1 “how to support a breastfeeding mother” a guide for childcare providers revised by utah...
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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...
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