Health Beat: Breastfeeding and early care and education

The first week in August is World Breastfeeding Week. It is a time for people around the world to promote and encourage breastfeeding. Breastfeeding Support: Close to Mothers is the theme for World Breastfeeding Week 2013. This theme focuses on the importance of all aspects of breastfeeding support.

Having an annual commemorative week is worthwhile, but ensuring that mothers have the support they need to breastfeed successfully requires ongoing efforts. Breastfeeding is one of the most effective steps a mother can take to protect the health of her baby. Support for breastfeeding should be provided in all places, including early care and education (ECE) facilities (i.e., care centers, nursery schools and family homes).

The American Academy of Pediatrics recommends exclusive breastfeeding for the first six months and continued breastfeeding for at least the first year as foods are introduced. Unfortunately, most mothers in the United States do not meet these recommendations. One factor affecting breastfeeding duration is that many mothers are away from their children during the day and may not receive the support they need to continue breastfeeding. In 2007, 60 percent of women with children younger than age 3 were in the workforce. As a result, many children are cared for by people other than their parents.

ECE providers and teachers influence the lives and health of the families they serve and have an important role in supporting breastfeeding mothers and babies. ECE facilities can support breastfeeding mothers by ensuring that staff members are well-trained to meet national recommendations for supporting breastfeeding mothers. Support may include allowing mothers to breastfeed at the facility, feeding a mother's pumped breast milk to her baby, thawing and preparing bottles of pumped milk and keeping extra breast milk in a freezer.

As of December 2011, only six states (Arizona, California, Delaware, Mississippi, North Carolina and Vermont) have licensing regulations that meet the national recommendations for encouraging and supporting breastfeeding.

Examples of efforts to increase support for breastfeeding women:

The Mississippi Department of Health WIC program developed a training curriculum for ECE providers entitled How to Support a Breastfeeding Mother: A Guide for the Childcare Center. The curriculum incorporates provider guidelines on supporting breastfeeding mothers as well as guidelines for the storage and handling of expressed breast milk.

The New York State Department of Health's Child and Adult Care Food Program (CACFP) recognizes ECE centers and family day care homes that participate in CACFP and support breastfeeding families with breastfeeding-friendly certificates. A website provides ECE centers and family day care homes with self-assessment to apply for this designation and lists the breastfeeding friendly centers and homes.

The Wake County Breastfeeding-Friendly Child Care Initiative supports breastfeeding in ECE centers serving low-income families through collaboration between the Carolina Global Breastfeeding Institute and the Wake County Child Care Health Consultants and Wake County SmartStart. Activities include identifying the knowledge, attitudes and practices that support breastfeeding among ECE center staff, mandatory trainings for ECE providers and a toolkit of materials for both providers and breastfeeding families.

The Wisconsin Department of Health Services developed the Ten Steps to Breastfeeding Friendly Child Care Centers, a resource kit to help ECE centers and family homes promote breastfeeding, and provide support for breastfeeding mothers.

Arizona's Empower Pack Program is a resource for ECE providers to help children make healthy choices related to nutrition, physical activity and tobacco. The program includes a self-assessment, a sample breastfeeding policy, and a video on how to support and work with breastfeeding mothers.

The Utah Department of Health's Nutrition, Physical Activity and Nutrition Program provides an online training comprising six workshops about preventing childhood obesity. This training is approved for professional development credit. Training Module 6, "How to Support a Breastfeeding Mother: A Guide for Childcare Providers," provides ECE directors and staff accurate information and resources to best support breastfeeding mothers whose babies are in their care.