Intervention Research to Improve Breastfeeding Support in Child Care Centers

Background/Purpose: Despite national child care standards that emphasize the importance of breastfeeding support, many child care facilities find it difficult to provide adequate support for breastfeeding families. As part of an intervention study in Wake County, North Carolina, we have piloted an approach to improve breastfeeding support in child care centers. Methods: Child care centers participated in an initial assessment and were randomly assigned to two matched groups. The intervention group received a training for center staff, and written materials for use by the center, developed to address the findings of the initial assessment Pre- and post-tests were administered to staff attending the training. Follow-up visits were made to each center 6-8 weeks after the training. A second assessment was completed to compare those that received the intervention with those that did not. Results: Preliminary data indicate that the intervention resulted in changes in centers' breastfeeding practices and policies, as well as in staff knowledge, attitudes, and practices. Pre- and post-test data showed significant improvement in trainees' knowledge and attitudes in 13 of 15 questions. Follow-up visits showed that every center implemented at least one change following the training. Comparing the intervention group with the control, the intervention group showed multiple areas of improvement, including use of guidelines for proper handling of human milk, communication of the health benefits of breastfeeding, and improved attitudes toward providing breastfeeding support. Conclusion: The piloted approach, including materials, training, and follow-up, is a promising approach for improving breastfeeding support in child care centers.