Online Program

Assuring policies that promote breastfeeding in childcare: A qualitative study from a multi-state sample of childcare facilities

Tuesday, November 3, 2015

Katherine Stern, MPH, Gretchen Swanson Center for Nutrition, Omaha, NE
Daniel Schober, PhD, MPH, Gretchen Swanson Center for Nutrition, Omaha, NE
Eric Calloway, Ph.D., R.D., Gretchen Swanson Center for Nutrition, Omaha
Amy Yaroch, PhD, Gretchen Swanson Center for Nutrition, Omaha, NE
Background: In the United States, over 2.5 million working mothers have a child younger than one year of age. Policies that promote breastfeeding in childcare centers are important to ensure mothers breastfeed for the recommended duration (6-24 months). This study examined how childcare centers improved or created organizational policies for the promotion of breastfeeding.

Methods: Interviews (N=31) with center directors across six states were conducted. Each center had recently participated in a national program aimed at improving policies and practices for physical activity and nutrition, including promotion of breastfeeding. We used a grounded theory approach, conducting semi-structured, qualitative interviews to examine: a.) Motivation to create or change center policy to promote breastfeeding, b.) The process of bringing about this change, and c.) The implementation and enforcement of policy that promotes breastfeeding. After theoretical saturation was reached, a content analysis of breastfeeding policy was conducted. Data were analyzed using NVivo version 10.1.3.

Results: Key themes for motivating change included: internal discussions among staff and participation in external trainings. Change involved educating parents about policy and facilitating staff trainings. Enforcing policy involved retraining and reminding staff about policy when occasions emerged. Few barriers to creating or enhancing policy were identified. Content analysis showed that the majority of breastfeeding policy focuses on handling breast milk, with less emphesis on the promotion of breastfeeding.

Conclusion: While creating or enhancing breastfeeding policy may be fairly straightforward, implementing and enforcing the policy is more challenging and may require various strategies over time.

Learning Areas:

Chronic disease management and prevention
Conduct evaluation related to programs, research, and other areas of practice
Public health administration or related administration

Learning Objectives:
Describe the process that childcare centers use to develop policies to promote breastfeeding Identify the resources and barriers to developing policies that promote breastfeeding Name key steps that childcare centers have taken to enforce breastfeeding policy and educate staff and parents about it

Keyword(s): Breastfeeding

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None

Qualified on the content I am responsible for because: I have received my Master's in Public Health form the University of Nebraska Medical Center in Maternal and Child Health. I served as a researcher and project manager on this project.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.