Comments on: Against Rooming In

By: Dorit Fabricius

Dorit Fabricius — Sat, 07 Nov 2009 23:29:20 +0000

I agree with Kim in her point she makes that it would be most desirable to meet both, the child’s and the mother’s needs equally. Yes, in the initial crucial bonding phase directly after birth, most mothers and babies are in fact alert enough to use this precious time for bonding and breast-feeding, but after that I think the most practical support for the mother (and hence for the baby in the long run) is, to do rooming-in in a ore flexible way, meaning, let a nurse or family member take care of the baby when he is sleeping so that mum can also sleep during that time and wake her for breast-feeding (or, if she is really that exhausted, let her pump some milk and give breast milk with a syringe or even a bottle to the baby, because if baby is latched on at almost each feeding he will eventually learn breast-feeding, the potential problem of nipple confusion is overestimated). Whenever mum is strong enough to take care for baby herself in her room, she should do so. This would be a type of rooming-in that does not insist on 24 hours non stop, but rather leaves space for individual needs and still supports breast-feeding. We have lots of data on the benefit of rooming-in versus nursery, but I am still waiting for a study to compare the rather flexible approach to rooming-in with the strict rooming-in philosophy and take the mother into account. I would assume that the results will not reveal any disadvantages for the baby.

Dorit, a mum of two kids and a pediatrician

By: Khadeejah Jolicoeur

Khadeejah Jolicoeur — Mon, 10 Aug 2009 14:57:48 +0000

First I would like to say that I am sorry for your bad experience and that surely, you are not the only one having faced this or similar situation. I am a student studying parenting, lactation and breastfeeding, and I would like to share some information with you in the hope of benefiting you and others that will read this.
The information given to you about rooming-in with your newborn was correct, but there is a system that comes with this practice that seems to have been missing in that hospital you delivered.
First and foremost, any drug powerful enough to obliterate labor pain is too powerful to have no other consequences. The epidural you were given comes with repercussions including that it:
o Causes the baby to be drowsy and affects his motor skills;
o Delays his pre-feeding behaviour lessening the likelihood of early breastfeeding;
o Increases his crying and raises his body temperature;
o Reduces both the mothers and baby’s beta-endorphins (in the baby, they are found in high concentration in colostrum contributing to fetal adaptation, overcoming birth stress, postnatal developments);
o Baby’s whose mother received an epidural have poorer alertness and ability to orient;
o Also, babies depressed by epidural drugs are less capable of stimulating the mother’s milk production at postnatal period.
Then, to top this off, if you were separated, even for a short time, after the delivery, then most likely it caused your baby to become distressed, which usually causes despair and withdrawal with lowered heart rate and temperature accompanied with a massive rise in stress hormones. A study by DiGirolamo (2001) found the strongest risk factors for breastfeeding termination were late breastfeeding initiation, which occurs when mothers and babies are separated, and milk supplements are given to the infant.
Alternatively, immediate after birth initiation of skin-to-skin releases a set of instinct behaviors in the new born accompanied by high blood levels of beta-endorphins, oxytocin and prolactin in both mother and infant encouraging successful breastfeeding and co-dependence.
Then when the mother is stressed during labor, it causes a significant rise in cortisol levels. Maternal stress interferes also with oxytocin release affecting milk removal.
Did the hospital inform you about the:
1. consequences of bottle and artificial milk feeding;
2. avoiding to wash baby and mother after birth;
3. how to recognize a good latch of baby to breast;
4. how to recognize proper intake and output of milk.
After delivery, the mother’s body is usually alert and ready to care for the baby. This state is boosted by the immediate skin-to-skin contact ensuring onset of hormones and bonding chemicals. Also at this time there is available dedicated professional support overseeing the mother and baby’s progress. These two factors then usually lead to a content mother and baby.
In a nut shell, it seems like you did not have optimal practices after your baby’s birth and your baby didn’t latch on properly – did not have his lips turned out against your breasts for good stimulation for his oxytocin release to calm and satisfy him. Without uninterrupted skin to skin cuddling there were less hormones to help you bond and transfer your milk to him.
I hope, in time, that you will decide to have another baby. If you do the try to deliver in a hospital where rooming-in is supported by the practices which assist in bonding and breastfeeding, particularly a hospital that offers lactation support. The main things to look for are uninterrupted skin-to-skin contact right after birth, and then, rooming-in should be a pleasure and a precious bonding experience, while taking nothing away from your rest and recovery.
For any other questions and difficulties, you may refer to the following: La Leche League organization; or any Lactation Consultants in your area. Best success!

By: Christina

Christina — Thu, 23 Jul 2009 17:50:30 +0000

I’m interested in learning more about whether forced rooming in is an issue drawing more attention – especially among birth activists and maternity user groups. Does anyone know of any other work done on this area-say a survey that may illustrate women’s preferences or other examples of women’s experiences with rooming in either in australia, the U.S. or abroad? Well-written and great piece Kim! I’m personally still a fan of rooming-in but I also believe 100% in offering and then supporting women’s choices in all areas of birth. Also, I do agree with Kristen in that the lack of nursing and birth assistant support during the postnatal time is of critical importance – I’d be more inclined to push for improvements in postnatal support than not support rooming in.

By: Kristen

Kristen — Mon, 13 Jul 2009 21:48:15 +0000

This is an argument for better post-natal support, not against rooming in! I’m sorry you were utterly exhausted – but did you really want your baby being fed formula in a nursery and increasing his risk of asthma and other nasties? Because unless you wanted the nurses to feed him formula, somebody needed to wake you for those all important first feeds…
Perhaps next time you could organise a post-partum doula to help for the first week or so?

By: Rachel

Rachel — Mon, 13 Jul 2009 09:04:53 +0000

I so agree with you Kim. I really felt the pressure to have my son room-in with me after he was born – I felt that I was being a bad mother by wanting a few hours sleep! I wish I’d been stronger!