Mary Foley RN, BSN, IBCLC Lactation Program Coordinator Maternal-Newborn Service Melrose-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

AKA… How to Get Your Night Staff to Hate You Step 7 Rooming-In AKA… How to Get Your Night Staff to Hate You

Rooming-In x 16 Months Rooming-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 @ Night Nursery Parent Fatigue Unrealistic expectations Staff/Parents Physicians Family/Friends/Father Hospital Procedures Low supervision/modeling Night Culture

RSVP: mfoley@hallmarkhealth.org Melrose-Wakefield Hospital Maternal-Newborn Service 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 Summit Thursday, November 12th 2009 6-8 PM Perkins Lecture Hall RSVP: mfoley@hallmarkhealth.org

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

Because the best place for baby Rooming In: Because the best place for baby is with mom.  Rooming-In Rooming-in means that your baby stays with you in your room 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 need assistance in special circumstances. “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 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. by Rooming-In.

Public Notification Local 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!