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Mary FoleyRN, BSN, IBCLC
Lactation Program Coordinator
Maternal-Newborn ServiceMelrose-Wakefield Hospital
Melrose-Wakefield Hospital
•10 miles north of Boston
•1200 births per year
•No VBACs
•CS rate 20% primary, 20% repeat
•Culture mix: Caucasian, Asian, Indian, Haitian, Hispanic
•Socioeconomic: middle-to-low income
• Average age of nurses: 50
•Certificate of Intent for Baby-Friendly x 4 years
Baby Friendly Hospital Certificate of Intent 2007
On our journey to becoming a Baby Friendly Hospital, we found one of our more difficult challenges to be Step 7…Rooming-In
Step 7Rooming-In
AKA…
How to Get Your Night Staff
to Hate You
Rooming-In x 16 MonthsRooming-In
Prior to 2009 there were very few mothers requesting rooming-in
Infants were routinely separated from mothers following birth and throughout the hospital stay
Supplementation at night was not unusual
Rates of exclusive breastfeeding were low
Obstacles to Rooming-In
@ NightNursery
Parent Fatigue
Unrealistic expectations Staff/Parents
Physicians
Family/Friends/Father
Hospital Procedures
Low supervision/modeling
Night Culture
What is Rooming-In &
Why are We Doing It?Beginning in January, 2010 MWH
Maternal-Newborn Service will be transitioning to the “rooming-in”
model of mother-baby care. Healthy mothers and babies will be cared for together in the
same room. Come and join us for dinner and discussion at the:
Rooming-In SummitThursday, November 12th 2009
6-8 PMPerkins Lecture Hall
RSVP: mfoley@hallmarkhealth.org
Melrose-Wakefield HospitalMaternal-Newborn Service
Panel Question and Answer/Discussion
How it Helped:Attended by physicians and nurses together
Everyone hears the same message
Allows a peek into another practice style
Helped LCs to not feel like the “crazies”
Influence of MGH was effective
Influence of competitor was effective
RNs were able to ask tough questions and get real answers
Physicians, Family, Friends, Culture
“Get your sleep in the hospital while you have the luxury of the nursery!”
Parent Sleep a Major Issue in first 3 months
Educated physicians and offices by doing visits to every OB office & speaking at OB meetings
Newspaper & Hospital Publications/Rooming-In
“Having my son with me was a wonderful experience. I felt closer to him every minute and was glad I had him with me.”~ Leanne
Rooming In: Because the best place for
baby is with mom.
Rooming-in means that yourbaby stays with you in yourroom throughout your hospital stay. Why is rooming-in best?* Babies sleep better and cry less* Baby gains weight better* You get to know your baby sooner* You are better prepared to take care of your baby when you go home What about sleep?Research shows mothers often sleep better when Rooming-In than when the baby is out of the room. What about special circumstances?The nursery is available if you should needassistance in special circumstances.
Baby will be with you throughout the day & night, except for short visits to the nursery for medical procedures. The nursery nurse will be on the maternity unit teaching and assisting you with the care of your baby as needed.
Rooming-In
Public NotificationLocal Newspaper
Updates….. April 2011 •Higher incidence of rooming-in
•Supplementation down
•Exclusivity rates up
•More mothers aware of rooming-in model of care
•Physicians supporting rooming-in
•Nurses are beginning to see rooming-in as the norm
•Labwork being drawn in room
•Hearing screenings done in room
•Baths done in room
Lessons Learned
Education is Key! Physicians, Staff, Parents, Community
Prepare in Advance – Set a Target Date
Build Relationships with Night Staff
Positive Reinforcement
Expect Change to be Gradual
Communicate Expectations in a Variety of Ways (e-mail, direct, staff meetings, signs etc)
If your baby is "beautiful and perfect, never cries or fusses,
sleeps on schedule and burps on demand, an angel all the time,"
you're the grandma."-- Theresa Bloomingdale
Thanks!
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