Dianna Pickett, Kristen Becker, Kathleen Anger, Ken Rosenberg, Bobbie Weber Oregon Public Health Division, Office of Public Health; Oregon State University Presented to the Oregon Public Health Association Annual Meeting October 19 th, 2010

2 Monday October 26 10:45 am

3  Among preschoolers in general, there is a higher proportion of 3-4 year olds in child care centers than 1-2 year olds.  Families in poverty with employed mothers and preschoolers use relative care more often than centers care. CENSUS REPORT ON CHILD CARE (data from 2002, published 2005)

1/3 of children in care are in paid care: 32.9% 2/3 unpaid care… Think “unregulated” care: 67.1% 4 Child Care and Education in Oregon and Its Counties: 2008 Oregon Child Care Research Partnership June 2009

Using PRAMS and PRAMS 2 data we looked at breast feeding initiation and duration related to child care arrangements.

 Oregon PRAMS : ◦ Stratified random sample of live births to Oregon resident women ◦ Women participate by mail or phone when their infant is 2-3 months old ◦ Approximately 75% weighted response rate in 2004 and 2005 ◦ Results are weighted  Oregon PRAMS-2 ◦ Follow-up survey for PRAMS respondents when their child is 2 years old ◦ Women participate by mail or phone ◦ Approximately 57% response rate for 2004 and 2005 births (weighted back to original PRAMS sample) ◦ Results are weighted 7

What are your childcare arrangements?% Childcare center15.2% Child’s grandparent14.6% Childcare in non-relative’s home13.0% Other7.2% Paid care in your home6.8% Other relative3.5% Babysitter/friend/neighbor3.4% Chose more than one response36.2% Do you have regular childcare arrangements for your two-year–old now? % YES51.1% NO48.9%

We grouped respondents based on age, race, education, and breastfeeding duration. LEAST likely to have risk factors used FORMAL care settings: -Childcare center -Paid in-home care -Non-relative’s home MOST likely to have risk factors used INFORMAL care settings: -Other relatives -Grandparents -Babysitter/Friend Neighbor -Other

Average age * % High school or less* % Non- white % Not Married* % <100% FPL* Women using FORMAL care %18.5%18.9%11.0% Women using INFORMAL care %24.6%33.3%27.4% ALL PRAMS-2 respondents** %28.3%27.7%28.3% *At birth of index child **Includes women with multiple types of child care and no regular child care PRAMS and PRAMS-2, births

*Includes women with multiple types of child care and no regular child care

Health Care Differences by Child Care Type PRAMS-2, births *Includes women with multiple types of child care and no regular child care

Dental Care Differences by Child Care Type PRAMS-2, births *Includes women with multiple types of child care and no regular child care

 We are not claiming that childcare type causes differences in breastfeeding rates.  There are differences in the characteristics of women using different types of child care.  Women using informal care appear to be more vulnerable than other groups in the areas of: ◦ Breastfeeding ◦ Having a regular health care provider for their child ◦ Dental care for their child

Prevention and health promotion for informal child care providers  Offer training on breast feeding  Consult on breast feeding-friendly practices.  Promote child health insurance programs  Encourage child health record-keeping and immunization up-dating processes  Share what PRAMS data has revealed with others.

Full report available at: admin/site/publications/ files/homevisitingkinshipffn.pdf

Dianna Pickett, Healthy Child Care Oregon Office of Family Health Kristen Becker, Research Analyst Office of Family Health