Breastfeeding provides many benefits for both mother and baby. Mothers who breastfeed have a lower risk of breast cancer, obesity, and diabetes. Babies who are formula fed have a higher risk of cancer, diabetes, obesity and SIDS. Breastfeeding is also economical and very convenient. Sharing information about breastfeeding helps mothers make an important decision about their health and the health of their baby.
Early childhood educators can encourage mothers of infants to breastfeed by telling them about the benefits of breastfeeding and what the program is willing to do to help. A breastfeeding mother will be reassured by hearing about how caregivers/teachers will store her milk, and how they will make sure that her baby gets only her milk. Ask about the mother’s schedule. Ask her to leave enough labeled bottles of her breast milk so that her baby can be fed if she gets delayed at pick-up time.
In the national health and safety performance standards for child care, Caring for Our Children states, “Facilities should encourage, provide arrangements for and support breastfeeding.” Specific recommended actions in Standard 126.96.36.199 include:
- Organize a quiet, comfortable, and clean place in the facility for mothers to breastfeed their babies. Provide an electric outlet there so that mothers can pump their breast milk. Parents and staff members can use this place to breastfeed.
- Provide a list of community resources that offer help with breastfeeding.
- Find out whether the mother is feeding the baby on a schedule or on cue. Ask her if she wants the facility feeding of her baby timed so the baby is hungry and eager to breastfeed at pick up time.
- Include a breastfeeding policy in the written policies for the facility. To retrieve a sample breastfeeding policy for use in child care facilities, see the ECELS Breastfeeding Friendly Child Care Self-Learning Module at http://www.ecels-healthychildcarepa.org. Successfully completing the module provides two hours of PA Keys Professional Development Credit. The module meets STAR 2 Health and Safety Performance Standard and addresses several ITERS categories.
Receiving, storing, preparing and feeding breastmilk requires attention to some specifics addressed in Caring for Our Children, Standards 188.8.131.52 and 184.108.40.206. These standards provide details about the key points listed below:
Instruct mothers to clean and sanitize the bottle, nipples and any spill-proof container used to hold the milk in a dishwasher or by hand in the same way she washes dishes, glassware and tableware. Glass bottles or plastic bottles labeled BPA-free or with #1, #2, #4, or #5 are acceptable. ingle use plastic bags sold for storage and subsequent feeding of human milk are OK. Use waterproof ink on a label that will stay on the bottle if the milk bottle or bag is warmed in water. Write the infant’s full name, date and time the milk was expressed on the label. Put the expressed human milk in the labeled bottle or bag and place it in a spill-proof container. Either refrigerate or freeze the milk. It’s a good idea bring it to the facility in an insulated container to keep it cool.
On arrival, store the bottle or container in the facility refrigerator, or, if frozen, in a freezer section or stand-alone freezer with its own door, not a compartment shared with a refrigerator. As with formula feeding, remember hand hygiene before and after every feeding. Use the mother’s expressed milk only for her own infant. Check the infant’s full name and the date on the bottle so that the oldest milk is used first and for the right child. The only exception is in the case of siblings. If twin A gets milk labeled for Twin B, that is fine. Thaw frozen human milk in the refrigerator or under cool, running tap water. Warm milk for feeding briefly in bottle warmers or under warm running water so that the temperature does not exceed 98.6°F. Swirl, but do not shake the milk container gently to distribute the temperature evenly. Test the temperature of the milk before feeding. Do not use infant formula for a breastfed infant without the mother’s written permission. At the end of the day, return to the mother any human milk of more than an ounce left in a container that was not used for direct feeding.
Show and explain to the mother why the program did not feed any milk if it is in an unsanitary bottle, curdled, smells rotten, and/or has not been stored according to the storage guidelines of the American Academy of Breastfeeding Medicine. These are the guidelines in Caring for Our Children, Standard 220.127.116.11.
Older infants may drink expressed human milk from a clean cup with the help of a caregiver/teacher to avoid spills. The support a child care program gives to continue breastfeeding for at least the first year of life can make a difference or many years after.
Contributed by Nikki Lee, Lactation Consultant, Philadelphia Department of Public Health and Dottie Schell, Program Director, Breastfeeding Education, Support and Training (BEST) and PA Premie Network