Hospital efforts to support breastfeeding by having babies room-in with mothers may have a rare unintended consequence: an increased risk of newborn falls. Neonatal falls are increasingly recognized as a postpartum safety risk, with as many as 1,600 newborns falls occurring in U.S. hospitals each year, researchers note in a paper online December 28 in Pediatrics.

Neonatal falls are increasingly recognized as a postpartum safety risk, with as many as 1,600 newborns falls occurring in U.S. hospitals each year, researchers note in a paper online December 28 in Pediatrics. While this represents a miniscule fraction of all births, doctors are increasingly concerned that at least some of these falls may be resulting from new mothers falling asleep while breastfeeding babies in their hospital beds.

Breast Feeding

To assess the potential for breastfeeding programs to influence the risk of recent falls, researchers looked at three cases that happened after one hospital initiated several changes designed to support breastfeeding and mother-baby bonding. "To encourage successful breastfeeding, it is important to keep mothers and babies together in one room, as much as possible," said lead study author Dr. Colleen Hughes Driscoll of the University of Maryland School of Medicine in Baltimore.

"This practice is somewhat different from earlier decades when babies spent a significant part of the postpartum hospitalization in the nursery, away from their mother," Driscoll said by email. "Though this separation was likely a barrier to successful breastfeeding, it may have provided additional opportunities for mothers to rest and recover."

The researchers examined data on new falls recorded in medical records from January 2011 to February 2018. They also looked at data on breastfeeding from medical records and from patient surveys done starting in 2015 as part of a new effort to support breastfeeding and rooming-in at the hospital.

Three falls occurred within one year of starting a range of breastfeeding supports the hospital needed to implement to be designated as a "baby friendly hospital." Qualifying as Baby-Friendly, under the joint WHO and UNICEF program that created the designation requires policies that include educating families to make informed decisions about infant feeding, encouraging mothers to hold babies skin-to-skin right after birth, allowing rooming-in and offering lactation support.

"We found that as we improved our ability to support mothers with successful breastfeeding, there was a surge in newborn falls," Driscoll said. "This suggests that we may be adding to the burden of maternal fatigue, and increasing the risk of newborn falls."