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 BabyFriendly 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 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
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
Rooming-In
Rooming In:
Because the best place for baby
is with mom. 
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.
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.
“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
Public Notification
Local Newspaper
Updates…..
•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 roomingin as the norm
•Labwork being drawn in room
•Hearing screenings done in room
•Baths done in room
April 2011
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!