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Breastfeeding Friendly Child Care Provider Training. 10 Steps Toolkit. Amber France MS IBCLC Wood County Health Department afrance@co.wood.wi.us (715)421-8937. Wood County Breastfeeding Coalition HPWC Chronic Disease Prevention Team Wood County Health Department. Grant.

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breastfeeding friendly child care provider training

Breastfeeding Friendly Child Care Provider Training

10 Steps Toolkit

Amber France MS IBCLC

Wood County Health Department

afrance@co.wood.wi.us

(715)421-8937

Wood County Breastfeeding Coalition

HPWC Chronic Disease Prevention Team

Wood County Health Department

grant
Grant
  • Investing Early Grant from Celebrate Children Foundation
  • Develop Training/Materials
  • Process
  • Outcomes
risks of formula
Risks of Formula
  • Lower IQ
  • Increased risk of SIDS
  • Increase in infectious illness
  • Higher risk of inflammatory bowel diseases
  • Increase NEC in preemies
  • Higher risk of cancer
  • Higher risk for cardiovascular disease
  • Higher risk of diabetes
  • No protection from asthma & eczema
  • Higher risk of childhood obesity
  • More cavities
  • Problems with oral/jaw structure
benefits to mom
Benefits to Mom
  • Life is easier
  • Saves money
  • Feel great
  • Health benefits
  • Miss less work
benefits to the community
Benefits to the Community

“If 90 percent of families breastfed exclusively for 6 months, nearly 1,000 deaths among infants could be prevented.”

  • Save $13 billion per year
  • More productive workforce
  • Better for environment
benefits to childcare provider
Benefits to Childcare Provider
  • Babies are sick less
  • Babies are happier
  • Diaper odor is less
  • Baby may spit up less
  • Easier transition
  • More marketable
cacfp meal pattern
CACFP Meal Pattern
  • Breastmilk is part of the Meal Pattern
    • Reimbursable component of infant meal pattern
    • Children >12 months, breastmilk substitute cow’s milk in the meal pattern for reimbursement
healthy people 2020 goals1
Healthy People 2020 Goals
  • Increase the proportion of employers that have worksite lactation support programs
aap policy statement
AAP Policy Statement
  • Exclusive breastfeeding for the 1st 6 months
  • Continued breastfeeding through at least the 1st year or longer as mutually desired
  • Medical contraindications are rare

WHO recommends at least 2 years!

surgeon generals call to action
Surgeon Generals Call To Action

“One of the most highly effective preventive measures a mother can take to protect the health of her infant and herself is to breastfeed.”

“The success rate among mothers who want to breastfeed can be greatly improved through active support from their families, friends, communities, clinicians, health care leaders, employers, and policymakers.”

10 steps to breastfeeding friendly child care centers
10 Steps to Breastfeeding Friendly Child Care Centers
  • Step 1: Designate an individual or group who is responsible for development and implementation of the 10 steps.
  • Step 2: Establish a supportive breastfeeding policy and assure that all staff are aware of and following the policy.
  • Step 3: Establish a supportive worksite policy for staff members who are breastfeeding.
steps continued
Steps Continued
  • Step 4: Train all staff so that they are able to carry out breastfeeding promotion and support activities.
  • Step 5: Create a culturally appropriate breastfeeding friendly environment.
  • Step 6: Inform expectant and new families and visitors about your Center’s breastfeeding friendly policies.
  • Step 7: Stimulate participatory learning experiences with the children related to breastfeeding.
steps continued1
Steps Continued
  • Step 8: Provide a comfortable place for mothers to breastfeed or pump their milk in privacy, if desired. Educate families and staff that a mother may breastfeed her child wherever they have legal right to be.
  • Step 9: Establish and maintain connections with your local breastfeeding coalition or other community resources.
  • Step 10: Maintain an updated resource file of community breastfeeding services and resources kept in an accessible area for families.
self appraisal questionnaire
Self-Appraisal Questionnaire
  • Reviews existing practices
  • Compliance with requirements
  • Assess key areas for improvement
  • Tool to prioritize
step 1
Step 1

Designate an individual or group who is responsible for development and implementation of the 10 steps.

step 11
Step 1
  • Designate individual or small group to
    • Initiate & asses progress
    • Review policies, procedures, & protocols
    • Ensure staff receive orientation & training
step 12
Step 1
  • Support from Management & Staff
  • Assemble team
  • Designate a coordinator
  • Team meetings
  • Planning
  • Action Plan
  • Continuing Education
gain support from management staff step 1
Gain Support From Management & Staff (Step 1)
  • 75% women employed with children <3 years
  • 51% under 2 cared for by someone other than parent
  • Child care vital role in breastfeeding
  • Benefits to family & center
  • Child care setting: Natural, logical place for support
assemble a team designate a coordinator step 1
Assemble a Team & Designate a Coordinator (Step 1)
  • Depend on size of center
  • Both management and direct staff
  • Designate a coordinator
  • Team meetings
action plan step 1
Action Plan (Step 1)
  • Written guidance
  • Example in tool-kit
step 2
Step 2

Establish a supportive breastfeeding policy and assure that all staff are aware of and following the policy.

policy step 2
Policy (Step 2)
  • Support & protect mothers/infants
  • Addresses
    • Breastfeeding mothers welcome
    • Accurate information
    • Trained staff
  • Sample policies
step 3
Step 3

Establish a supportive worksite policy for staff members who are breastfeeding.

supportive environment step 3
Supportive Environment (Step 3)
  • Supportive staff
  • Comfortable environment
  • Supporting employees
  • Example lactation areas
step 4
Step 4

Train all staff so that they are able to carry out breastfeeding promotion and support activities.

safe storage
Safe Storage
  • Store in 1-4 oz. portions
  • Label milk
    • Infants full name
    • Date
    • Amount
  • Discuss with parents
  • Use Academy of Breastfeeding Medicine Storage Guidelines

Example:

Sammy Smith

Date pumped: 12/12/12

Amount: 4 oz.

storage guidelines for healthy full term infants
Storage Guidelines (For Healthy Full Term Infants)

*The Academy of Breastfeeding Medicine (Protocol #8)

handling breastmilk
Handling Breastmilk
  • Separation
  • Swirl – Don’t shake
  • Thaw
    • Refrigerator
    • Under warm water
  • Do not refreeze
warming breastmilk
Warming Breastmilk
  • Do not use a microwave
  • Use warm water
    • Under running water
    • In container of warm water
    • Bottle warmer
  • Excessive heat destroys properties
  • Some like cold milk
feeding baby
Feeding Baby
  • Easily digested
  • Typically 1 ½ to 3 hours
  • Hunger cues
  • Avoid large feedings
amount of breastmilk
Amount of Breastmilk
  • Growth Spurts
  • Needs as baby grows
  • Breastmilk vs formula composition
how to feed baby
How to Feed Baby
  • Mimic breastfeeding
  • Switch arms
  • Baby control feeding
  • Feed slowly
  • Stop with baby’s cues
what if baby refuses the bottle
What If Baby Refuses The Bottle?
  • Reverse Cycle Feeding
  • Different Containers
getting enough
Getting Enough?
  • Weight gain – Most Important
  • Wet diapers
  • Spit up is normal
  • Not good indicators
    • Baby cries after feedings
    • Mom can only pump ½ ounce
    • Baby will continue to take more milk after first bottle
bowel movements
Bowel Movements
  • Mustard color
  • Seedy
  • Runny to pudding

consistency

  • Normal not to stool

daily

what hurts supply
What Hurts Supply?
  • Supply and demand
  • Low supply triggers
    • Supplements
    • Skipping Feedings
    • Pacifiers
    • Illness
tools to increase supply
Tools to Increase Supply
  • Referral to Lactation Consultant
  • To Increase (at center)
    • Give only what was pumped the previous day
    • Do not supplement
  • To Increase (with mom)
    • No pacifiers
    • Nurse more often
    • Do not skip pumping at work
breast milk is not a body fluid
Breast Milk is NOT a Body Fluid*
  • No need for separate refrigerator
  • No gloves
  • Not contaminated by touch

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

how can staff support breastfeeding
How Can Staff Support Breastfeeding?
  • Verbalize and initiate support
  • Encourage mom to get help
  • Be accommodating
infant care plans
Infant Care Plans
  • Staff develop with family
  • Individualize
  • Familiarize all staff
introduction to solids
Introduction to Solids
  • Delay solids until around 6 months
    • AAP guidelines
  • Good starters
step 5
Step 5

Create a culturally appropriate breastfeeding friendly environment.

step 51
Step 5
  • Written and verbal communication
  • Eliminate/limit visibility of formula
  • No baby bottle pictures
  • Racial/ethnically diverse pictures& materials
  • Monitor staff
step 6
Step 6

Inform expectant and new families and visitors about your Center’s breastfeeding friendly policies.

step 61
Step 6
  • Breastfeeding policies and handouts
  • Information on local laws
  • Signage
step 7
Step 7

Stimulate participatory learning experiences with the children related to breastfeeding.

step 8
Step 8

Provide a comfortable place for mothers to breastfeed or pump their milk in privacy, if desired. Educate families and staff that a mother may breastfeed her child wherever they have legal right to be.

breastfeeding laws step 8
Breastfeeding Laws (Step 8)

Wisconsin State Statute 253.16

“A mother may breastfeed her child in any public or private location where the mother and child are otherwise authorized to be. In such a location, no person may prohibit a mother from breastfeeding her child, direct a mother to move to another location to breastfeed her child, direct a mother to cover her child or breast while breastfeeding, or otherwise restrict a mother from breastfeeding”

step 9
Step 9

Establish and maintain connections with your local breastfeeding coalition or other community resources.

step 10
Step 10

Maintain an updated resource file of community breastfeeding services and resources kept in an accessible area for families.

resources step 10
Resources (Step 10)
  • Your local breastfeeding coalition will update you on the latest breastfeeding information.
contact info
Contact Info

Amber France MS IBCLC

Wood County Health Department

afrance@co.wood.wi.us

(715)421-8937

references
References
  • http://www.cdph.ca.gov/programs/breastfeeding/Documents/MO-HowDoesForWAFBF-Eng.pdf
  • http://infantnutritioncouncil.com/breastmilk-information/
  • http://www.americanpregnancy.org/firstyearoflife/whatsinbreastmilk.html
  • http://www.womenshealth.gov/breastfeeding/why-breastfeeding-is-important/index.html
  • http://www.usbreastfeeding.org/Portals/0/Publications/Child-Care-2002-USBC.pdf
  • http://digitalcommons.unl.edu/cgi/viewcontent.cgi?article=1007&context=sociologydiss&sei-redir=1&referer=http%3A%2F%2Fwww.google.com%2Furl%3Fsa%3Dt%26rct%3Dj%26q%3Dbenefits%2520of%2520breastfeeding%2520to%2520childcare%2520centers%26source%3Dweb%26cd%3D4%26ved%3D0CFEQFjAD%26url%3Dhttp%253A%252F%252Fdigitalcommons.unl.edu%252Fcgi%252Fviewcontent.cgi%253Farticle%253D1007%2526context%253Dsociologydiss%26ei%3DAKPPULXbHoakyQG5q4HYCQ%26usg%3DAFQjCNGykr2msusoayso3sdiQCL2FosR_A#search=%22benefits%20breastfeeding%20childcare%20centers%22
  • http://www.dhs.wisconsin.gov/hw2020/health/nutrition/reportcard09.pdf
  • http://kellymom.com/bf/normal/growth-spurts/
references1
References
  • http://www.workandpump.com/reversecycling.htm
  • http://www.nbci.ca/index.php?option=com_content&view=article&id=23:is-my-baby-getting-enough-milk&catid=5:information&Itemid=17
  • http://www.mayoclinic.com/health/low-milk-supply/AN02187
  • http://kellymom.com/bf/got-milk/supply-worries/low-supply/
  • http://www.osha.gov/pls/oshaweb/owadisp.show_document?p_table=INTERPREATIONS&p_id=20952
  • http://kellymom.com/nutrition/starting-solids/solids-how/
  • http://mchb.hrsa.gov/pregnancyandbeyond/breastfeeding/
  • http://wdrs.fnal.gov/elr/familybalance/mothersroom.html
  • http://uvahealth.com/directions-locations/clinics/images-and-docs/augusta-pediatrics-indoor-shots/nursing%20room.jpg/view
  • http://www.meadjohnson.com.ph/news_lactation-suite-room-for-nourishment.html
  • http://rakhealthmatters.wordpress.com/2012/03/21/breastfeeding-and-the-milk-supply-over-time/