Separate care for new mother and infant versus rooming-in for increasing the duration of breastfeeding

Abstract

Background: Separate care for new mothers and infants became widespread when hospitals became the predominant site for childbirth. Our objective was to assess the effect of mother-infant separation versus rooming-in on the duration of exclusive and total breastfeeding. Methods: We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (7 April 2010) for randomised or quasi-randomised controlled trials investigating the effect of separate mother-infant care versus rooming-in after hospital or home birth on the duration of breastfeeding, proportion breastfeeding at 6 months and adverse neonatal and maternal outcomes. Two review authors independently assessed the studies for inclusion. Results were expressed as mean difference (MD) and relative risk (RR) with a 95% confidence interval (95% CI). Results: Of 20 reports from 18 potential trials, only one trial involving 176 women was included. The mean days of any breastfeeding was lower in the separate care group compared to the rooming-in group but this difference was not significant (MD -0.35; 95% CI-1.47 to 0.77). The rate for exclusive breastfeeding before discharge from hospital (at day 4 of life) was significantly lower in the separate care group compared to the rooming-in group (RR 0.52; 95% CI 0.36-0.75). Conclusion: We found little evidence to support or refute the practice of mother-infant separation. Therefore we see no reason to practise it. Rooming-in should be considered the norm until further evidence is available. We recommend a well-designed trial to investigate all of the primary and secondary outcomes suggested in this review.