Association between rooming-in policy and neonatal hyperbilirubinemia

Background: The practices promoted by the Baby-friendly Hospital Initiative have become a part of current mainstream postpartum infant care. Rooming-in to facilitate skin-to-skin contact and breastfeeding is a major component of this initiative. However, whether rooming-in is associated with admissi...

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Bibliographic Details
Main Authors: Ken-Hsyuan Shan, Teh-Ming Wang, Ming-Chih Lin
Format: Article
Language:English
Published: Elsevier 2019-04-01
Series:Pediatrics and Neonatology
Online Access:http://www.sciencedirect.com/science/article/pii/S1875957217302619
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Summary:Background: The practices promoted by the Baby-friendly Hospital Initiative have become a part of current mainstream postpartum infant care. Rooming-in to facilitate skin-to-skin contact and breastfeeding is a major component of this initiative. However, whether rooming-in is associated with admission for neonatal hyperbilirubinemia has seldom been reported. The aim of this study was to evaluate the association between rooming-in and neonatal hyperbilirubinemia. Methods: This was a retrospective cohort study. Term neonates were consecutively enrolled from the nursery of a medical center from January 2011 to December 2013. During the study period, rooming-in care was strongly encouraged according to the World Health Organization guidelines, if the parents agreed. The endpoint was defined as admission for phototherapy. Risk of neonatal hyperbilirubinemia in rooming-in neonates was calculated. Potential confounding factors, including exclusive breastfeeding, potential ABO incompatibility, Glucose-6-Phosphate Dehydrogenase (G6PD) deficiency, and body weight loss (BWL), were adjusted by multiple logistic regression models. Results: Totally, 3341 infants were enrolled in this study after excluding 40 infants admitted for other reasons. The rooming-in rate increased yearly during the study period. However, the rate of neonatal hyperbilirubinemia also increased simultaneously. The odds ratio (OR) of neonatal hyperbilirubinemia in the rooming-in group was 7.04 (95% CI, 4.41∼11.24). The rooming-in group demonstrated a higher percentage of exclusive breastfeeding and BWL >10% at 3 days of age. After adjusting for potential confounding factors, rooming-in was still a significant risk factor for neonatal hyperbilirubinemia (OR: 8.48; 95% CI: 5.04∼14.25). Conclusions: The practice of rooming-in is now part of the mainstream postpartum newborn care. However, the increased incidence of neonatal hyperbilirubinemia is a potential side effect of which healthcare providers should be aware. Further research is needed to confirm the role of rooming-in in neonatal hyperbilirubinemia. Key Words: breastfeeding, neonatal hyperbilirubinemia, rooming-in
ISSN:1875-9572