Carolina Ten Steps to Breastfeeding-Friendly Child Care: Replication and scale-up

INTRODUCTION

Health organizations recommend that mothers exclusively breastfeed their infants for the first six months “to achieve optimal growth, development and health.” (WHO 2011)  However, most mothers in the US are not exclusively breastfeeding at three months.  Early Care and Education (ECE) providers play a key role in supporting breastfeeding mothers and children in their care.  The Carolina Ten Steps to Breastfeeding-Friendly Child Care was developed to support ECE providers.  The positive results from a pilot study in one NC county warranted statewide scale-up.

APPROACH

Training and materials were developed in the pilot study and modified based on pilot study outcomes.  Scale-up planning included: Collaboration with state-level organizations and agencies associated with child care; Development of a Training of Trainers (TOT) program; and Updated materials for statewide applicability.

RESULTS

Scale-up resulted in increased partnership with state agencies, including creation of a new State Designation that includes recognition of BFCC materials and training.  Ninety trainers from across the state and covering a wide range of disciplines participated in the TOT.  Preliminary data suggested increased breastfeeding knowledge and attitudes of the trainers.  Challenges included maintaining the trainer pool, structuring trainings to meet child care program needs, and motivating ECE provider training attendance.

DISCUSSION

Breastfeeding provides lifelong benefits to the infant and mother, yet research has indicated that infants routinely cared for by someone other than their mothers are significantly less likely to be breastfed.  Program support to overcome challenges to breastfeeding in child care can support mothers to succeed in breastfeeding.