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Updated: Feb 6, 2026

Hemodynamic Precision in the Neonatal Intensive Care Unit using Targeted Neonatal Echocardiography
Published on: January 27, 2023
Association between rooming-in policy and neonatal hyperbilirubinemia
Ken-Hsyuan Shan1, Teh-Ming Wang1, Ming-Chih Lin2
1Department of Pediatrics, Taichung Veterans General Hospital, Taiwan.
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.
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