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

In the early part of the 20th century when hospitals became the place of birth for babies the practice of providing separate care for the infant and mother became established in industrialised countries. Babies were kept securely in a separate nursery. The infant is brought to the mother’s room for breastfeeding, on demand or during scheduled feeding times, or the baby’s mother walks to the nursery to breastfeed her infant. Breast-milk production begins immediately after parturition. Its regulation is controlled by the mother’s physical and psychological condition, the frequency of breastfeeding, effective infant's suckling, the stimulus of the sight and sound of the baby's cry, and self-confidence and contact with the baby. Separating infants from their mothers after birth can reduce the frequency of breastfeeding and the amount of breast milk a mother produces. Whereas infants staying together with the mother throughout their hospital stay would have more frequent suckling of the breast and thus promote closeness and bonding. Many hospitals have now started to keep the mother and baby in the same room, particularly since the advent of the WHO/UNICEF Baby Friendly Hospital Initiative in 1991. This systematic review aimed to establish from randomised controlled trials whether separate care or rooming in after birth resulted in a longer duration of exclusive breastfeeding once they had returned home. The review included one trial (involving 176 women), which looked at exclusive breastfeeding four days after birth and found this was less in the separate care group. It did not report all the important primary and secondary outcomes pre-specified in our review protocol. Thus, we found little evidence to support or refute the practice of mother-infant separation post delivery, therefore, we see no reason to practice it.