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““How To Support A How To Support A Breastfeeding Mother”Breastfeeding Mother”

A Guide forA Guide for

Childcare Childcare ProvidersProviders

Revised by Utah Physical Activity Nutrition and Obesity Program

Developed by the Mississippi State Department of Health WIC Program, revised by Wisconsin

ObjectivesObjectives

Describe importance of breastfeeding for infants Describe importance of breastfeeding for infants and mothers and risks of not breastfeedingand mothers and risks of not breastfeeding

Describe safe handling of human milkDescribe safe handling of human milk Describe elements of a breastfeeding-friendly child Describe elements of a breastfeeding-friendly child

care environmentcare environment Describe the role of the child care environment and Describe the role of the child care environment and

staff in helping mothers and infants to achieve their staff in helping mothers and infants to achieve their breastfeeding goalsbreastfeeding goals

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AAP Policy StatementAAP Policy Statement

Breastfeeding is the normal way to feed a Breastfeeding is the normal way to feed a babybaby

Breastfeed exclusively for the first 6 monthsBreastfeed exclusively for the first 6 months Continue for at least 1 year*Continue for at least 1 year* And as long thereafter “as is mutually And as long thereafter “as is mutually

desired”desired”*The World Health Organization

(WHO) recommends 2 years.

http://www.aap.org/policy/re9729.htmlhttp://www.who.int/child-adolescent-health/NUTRITION/infant_exclusive.htm

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Healthy People 2020 Healthy People 2020 GoalsGoals

– At least 82% ever breastfedAt least 82% ever breastfed– At least 60% at 6 monthsAt least 60% at 6 months– At least 34% at 1 year At least 34% at 1 year – At least 44% exclusively breastfed at 3 At least 44% exclusively breastfed at 3

months months – At least 24% exclusively breastfed at 6 At least 24% exclusively breastfed at 6

monthsmonths

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Utah Breastfeeding DataUtah Breastfeeding Data

– 89.8% ever breastfed89.8% ever breastfed– 58.3% at 6 months58.3% at 6 months– 35.4% at 12 months35.4% at 12 months– 41.3% exclusively at 3 months41.3% exclusively at 3 months– 16.3% exclusively at 6 months16.3% exclusively at 6 months

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Breastfeeding

is the Normal Way to Feed a Child

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Benefits to BabyBenefits to Baby

Reduced risks for:Reduced risks for: otitis media (ear infections)otitis media (ear infections) upper and lower respiratory infectionsupper and lower respiratory infections urinary tract infectionsurinary tract infections gastroenteritisgastroenteritis NEC in preemiesNEC in preemies allergiesallergies overweight/obesityoverweight/obesity

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More Benefits to More Benefits to BabyBaby

Reduced risks of:Reduced risks of: DiabetesDiabetes Crohn’s diseaseCrohn’s disease Childhood leukemiaChildhood leukemia Cardiovascular diseaseCardiovascular disease Sudden Infant Death Sudden Infant Death

Syndrome (SIDS)Syndrome (SIDS)

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More Benefits for More Benefits for babybaby

Breastfeeding...Breastfeeding...

Enhances brain and IQ developmentEnhances brain and IQ development

Optimizes mother-infant bondingOptimizes mother-infant bonding

Enhances strong jaw and facial developmentEnhances strong jaw and facial development

– reduces need for orthodontic treatment later in childhood.reduces need for orthodontic treatment later in childhood.

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Breastfeeding Saves Breastfeeding Saves MoneyMoney

The cost of formula feeding for one The cost of formula feeding for one year is ~$1,500 (just for the formula)year is ~$1,500 (just for the formula)

The cost of breastfeeding is PRICELESSThe cost of breastfeeding is PRICELESS

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Breastfeeding Saves Breastfeeding Saves MoneyMoney

A minimum of $3.6 billion would be saved if A minimum of $3.6 billion would be saved if breastfeeding were increased from current levels to breastfeeding were increased from current levels to those recommended in Healthy People 2010!those recommended in Healthy People 2010!– At least 75% initiate breastfeeding At least 75% initiate breastfeeding – At least 50% continue breastfeeding at least 6 At least 50% continue breastfeeding at least 6

monthsmonths– At least 25% continue breastfeeding at least 12 At least 25% continue breastfeeding at least 12

monthsmonths

These cost savings are calculated from just 3 illnesses: These cost savings are calculated from just 3 illnesses: otitis media, gastroenteritis and necrotizing otitis media, gastroenteritis and necrotizing entercolitisentercolitis

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Benefits for MomBenefits for Mom

Promotes rapid recovery after having a babyPromotes rapid recovery after having a baby Decreases risk of anemiaDecreases risk of anemia Helps in weight reductionHelps in weight reduction Reduces risk of breast cancer, especially Reduces risk of breast cancer, especially

premenopausalpremenopausal Reduces risk of ovarian cancerReduces risk of ovarian cancer May reduce risk of endometrial cancer (of the May reduce risk of endometrial cancer (of the

uterus lining)uterus lining) Reduces risk for osteoporosisReduces risk for osteoporosis

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Breastfeeding Benefits Breastfeeding Benefits EmployersEmployers

Less employee turnoverLess employee turnover

Faster return from maternity leaveFaster return from maternity leave

Less employee absenteeismLess employee absenteeism

Happier employeeHappier employee

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Breastfeeding Benefits Breastfeeding Benefits Childcare ProvidersChildcare Providers

Baby is sick less oftenBaby is sick less often

Diapers have less odorDiapers have less odor

Baby spits up lessBaby spits up less

Baby is happierBaby is happier

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AAP AAP RecommendationsRecommendations

Breastfeed for Breastfeed for at leastat least 12 months 12 months

Provide breast milk even when mom and child Provide breast milk even when mom and child

are separatedare separated

Encourages family & community supportEncourages family & community support

Media should portray breastfeeding as the normMedia should portray breastfeeding as the norm

Employers provide facilities and timeEmployers provide facilities and time

Breastfeeding Best Practices for Breastfeeding Best Practices for Child Care ProvidersChild Care Providers

Facility has a written policy on breastfeedingFacility has a written policy on breastfeeding Each breastfeeding infant will have a feeding plan Each breastfeeding infant will have a feeding plan

on file, which is completed by the parent(s) and on file, which is completed by the parent(s) and facility as a team to address their unique feeding facility as a team to address their unique feeding patternspatterns

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Elements of Breastfeeding PolicyElements of Breastfeeding Policy

Breastfeeding mothers shall be provided a place Breastfeeding mothers shall be provided a place to breastfeed or express their milkto breastfeed or express their milk

A refrigerator will be made available for storage A refrigerator will be made available for storage of expressed breast milkof expressed breast milk

Sensitivity will be shown to breastfeeding Sensitivity will be shown to breastfeeding mothers and their babiesmothers and their babies

Staff shall be trained in handling human milkStaff shall be trained in handling human milk

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Policy Elements, continuedPolicy Elements, continued

Breastfeeding employees shall be provided Breastfeeding employees shall be provided flexible breaks to accommodate breastfeeding or flexible breaks to accommodate breastfeeding or milk expressionmilk expression

Breastfeeding promotional information will be Breastfeeding promotional information will be displayeddisplayed

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Elements of Feeding PlanElements of Feeding Plan

Baby’s usual scheduleBaby’s usual schedule How breast milk is to be stored and servedHow breast milk is to be stored and served What the provider should do if baby is hungry What the provider should do if baby is hungry

and mom is unavailable, or her supply of and mom is unavailable, or her supply of expressed breast milk is goneexpressed breast milk is gone

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Sample Infant Feeding PlanSample Infant Feeding Plan

Breastfeeding Infant Feeding Plan Directions: To be completed by the parent(s) and the infant care giver. Plan should be updated every other month to reflect child’s current feeding pattern.

Child care facility name:

Name of child:

Date of birth:

Parent’s names:

Date of initial plan:

Date(s) of plan updates:

Describe baby’s usual feeding schedule.

How is breastmilk to be stored and served?

Outline the mother’s wishes regarding when to begin infant foods and what foods to give baby.

What should the provider do if baby is hungry and mom is late or her supply of expressed breastmilk is gone?

Mom reminders:

Let your provider know if you want to breastfeed at the child care facility? Decide how many feedings you think your baby might need at child care and give your provider

enough milk each day.

Model Breastfeeding Best PracticesModel Breastfeeding Best Practices

Breastfeeding employees shall be provided Breastfeeding employees shall be provided flexible breaks to accommodate breastfeeding or flexible breaks to accommodate breastfeeding or milk expressionmilk expression

Breastfeeding promotion information will be Breastfeeding promotion information will be displayeddisplayed

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Post the International Breastfeeding Post the International Breastfeeding Symbol in Your FacilitySymbol in Your Facility

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ActivityActivity

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Child Care Providers Information

Breastfeeding Support in Child Care Centers

More and more mothers today choose to give their infants the healthiest start in life possible by breastfeeding. Thanks to abundant research, all major health organizations today promote breastfeeding as the perfect form of infant nutrition, and call on local communities to provide the support new mothers need to be successful. Breastfeeding rates in Utah are increasing and new mothers are seeking out childcare centers that will support their efforts.

What can you do to protect and support breastfeeding in your facility?

Establish a supportive breastfeeding policy and be sure that all staff are aware of and follow the policy.

Provide training for your staff in proper handling and storage of human milk.

Provide positive breastfeeding promotion messages in the center. Loving Support posters are available at the Utah Department of Health.

Set aside a place for mothers to breastfeed or pump milk for their infants in

privacy (if desired). Make it clear to mothers, staff and other parents that a mother may breastfeed her child wherever she and her child have a legal right to be (established by Utah Code Ann. 76-9-702(2002))

Encourage expectant mothers to breastfeed by making information available, including community resources. Put mothers in touch with other mothers who have successfully combined breastfeeding and working.

Provide recognition and encouragement to mothers who choose to breastfeed.

Recognize that mothers may have strong feelings about continuing to breastfeed

when they are separated from their babies. The knowledge that you support their decision to breastfeed may increase their confidence in you as their child care provider and translate to positive community recognition for you.

ActivityActivity

Improving YOUR Facility’s Breastfeeding Environment

Complete the following brainstorming exercise in pairs or by yourself. Then Share your ideas with the group.

List 3 breastfeeding practices you currently follow.

1.

2.

3.

List 2 additional practices you can do in your facility to support breastfeeding mothers.

1.

2.

BreastfeediBreastfeedingng

is the is the Gold Gold

StandardStandard

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Breastmilk as part of the Meal PatternBreastmilk as part of the Meal Pattern

If your center participates in the Child and If your center participates in the Child and Adult Care Feeding Program…Adult Care Feeding Program…– Breastmilk is a reimbursable component of Breastmilk is a reimbursable component of

the infant meal patternthe infant meal pattern

– For children over 12 months - breast milk is For children over 12 months - breast milk is a substitute for cow’s milk in the meal a substitute for cow’s milk in the meal pattern for children and the meal is pattern for children and the meal is reimbursablereimbursable

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Storing that Liquid GoldStoring that Liquid Gold

There are different sets of There are different sets of recommendations from different recommendations from different organizations.organizations.

As a childcare center you should be As a childcare center you should be using guidelines from AAP and CDCusing guidelines from AAP and CDC

Mom may be following a different set of Mom may be following a different set of guidelinesguidelines

Working with mom regarding storage of Working with mom regarding storage of breast milk will avoid problemsbreast milk will avoid problems

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Storing that Liquid GoldStoring that Liquid Gold

At room temperature (66-72At room temperature (66-72OOF)….…6-8 hoursF)….…6-8 hours

In an insulated cooler (on ice)…..24 hoursIn an insulated cooler (on ice)…..24 hours

In a refrigerator (32-39In a refrigerator (32-39OOF)……...….….5 daysF)……...….….5 days

In a freezer inside a refrigerator……. 2 weeksIn a freezer inside a refrigerator……. 2 weeks

In a freezer with a separate door....3-6 monthsIn a freezer with a separate door....3-6 months

In a separate deep freeze (0)In a separate deep freeze (0)OOF...6-12 monthsF...6-12 months*From CDC; reference: Academy of Breastfeeding *From CDC; reference: Academy of Breastfeeding

Medicine. (2004).Medicine. (2004).

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Handling of Handling of BreastmilkBreastmilk

Label the bottles with baby’s name, the date the Label the bottles with baby’s name, the date the breast milk was collected and the date thawedbreast milk was collected and the date thawed

Breastmilk separates into layersBreastmilk separates into layers Swirl gently to mix layers back togetherSwirl gently to mix layers back together Thawed breast milk can be kept in the refrigerator Thawed breast milk can be kept in the refrigerator

for 24 hrs. Do not refreezefor 24 hrs. Do not refreeze Heat breast milk in warm water Heat breast milk in warm water

never microwave breast milknever microwave breast milk After a feeding, throw out any unused breast milk left After a feeding, throw out any unused breast milk left

in the bottlein the bottle

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BreastmilkBreastmilkIs NOT Classified as a Body Fluid*Is NOT Classified as a Body Fluid*

You do You do notnot need to store breast milk in a separate need to store breast milk in a separate refrigeratorrefrigerator

You do You do notnot need to wear gloves to give a bottle of need to wear gloves to give a bottle of breast milkbreast milk

You do You do notnot contaminate breast milk by touch. contaminate breast milk by touch. Touching breast milk is not a hazardous exposure Touching breast milk is not a hazardous exposure nor a potential contaminantnor a potential contaminant

*According to OSHA’s and CDC’s definitions,breastmilk is *According to OSHA’s and CDC’s definitions,breastmilk is classified as “food” and does not require universal precautions classified as “food” and does not require universal precautions for handling body fluids.for handling body fluids.

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Feeding Suggestions for Feeding Suggestions for Childcare WorkersChildcare Workers

Hold baby closeHold baby close Discuss with mom ahead of time how to Discuss with mom ahead of time how to

handle times when baby is hungry at the end handle times when baby is hungry at the end of the day of the day

Mom may be ready or want to feed her baby Mom may be ready or want to feed her baby as soon as she arrives at the centeras soon as she arrives at the center

Provide a “nursing nook” in the childcare Provide a “nursing nook” in the childcare center where mom can breastfeed her babycenter where mom can breastfeed her baby

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Other Ways to be SupportiveOther Ways to be Supportive

Some babies prefer to wait for their mother’s Some babies prefer to wait for their mother’s

return and not eat much at the childcare centerreturn and not eat much at the childcare center

Keep 1 bottle of frozen milk in the freezer for Keep 1 bottle of frozen milk in the freezer for

emergenciesemergencies

Keep track of the number of ounces of breast Keep track of the number of ounces of breast

milkmilk baby atebaby ate

Praise mom for providing the very best Praise mom for providing the very best

nutrition to her babynutrition to her baby

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Critical Times for Support...Critical Times for Support...

The transition back to work can be a difficult time The transition back to work can be a difficult time for moms and babies and she may feel that she is for moms and babies and she may feel that she is unable to pump enough or continue pumping. unable to pump enough or continue pumping. Praise her efforts and encourage her to talk to a Praise her efforts and encourage her to talk to a breastfeeding professionalbreastfeeding professional

When baby is teethingWhen baby is teething When mom needs to take medicationsWhen mom needs to take medications When baby is having a “growth spurt”When baby is having a “growth spurt” When pumping isn’t going well When pumping isn’t going well When mom thinks her supply is decliningWhen mom thinks her supply is declining

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Baby’s Hunger CuesBaby’s Hunger Cues

Turning his or her head side to side in search Turning his or her head side to side in search

of the breastof the breast

Making sucking noisesMaking sucking noises

Sucking on hand or fistSucking on hand or fist

Crying is a late cue. Try to feed baby before Crying is a late cue. Try to feed baby before

he or she start cryinghe or she start crying

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Things to RememberThings to Remember

If breastfeeding is not going well, the solution If breastfeeding is not going well, the solution is to fix the breastfeeding -- NOT to “wean to is to fix the breastfeeding -- NOT to “wean to a bottle”a bottle”

Most potential problems are easily managed Most potential problems are easily managed without interrupting breastfeedingwithout interrupting breastfeeding

A little breastfeeding is better than noneA little breastfeeding is better than none For help call: WIC, La Leche League, Baby For help call: WIC, La Leche League, Baby

Your Baby, The Utah Breastfeeding Coalition Your Baby, The Utah Breastfeeding Coalition or your health care provideror your health care provider

Helpful WebsitesHelpful Websites10 Favorite Breastfeeding Websites for Families

11.. La Leche League International http:/ / www.llli.org/ Site features:

Answer pages Mother-to-mother forums Ask a question Podcasts on breastfeeding topics Breastfeeding Laws

22.. American Academy of Pediatrics http:/ / www.aap.org/ healthtopics/ breas tfeeding.cfm Site features:

Family resource guides Educational information AAP Policy on breastfeeding

33.. Dr. J ack Newman http:/ / www.drjacknewman.com/ Site features:

Video clips Breastfeeding help

44.. Breastfeeding.com http:/ / www.breastfeeding.com/ Site features:

Reading Room Video clips Mothers’ stories Working Mother Shopping

55.. Promotion of Mother’s Milk, Inc http:/ / www.promom.org/ Site features:

Breastfeeding Information 101 Reasons to Breastfeed Your Child 3-Minute Activist Gallery

66.. Kelly Mom http:/ / www.kellymom.com/ Site features:

Handouts Books and Supplies Breastfeeding Forum

77.. World Alliance for Breastfeeding Action http:/ / www.waba.org.my/ Site features:

Mother Support Men’s Initiative Breastfeeding Links Photo Gallery Resources

88.. U.S. Department of Health and Human Services http:/ / www.womenshealth.gov/ breastfe eding/ Site features:

National Breastfeeding Helpline Basic Mother Support Resources Breastfeeding Links

99.. United States Breastfeeding Committee http:/ / www.usbreastfeeding.org/ Site features:

Links to resources Parenting in the workplace Babies at work Support Resources for family members

1100.. Utah Breastfeeding Coalition http:/ / www.utahbreastfeeding.org Site features:

Resources for Mothers Resources for Healthcare Providers Resources for Employers

Adapted from Colorado WIC Program

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Breastfeeding...

Baby’s Best Start