This study analyzed the effect of management of rooming-in, conducted in one of the regional hospitals in Thailand, on the success of breastfeeding. Data based on 2,000 infants born in 1987 and 1990 showed a significant improvement on separation time of infant and mother after delivery and predominant breastfeeding, where the infant's predominant source of nourishment has been breastmilk. Separation time was reduced from 6.3 +/- 3.2 to 1.62 +/- 0.42 hours and predominant breastfeeding was significantly increased from 85 to 99 percent. Data obtained from the community related to the initiation and predominant breastfeedings showed a significant increase (p less than 0.05). No significant difference was demonstrated, however, on current breastfeeding among infants who were delivery before and after initiation of the rooming-in system. Also analyzed were data on prevalence of deserted children. The findings showed a progressive reduction of deserted children after management of rooming-in. The study concludes that the practices of obstetricians were a key to successful breastfeeding. Promotion and management of rooming-in significantly improves the success of breastfeeding and reduction of deserted children in the hospital.
PIP: In 1988, Maharaj Nakhonratchasima Hospital in Nakhonratchasima province, Thailand, adopted the WHO/UNICEF recommendations on breast-feeding promotion. Rooming-in was introduced and assumed to effect initiation of breast feeding. The hypothesis of this study was that rooming-in mothers would have higher initiation rates and more predominant breast feeding at time of discharge and would have lower rates of child desertion in the hospital. Mothers with children 0-24 months of age were randomly selected into 2 groups of infants with normal deliveries before (210 infants) and after (160 infants) the rooming-in system (1987 and 1990). There were no significant differences in the group on family size, marital status, housing, education, age, and employment variables. The findings were that separation time decreased significantly from 6.3 +or- 3.2 hours in 1987 to 1.62 +or- .42 hours in 1990. Predominant breast-feeding (0-4 months) prevalence at discharge increased from 85% to 99%, which was a significant increase at p 0.05. 92% initiated breast feeding in 1987 while 99% initiated breast feeding in 1990 with rooming-in. Predominant breast feeding (0-4 months) increased significantly from 33% in 1987 to 56% in 1990. Current breast feeding at 24 months did not show a significant increase, i.e., 44% in 1987 vs. 48% in 1990. The rate of child desertion decreased significantly from 3.6/1000 live births in 1987 to .1/1000 live births in 1990. Predominant breast feeding was selected as the appropriate variable since mothers regularly give infants some water after breast feeding. Advice is given to spoon feed with water to avoid confusion with the nipple. Rooming-in has clear advantages for support of breast feeding and has had unintended positive side effects of enhanced bonding and lowering of desertion rates. Desertion rates tend to be higher among adolescents under 15 years old and mothers of low educational level. A by-product of rooming-in is the reduction of time spent on infant care by health personnel. The obstetrician is an important person in promoting breast feeding before and after the baby is born; recommendations are made to enhance hospital breast feeding.