Transcript Breastfeeding workshop - Tooele County Health Department

“How To Support A
Breastfeeding Mother”
A Guide for
Childcare Providers
Revised by Utah Physical Activity Nutrition and Obesity Program
Developed by the Mississippi State Department of Health WIC Program, revised by
Wisconsin
1
Objectives
Describe importance of breastfeeding for infants
and mothers and risks of not breastfeeding
 Describe safe handling of human milk
 Describe elements of a breastfeeding-friendly
child care environment
 Describe the role of the child care environment
and staff in helping mothers and infants to
achieve their breastfeeding goals

2
AAP Policy Statement




Breastfeeding is the normal way to feed a baby
Breastfeed exclusively for the first 6 months
Continue for at least 1 year*
And as long thereafter “as is mutually desired”
*The World Health Organization
(WHO) recommends 2 years.
http://www.aap.org/policy/re9729.html
http://www.who.int/child-adolescent-health/NUTRITION/infant_exclusive.htm
3
Healthy People 2020 Goals
–
–
–
–
At least
At least
At least
At least
months
– At least
months
82%
60%
34%
44%
ever breastfed
at 6 months
at 1 year
exclusively breastfed at 3
24% exclusively breastfed at 6
4
Utah Breastfeeding Data
–
–
–
–
–
89.8% ever breastfed
58.3% at 6 months
35.4% at 12 months
41.3% exclusively at 3 months
16.3% exclusively at 6 months
5
Breastfeeding
is the Normal Way to Feed
a Child
6
Benefits to Baby
Reduced risks for:
 otitis media (ear infections)
 upper and lower respiratory infections
 urinary tract infections
 gastroenteritis
 NEC in preemies
 allergies
 overweight/obesity
7
More Benefits to Baby
Reduced risks of:
 Diabetes
 Crohn’s disease
 Childhood leukemia
 Cardiovascular disease
 Sudden Infant Death
Syndrome (SIDS)
8
More Benefits for baby
Breastfeeding...

Enhances brain and IQ development

Optimizes mother-infant bonding

Enhances strong jaw and facial development
– reduces need for orthodontic treatment later in childhood.
9
Breastfeeding Saves Money


The cost of formula feeding for one year
is ~$1,500 (just for the formula)
The cost of breastfeeding is PRICELESS
10
Breastfeeding Saves Money


A minimum of $3.6 billion would be saved if breastfeeding
were increased from current levels to those recommended
in Healthy People 2010!
– At least 75% initiate breastfeeding
– At least 50% continue breastfeeding at least 6 months
– At least 25% continue breastfeeding at least 12 months
These cost savings are calculated from just 3 illnesses:
otitis media, gastroenteritis and necrotizing entercolitis
11
Benefits for Mom







Promotes rapid recovery after having a baby
Decreases risk of anemia
Helps in weight reduction
Reduces risk of breast cancer, especially
premenopausal
Reduces risk of ovarian cancer
May reduce risk of endometrial cancer (of the
uterus lining)
Reduces risk for osteoporosis
12
Breastfeeding Benefits
Employers

Less employee turnover

Faster return from maternity leave

Less employee absenteeism

Happier employee
13
Breastfeeding Benefits
Childcare Providers

Baby is sick less often

Diapers have less odor

Baby spits up less

Baby is happier
14
AAP Recommendations

Breastfeed for at least 12 months

Provide breast milk even when mom and child are
separated

Encourages family & community support

Media should portray breastfeeding as the norm

Employers provide facilities and time
15
Breastfeeding Best Practices for
Child Care Providers
Facility has a written policy on breastfeeding
 Each breastfeeding infant will have a feeding plan
on file, which is completed by the parent(s) and
facility as a team to address their unique feeding
patterns

16
Elements of Breastfeeding Policy
Breastfeeding mothers shall be provided a place
to breastfeed or express their milk
 A refrigerator will be made available for storage
of expressed breast milk
 Sensitivity will be shown to breastfeeding
mothers and their babies
 Staff shall be trained in handling human milk

17
Policy Elements, continued
Breastfeeding employees shall be provided
flexible breaks to accommodate breastfeeding or
milk expression
 Breastfeeding promotional information will be
displayed

18
Elements of Feeding Plan
Baby’s usual schedule
 How breast milk is to be stored and served
 What the provider should do if baby is hungry and
mom is unavailable, or her supply of expressed
breast milk is gone

19
Sample 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 Practices
Breastfeeding employees shall be provided
flexible breaks to accommodate breastfeeding or
milk expression
 Breastfeeding promotion information will be
displayed

21
Post the International Breastfeeding
Symbol in Your Facility
22
Activity
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.
23
Activity
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.
Breastfeeding
is the
Gold
Standard
Breastmilk as part of the Meal Pattern
If your center participates in the Child and
Adult Care Feeding Program…
– Breastmilk is a reimbursable component of the
infant meal pattern
– For children over 12 months - breast milk is a
substitute for cow’s milk in the meal pattern
for children and the meal is reimbursable
26
Storing that Liquid Gold




There are different sets of
recommendations from different
organizations.
As a childcare center you should be using
guidelines from AAP and CDC
Mom may be following a different set of
guidelines
Working with mom regarding storage of
breast milk will avoid problems
27
Storing that Liquid Gold
At room temperature (66-72OF)….…6-8 hours
In an insulated cooler (on ice)…..24 hours
In a refrigerator (32-39OF)……...….….5 days
In a freezer inside a refrigerator……. 2 weeks
In a freezer with a separate door....3-6 months
In a separate deep freeze (0)OF...6-12 months
*From CDC; reference: Academy of Breastfeeding
Medicine. (2004).
28
Handling of Breastmilk






Label the bottles with baby’s name, the date the
breast milk was collected and the date thawed
Breastmilk separates into layers
Swirl gently to mix layers back together
Thawed breast milk can be kept in the
refrigerator for 24 hrs. Do not refreeze
Heat breast milk in warm water
never microwave breast milk
After a feeding, throw out any unused breast
milk left in the bottle
29
Breastmilk
Is NOT Classified as a Body Fluid*



You do not need to store breast milk in a
separate refrigerator
You do not need to wear gloves to give a bottle
of breast milk
You do not contaminate breast milk by touch.
Touching breast milk is not a hazardous exposure
nor a potential contaminant
*According to OSHA’s and CDC’s definitions,breastmilk is classified
as “food” and does not require universal precautions for handling
31
body fluids.
Feeding Suggestions for
Childcare Workers




Hold baby close
Discuss with mom ahead of time how to handle
times when baby is hungry at the end of the day
Mom may be ready or want to feed her baby as
soon as she arrives at the center
Provide a “nursing nook” in the childcare center
where mom can breastfeed her baby
32
Other Ways to be Supportive



Some babies prefer to wait for their mother’s
return and not eat much at the childcare center
Keep 1 bottle of frozen milk in the freezer for
emergencies
Keep track of the number of ounces of breast
milk baby ate

Praise mom for providing the very best nutrition
to her baby
33
Critical Times for Support...






The transition back to work can be a difficult
time for moms and babies and she may feel that
she is unable to pump enough or continue
pumping. Praise her efforts and encourage her
to talk to a breastfeeding professional
When baby is teething
When mom needs to take medications
When baby is having a “growth spurt”
When pumping isn’t going well
When mom thinks her supply is declining
34
Baby’s Hunger Cues

Turning his or her head side to side in search of
the breast

Making sucking noises

Sucking on hand or fist

Crying is a late cue. Try to feed baby before he
or she start crying
35
Things to Remember




If breastfeeding is not going well, the solution is
to fix the breastfeeding -- NOT to “wean to a
bottle”
Most potential problems are easily managed
without interrupting breastfeeding
A little breastfeeding is better than none
For help call: WIC, La Leche League, Baby Your
Baby, The Utah Breastfeeding Coalition or your
health care provider
36
Helpful Websites
10 Favorite Breastfeeding Websites for Families
1.
2.
3.
4.
5.
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
American Academy of Pediatrics
http://www.aap.org/healthtopics/breas
tfeeding.cfm
Site features:
 Family resource guides
 Educational information
 AAP Policy on breastfeeding
Dr. Jack Newman
http://www.drjacknewman.com/
Site features:
 Video clips
 Breastfeeding help
Breastfeeding.com
http://www.breastfeeding.com/
Site features:
 Reading Room
 Video clips
 Mothers’ stories
 Working Mother
 Shopping
Promotion of Mother’s Milk, Inc
http://www.promom.org/
Site features:
 Breastfeeding Information
 101 Reasons to Breastfeed Your Child
 3-Minute Activist
 Gallery
6.
7.
8.
9.
Kelly Mom
http://www.kellymom.com/
Site features:
 Handouts
 Books and Supplies
 Breastfeeding Forum
World Alliance for Breastfeeding Action
http://www.waba.org.my/
Site features:
 Mother Support
 Men’s Initiative
 Breastfeeding Links
 Photo Gallery
 Resources
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
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
10. Utah Breastfeeding Coalition
http://www.utahbreastfeeding.org
Site features:
 Resources for Mothers
 Resources for Healthcare Providers
 Resources for Employers
Adapted from Colorado WIC Program
Breastfeeding...
Baby’s Best Start
38