Center Of Support

by Mary Jessica Hammes
February 09, 2012

Alicia V., a blogger and scientist in Mebane, North Carolina, was used to visiting her baby at the child care center to breastfeed. Since her daughter refused bottles, it had become a lunchtime routine.

But when her child was 15 months old and scheduled to move from the infant to the toddler room, the child care center told Alicia that she would not be able to nurse her child during her lunch breaks in the toddler classroom. She would still have access to the infant room or the staff lounge, but the toddler room was off limits. She recalls the center telling he, that it was “inappropriate to expose the toddlers to breastfeeding because some of their parents might object.”

Alicia immediately wrote a letter to the director with a tidy list of bullet points refuting that position by stating that breastfeeding is appropriate for toddlers, not in any way indecent, and completely protected by the law. She wrote that she enjoyed being in her daughter’s classroom, and that she wanted her daughter to feel comfortable—not excluded or ashamed.

After reading the letter, the director re-evaluated the center’s position and informed Alicia that she could breastfeed her child anywhere she chooses.

“I was pushing a comprehensive breastfeeding-friendly initiative to the board when the child care center got into financial trouble and suddenly closed,” says Alicia, who was able to breastfeed her daughter, now 5, for four years. (She currently breastfeeds her younger daughter, age 2). “It’s not that they were hostile to breastfeeding before; they were trying to be breastfeeding-friendly. I just brought up some issues that they hadn’t dealt with before and hadn’t had to think about yet.”

The business side of breastfeeding
All across the nation, the concept of a “breastfeeding-friendly” child care center is gaining momentum. According to the Centers for Disease Control and Prevention, two-thirds of American infants are routinely cared for by someone other than a parent, and about half of those children attend child care centers (the other half are in home-based settings). Whether traditional or home-based, child care providers “play an important role in promoting breastfeeding” for those mothers who use them, say the CDC.

In an effort to track how well child care centers nationwide do or do not support breastfeeding, the CDC Breastfeeding Report Card has a category that first appeared in 2010 called “State child care center regulation supports lactation.” States given the “optimal” rating based on the National Resource Center for Health and Safety in Child Care and Early Education best care standards on breastfeeding, provide accommodations for a mother to breastfeed her child onsite.

The 2011 report card rated only six states—Arizona, California, Delaware, Mississippi, North Carolina, and Vermont—“optimal.” All other states were either “less optimal” or “not optimal,” which suggests that U.S. day care centers still have a long way to go in supporting breastfeeding mothers.

It’s not just the CDC promoting breastfeeding in child care centers. Michelle Obama’s “Let’s Move” Child Care Checklist encourages child care centers to handle expressed breast milk and welcome mothers to breastfeed onsite.

There still is no nationwide program that specifically targets breastfeeding support by child care providers, but several states do have their own resource kits.

Apart from the health and financial benefits to both a mother and baby, it turns out that breastfeeding is also the best choice for child care centers. “Breastfeeding makes good business sense,” says The Wisconsin Department of Health Services in their “Ten Steps to Breastfeeding Friendly Child Care Centers” resource kit. The department cites research that shows companies providing time and space for women to express milk enjoy significant cost savings, including lower rates of absenteeism, lower health care costs, better retention of employees, and higher productivity and company loyalty. “We know it will take the active involvement of many public and private partners to change systems, community, and individual behaviors,” they admit, but note that child care centers are a key environment to make progress.

Wisconsin’s resource kit includes a self-appraisal questionnaire to help the child care center evaluate how they may already be helping breastfeeding mothers, and thoroughly reviews 10 steps—everything from training staff to offering comfortable places for moms to breastfeed or pump, to even incorporating the concept of breastfeeding in learning activities that will transform any center into a truly breastfeeding-friendly one.

Child care centers are “the natural and logical place for supporting breastfeeding,” says the Texas WIC program’s “Supporting Breastfeeding Mothers: A Guide for the Childcare Center.” The program notes that child care centers benefit from breastfeeding babies too: “Infants are more resistant to illness, diapers have less odor, baby is happier, [and] breastfed baby spits up less”—all things that would be appealing to any child care worker.

Working with your care providers
Of course, that’s not to say that a “less optimal” or “not optimal” state has no hope. New York—a “less optimal” state—encourages child care centers to achieve the “breastfeeding-friendly” designation. Like the Texas program, the New York Department of Health mentions the same benefits breastfeeding brings to child care centers, but adds another incentive: meals containing breast milk are reimbursed by the Child and Adult Care Food Program. An official breastfeeding-friendly designation can also help market the center in advertisements and on the Department of Health’s directory of breastfeeding-friendly day care centers.

Caroline Moran, director of the Imagine Early Learning Center at DUMBO in Brooklyn, New York, sees supporting breastfeeding as just part of the job. The center hosts educational seminars on breastfeeding and welcomes parents to send bottles of expressed breast milk or visit anytime during the school day to breastfeed their children. Imagine’s official Breastfeeding Support Policy, which includes contact information for breastfeeding resources, is part of the registration package.

“I think part of our job is to have a relationship with the parents,” says Moran. “One where we support them and make it as easy as possible for them to leave their children in a safe and nurturing environment.”

That kind of comfort can pave the way for extended breastfeeding, as it did for Carrie Bishop and Abigail Hill, both mothers in Athens, Georgia, who use child care while breastfeeding their toddlers.

Bishop (who breastfeeds her 2-year-old son) has always been able to breastfeed onsite. “[At pick-up time], the center would simply say, ‘Oh, have a seat.’ They never made me feel weird about it,” says Bishop, an instructional designer at the University of Georgia.

Hill, a clinical social worker, says child care staff welcomed her bottles of expressed milk and daily lunchtime visits to breastfeed first her older daughter and then her son (now 2 and still breastfeeding).

When looking for a child care center, Bishop suggests finding one that already has breastfeeding support policies, or, learn to speak up. You might have to be the parent who shows them how to handle breast milk, how to gently swirl instead of shake, how to offer smaller quantities in several bottles.

One mother who isn’t worried about early weaning is Sarah Ciccarello, an elementary school teacher in San Jose, California (an “optimal” state). Understanding that breast milk can sit at room temperature for 6–8 hours, the center where she sends her 4-month-old son agreed to re-offer partially consumed bottles of breast milk to complete a feeding. (As long as the bottles are refrigerated and the feeding is completed within 1–2 hours.) Staff also agreed to refrain from feeding her son for 1–2 hours before his scheduled pick up, so he’ll be hungry enough to nurse. She has breastfed her son onsite with no problems. When he went on a bottle-strike after Christmas break, they called her on the phone so she could plan to visit and feed him during her lunch break.

If your child care center isn’t as knowledgeable about best feeding practices but is receptive to learning more about breastfeeding, then you might need to pave the way to help future mothers navigate the uncertain waters of returning to work or school.

To jump-start the conversation, consider the following advice from the United States Breastfeeding Committee: “Integrating breastfeeding into child care settings promotes good health for the baby and mother, saves money, and contributes to the overall well-being of a community. It is not just a parent issue, a child care issue, or a health and nutrition issue, but ultimately an important public health issue that affects everyone.”

Mary Jessica Hammes is an Athens, Georgia-based writer, trapeze instructor, assistant preschool teacher, knitter, gardener, comic book enthusiast, and hula hooper. She is mom to Tommy.