such as full rooming‐in, which occurs at a critical time point for the mother–infant relationship, can moderate the association between maternal avoidant or anxious attachment dimensions and the mother's PPD levels. Postpartum practices, such as rooming‐in, can be personalized and thus beneficial in moderating personal risk factors for PPD. [ABSTRACT FROM AUTHOR]

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.