When considering rooming-in vs. nursery care, we encourage most mothers and babies to enjoy rooming-in. Full rooming-in allows you to exercise your mothering instincts when the hormones in your body are programmed for it. In our experience, and that of others who study newborns, mothers and babies who fully practice rooming-in vs. nursery care enjoy the following benefits:
Benefits of Rooming-in vs. Nursery Care
- Rooming-in babies seem more content because they interact with only one caregiver—mother.
- Full rooming-in changes the caregiving mindset of the attending personnel. They focus their attention and care on the mother, who is then more comfortable and able to focus on her baby.
- Rooming-in newborns cry less and more readily organize their sleep-wake cycles. Babies in a large nursery are sometimes soothed by tape recordings of a human heartbeat or music. Rather than being soothed electronically, the baby who is rooming-in with mother is soothed by real and familiar sounds.
- Mother has fewer breastfeeding problems. Her milk appears sooner, and baby seems more satisfied.
- Rooming-in babies get less jaundiced, probably because they get more milk.
- A rooming-in mother usually gets more rest. She experiences less separation anxiety, not wasting energy worrying about her newborn in the nursery, and in the first few days newborns sleep most of the time anyway. It’s a myth that mothers of nursery-reared babies get more rest.
- Rooming-in mothers, in our experience, have a lower incidence of postpartum depression.
Rooming-in is especially helpful for women who have difficulty jumping right into mothering. One day while making rounds I visited Jan, a new mother, only to find her sad. “What’s wrong?” I inquired. She confided, “All those gushy feelings I’m supposed to have about my baby—well, I don’t? I’m nervous, tense, and don’t know what to do.” I encouraged Jan, “Love at first sight doesn’t happen to every couple, in courting or in parenting. For some mother-infant pairs it is a slow and gradual process. Don’t worry—your baby will help you, but you have to set the conditions that allow the mother-infant care system to click in.” I went on to explain what these conditions were and how rooming-in vs. nursery care impacted these conditions.
Rooming-in vs. Nursery Care: Setting the Stage
All babies are born with a group of special qualities called attachment-promoting behaviors—features and behaviors designed to alert the caregiver to the baby’s presence and draw the caregiver, magnet-like, toward the baby. These features are the roundness of baby’s eyes, cheeks, and body; the softness of the skin; the relative bigness of baby’s eyes; the penetrating gaze; the incredible newborn scent; and, perhaps, most important of all, baby’s early language—the cries and precrying noises.
Here’s how the early mother-infant communication system works. The opening sounds of the baby’s cry activate a mother’s emotions. This is physical as well as psychological. Upon hearing her baby cry, a mother experiences an increased blood flow to her breasts, accompanied by the biological urge to pick up and nurse her baby. This is one of the strongest examples of how the biological signals of the baby trigger a biological response in the mother. There is no other signal in the world that sets off such intense responses in a mother as her baby’s cry. At no other time in the child’s life will language so forcefully stimulate the mother to act.
Picture what happens when babies and mothers take advantage of rooming-in vs. nursery care. Baby begins to cry. Mother, because she is there and physically attuned to baby, immediately picks up and feeds her infant. Baby stops crying. When baby again awakens, squirms, grimaces, and then cries, mother responds in the same manner. The next time mother notices her baby’s precrying cues. When baby awakens, squirms, and grimaces, mother picks up and feeds baby before he has to cry. She has learned to read her baby’s signals and to respond appropriately. After rehearsing this dialogue many times during the hospital stay, mother and baby are working as a team. Baby learns to cue better; mother learns to respond better. As the attachment-promoting cries elicit a hormonal response in the mother, her milk- ejection reflex functions smoothly, and mother and infant are in biological harmony.
The baby-in-plastic-box scene. Now contrast the rooming-in vs. nursery care scenes. Picture this newborn infant lying in a plastic box. He awakens, hungry, and cries along with twenty other hungry babies in plastic boxes who have by now all managed to awaken one another. A kind and caring nurse hears the cries and responds as soon as time permits, but she has no biological attachment to this baby, no inner programming tuned to that particular newborn, nor do her hormones change when the baby cries. The crying, hungry baby is taken to her mother in due time. The problem is that the baby’s cry has two phases: The early sounds of the cry have an attachment-promoting quality, whereas the later sounds of the unattended cry are more disturbing to listen to and may actually promote avoidance.
The mother who has missed the opening scene in this biological drama because she was not present when her baby started to cry is nonetheless expected to give a nurturing response to her baby some minutes later. By the time the nursery-reared baby is presented to the mother, the infant has either given up crying and gone back to sleep (withdrawal from pain) or greets the mother with even more intense and upsetting wails. The mother, who possesses a biological attachment to the baby, nevertheless hears only the cries that are more likely to elicit agitated concern rather than tenderness. Even though she has a comforting breast to offer the baby, she may be so tied up in knots that her milk won’t eject, and the baby cries even harder.
As she grows to doubt her ability to comfort her baby, the infant may wind up spending more time in the nursery, where, she feels, the “experts” can better care for him. This separation leads to more missed cues and breaks in the attachment between mother and baby, and they go home from the hospital without knowing each other.
Not so with the babies who experience rooming-in vs. nursery care. He awakens in his mother’s room, his pre-cry signals are promptly attended to, and he is put to the breast either before he needs to cry or at least before the initial attachment-promoting cry develops into a disturbing cry. Thus, both mother and baby profit from rooming-in. Infants cry less, mothers exhibit more mature coping skills toward their baby’s crying, and the infant-distress syndrome (fussiness, colic, incessant crying) is less common than with nursery-reared babies. We had a saying in the newborn unit: “Nursery-reared babies cry harder; rooming-in babies cry better.” A better term for “rooming-in” may be “fitting in.” By spending time together and rehearsing the cue-response dialogue, baby and mother learn to fit together well—and bring out the best in each other.