dianna pickett, kristen becker, kathleen anger, ken rosenberg, bobbie weber oregon public health...
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Relationships Between Child Care Type
and Breast FeedingDianna Pickett, Kristen Becker, Kathleen Anger, Ken Rosenberg,
Bobbie WeberOregon Public Health Division, Office of Public Health; Oregon
State UniversityPresented to the Oregon Public Health Association Annual
Meeting
October 19th, 2010
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Let’s go back in time to the
OPHA Conference 2009Monday October 26 10:45 am
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Among preschoolers in general, there is a higher proportion of 3-4 year olds in child care centers than 1-2 year olds.
Families in poverty with employed mothers and preschoolers use relative care more often than centers care.
CENSUS REPORT ON CHILD CARE (data from 2002, published 2005)
Who’s taking care of the kids in Oregon?
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1/3 of children in care are
in paid care: 32.9%
2/3 unpaid care… Think
“unregulated” care:
67.1%
Who’s taking care of the kids in Oregon?
Child Care and Education in Oregon and Its Counties: 2008 Oregon Child Care Research Partnership June 2009
Using PRAMS and PRAMS 2 data we looked at breast feeding initiation and duration
related to child care arrangements.
How does the breastfeeding infant fare in
child care?
Oregon PRAMS :◦ Stratified random sample of live births to Oregon resident
women◦ Women participate by mail or phone when their infant is 2-3
months old◦ Approximately 75% weighted response rate in 2004 and 2005◦ Results are weighted
Oregon PRAMS-2◦ Follow-up survey for PRAMS respondents when their child is 2
years old◦ Women participate by mail or phone◦ Approximately 57% response rate for 2004 and 2005 births
(weighted back to original PRAMS sample)◦ Results are weighted
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Oregon PRAMS: Pregnancy Risk Assessment Monitoring System
What are your childcare arrangements? %
Childcare center 15.2%
Child’s grandparent 14.6%
Childcare in non-relative’s home 13.0%
Other 7.2%
Paid care in your home 6.8%
Other relative 3.5%
Babysitter/friend/neighbor 3.4%
Chose more than one response 36.2%
Childcare Arrangement (PRAMS-2)
Do you have regular childcare arrangements for your two-year–old now?
%
YES 51.1%
NO 48.9%
Who uses which types of child care
We grouped respondents based on age, race, education, and breastfeeding
duration.LEAST likely to have risk
factors used FORMAL care settings:
-Childcare center-Paid in-home care-Non-relative’s home
MOST likely to have risk factors used INFORMAL care settings:
-Other relatives-Grandparents-Babysitter/FriendNeighbor-Other
?
Differences by Child Care Type
Average age *
% High school or
less*
% Non-white
% Not Married*
% <100% FPL*
Women using FORMAL care
30.93 21.2% 18.5% 18.9% 11.0%
Women using INFORMAL care
27.93 52.6% 24.6% 33.3% 27.4%
ALL PRAMS-2 respondents**
28.68 49.0% 28.3% 27.7% 28.3%
*At birth of index child**Includes women with multiple types of child care and no regular child care
PRAMS and PRAMS-2, 2004-2005 births
BF Initiation BF @ 10 weeks BF @ 6 months50
60
70
80
90
100
Formal Care
Informal Care
All PRAMS-2 Respondents*
Breastfeeding Rates by Childcare Type
PRAMS and PRAMS-2, 2004-2005 births
*Includes women with multiple types of child care and no regular child care
0
1
2
3
4
5
6
7
8
9
10
Formal Care
Informal Care
All PRAMS respondents*
% o
f R
esp
on
den
tsHealth Care Differences by Child Care Type
PRAMS-2, 2004-2005 births
*Includes women with multiple types of child care and no regular child care
Dental Care Differences by Child Care Type
Child has NOT ever had a dental visit0
10
20
30
40
50
60
70
80
90
100
Formal Care
Informal Care
All PRAMS respondents*
% o
f R
esp
on
den
ts
PRAMS-2, 2004-2005 births
*Includes women with multiple types of child care and no regular child care
We are not claiming that childcare type causes differences in breastfeeding rates.
There are differences in the characteristics of women using different types of child care.
Women using informal care appear to be more vulnerable than other groups in the areas of:◦Breastfeeding◦Having a regular health care provider
for their child◦Dental care for their child
Summary of PRAMS Findings
Prevention and health promotion for informal child care providers
Offer training on breast feeding Consult on breast feeding-friendly practices. Promote child health insurance programs Encourage child health record-keeping and
immunization up-dating processes Share what PRAMS data has revealed with
others.
Target
Full report available at: http://www.clasp.org/admin/site/publications/
files/homevisitingkinshipffn.pdf
Relationships Between Child Care Type
and Breast FeedingDianna Pickett , Healthy Child Care Oregon Office of Family [email protected]
Kristen Becker, Research AnalystOffice of Family [email protected]