Ten steps for breastfeeding-friendly child care: A new tool for improving breastfeeding support in child care centers

Background/Purpose: Ten Step programs have been successfully used to improve breastfeeding support in hospitals. We developed and used a similar framework to target breastfeeding support in child care centers. Methods: We developed “Ten Steps for Breastfeeding-Friendly Child Care Centers,” based on existing guidelines , as well as measurable objectives. Centers were recruited to participate in a breastfeeding support program, and center directors completed a self-assessment based on these ten steps. This assessment identified areas where centers were lacking, and we developed an intervention, including a training curriculum and materials, to address these deficits. . Results: The ten step framework identified multiple areas of weakness in child care centers, including lack of communication with parents about breastfeeding, and lack of informational materials for parents and staff. Identified areas were then addressed in the training and materials provided for the centers. After the training, follow-up visits found that every center reported implementing some changes in at least one of the ten steps.; for example, 72% reported doing more to inform families about the benefits of breastfeeding and 50% reported making their environment more breastfeeding-friendly. Conclusion: The “Ten Steps for Breastfeeding-Friendly Child Care Centers” provides a useful framework for improving breastfeeding support in child care centers, both for those creating interventions to improve practices and for child care providers wishing to enhance the breastfeeding-friendliness of their facilities.