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!