1. Breastfeeding Friendly: We’re Ready ! 1

2. Presented by: Cheryl Blevins, BS, RN, IBCLC, CEIM Angela Owings, BSN, RN Public Health Nurses Springfield-Greene County Health Department Breastfeeding Friendly: We’re Ready!

3. 3 Call to Action “One of the most highly effective preventative measures a mother can take to protect the health of her infant and herself is to breastfeed. The decision to breastfeed is a personal one, and a mother should not be made to feel guilty if she cannot, or chooses not to breastfeed. The success rate among mothers who choose to breastfeed can be greatly improved through activity support…” Action: Ensure that all early care and education providers accommodate the needs of breastfeeding mothers and infants. U.S. Department of Health and Human Services. Executive Summary: The Surgeon General’s Call to Action to Support Breastfeeding. Washington, DC: U.S. Department of Health and Human Services, Office of the Surgeon General; 2011.

4. What Do You Know About Breastfeeding? True/False Activity 4

5. Breastfed Babies are Healthier  63-77% lower risk of respiratory infections  64% lower risk of gastrointestinal infections  23-50% lower risk of ear infections  26-40% lower risk of asthma  36% lower risk of SIDS  30% lower risk of type 1 diabetes  40% lower risk of type 2 diabetes  24% less likely to become obese  15-20% lower risk of leukemia 5

6. Breastfeeding Mothers are Healthier  The longer and more exclusively a woman breastfeeds, the lower her risk of:  Type 2 diabetes  Breast and ovarian cancer  Osteoporosis  Rheumatoid arthritis  Heart disease  Increased weight loss 6

7. 7 Breastfeeding Report Card

8. Why Do Moms Need Your Support?  81% of moms desire to breastfeed  79% of moms start out breastfeeding  60% of moms do not meet their breastfeeding goals  Returning to work is the primary reason for ending breastfeeding  Shorter duration of breastfeeding if baby is in an early care and education environment 8

9. Advocating for Breastfeeding  Breastfeeding is more than a lifestyle choice, it’s a public health issue  Benefits for employers – Moms miss fewer days of work  Benefits for society – Decreased abuse and neglect – If 90% of mothers breastfed for 6 months:  1,000 infant deaths could be prevented  U.S. could save $13 billion 9

10. 10 Breast Milk Can Save Your Program Money  Breast milk is part of the CACFP meal pattern  It is reimbursable for infants if fed by a care provider  It’s free! No equipment to purchase  Cost-effective for families as well  For children over 12 months, breast milk may be substituted for cow’s milk  Doctor’s note is required  Human milk is food  You do not need to store human milk in a separate refrigerator  You do not need to wear gloves to give a bottle of human milk or formula  Contact with human milk is not hazardous exposure

11. Cultural Views of Breastfeeding  Many different cultures look at breastfeeding as a natural choice for feeding  Many countries have banned the practice of giving free or subsidized formula to new mothers  Accepting and understanding cultural differences allows staff to become culturally sensitive to those parents and families who decide to breastfeed  Some cultures discourage breastfeeding because it ‘spoils’ babies and/or discourages babies from sleeping through the night 11

12. 12  Affordable Care Act requires support of hourly employees  If mothers want to breastfeed upon return to work, they should have a: – Reasonable break time – Private space – A place to store their expressed milk – Freedom from retaliation by the employer for her choice to breastfeed Breastfeeding at Work

13. Breastfeeding-Friendly Worksite  Cost savings of $3 per $1 invested in nursing support  Reduced absenteeism to care for sick children because breastfed infants have less illness  Lower health care costs  Improved employee productivity with higher morale and greater employee loyalty  Increased ability to attract and retain valuable employees  Family-friendly image in the community 13

14. 14 MO Breastfeeding-Friendly Child Care Center 1. The child care provider has a written policy that reflects their support of breastfeeding 2. The child care facility provides an atmosphere that welcomes breastfeeding families. 3. The child care provider provides support and accurate breastfeeding information to parents 4. The child care provider feeds infants on demand and communicates with mothers about feeding practices 5. The child care provider trains all staff so they are able to support breastfeeding.

15. Kerri’s Story  Kerri attended the Taking Healthy Steps training last year  She took advantage of the Lactation Support Mini-Grant to purchase her refrigerator, chair, and screen  She was awarded both Breastfeeding Friendly Child Care Center and Workplace awards 15

16. CDC’s Breastfeeding and Early Care and Education: Increasing Support for Breastfeeding Families 16

17. How to Support Breastfeeding Mothers 17

18. Skills for the Childcare Worker Safe handling of breastmilk Breastmilk preparation Bottle-feeding the breastfed baby

19. Handling Human Milk  Handle as a food  Clean and sanitary sealed containers  Require label on each container  Baby’s name, date, time  Keep refrigerated or frozen 19

20. Handling Human Milk  1- 4 ounces in each bottle  Use oldest milk first – “first in, first out” rule  CDC Milk Storage Guidelines – handout  WIC “Rule of 5’s”

21. Breastmilk Preparatio n Defrosting safely Warming safely Leftover safety

22. Bottle feeding the breast-fed baby Watch for hunger cues:  Turning head from side to side in search of breast  Making sucking noises  Sucking on hand or fist  Crying is the last cue: Try to feed before this stage.

23. Bottle feeding the breast-fed baby  Hold baby in an upright position  Position the bottle parallel to the floor  Gently touch nipple to baby’s lip and wait for baby to open his mouth wide to begin feeding  Offer rest breaks  Switch to opposite side mid-feeding  End feeding when baby demonstrates satiety cues

24. Other supportive strategies  Encourage mom to keep a small supply on hand for “emergencies”  Anticipate growth spurts around 10 days, 3 weeks, 6 weeks, 3 months and 6 months of age  Be accommodating if mother asks to breastfeed at drop- off and pick-up times

25. “I fed the baby the wron g milk!”  Don’t panic  Risk of HIV transmission is very low  Contact all involved parents  May also contact Child Care Licensing representative or your Child Care Health Consultant for assistance  CDC also has instructions 25

26. Skills Evaluation Written quiz Skills demonstration