'Why do we need a policy?' Administrators' perceptions on breast-feeding-friendly childcare. Issue 3 (5th November 2018)

• Record Type: Journal Article
• Authors: Marhefka, Stephanie L; Sharma, Vinita; Schafer, Ellen J; Turner, DeAnne; Falope, Oluyemisi; Louis-Jacques, Adetola; Wachira, Mary M; Livingston, Taylor; Roig-Romero, Regina Maria
• Is Part Of: Public health nutrition. Volume 22:Issue 3(2019)
• Page Start: 553
• Page End: 563
• Publication Date: 2018-11-05
• Subjects: Human milk, -- Infant feeding, -- Breast-feeding, -- Day care, -- Childcare, -- Policy; Nutrition -- Periodicals; Nutrition policy -- Periodicals; Public health -- Periodicals; 613.2
• DOI: 10.1017/S1368980018002914
• Languages: English
• ISSNs: 1368-9800

Abstract

Abstract: Objective: Mothers' return to work and childcare providers' support for feeding expressed human milk are associated with breast-feeding duration rates in the USA, where most infants are regularly under non-parental care. The objective of the present study was to explore Florida-based childcare centre administrators' awareness and perceptions of the Florida Breastfeeding Friendly Childcare Initiative. Design: Semi-structured interviews were based on the Consolidated Framework for Implementation Research and analysed using applied thematic analysis. Setting: Childcare centre administrators in Tampa Bay, FL, USA, interviewed in 2015. Participants: Twenty-eight childcare centre administrators: female (100 %) and Non-Hispanic White (61 %) with mean age of 50 years and 13 years of experience. Results: Most administrators perceived potential implementation of the Florida Breastfeeding Friendly Childcare Initiative as simple and beneficial. Tension for change and a related construct (perceived consumer need for the initiative) were low, seemingly due to formula-feeding being normative. Perceived financial costs and relative priority varied. Some centres had facilitating structural characteristics, but none had formal breast-feeding policies. Conclusions: A cultural shift, facilitated by state and national breast-feeding-friendly childcare policies and regulations, may be important for increasing tension for change and thereby increasing access to breast-feeding-friendly childcare. Similar to efforts surrounding the rapid growth of the Baby Friendly Hospital Initiative, national comprehensive evidence-based policies, regulations, metrics and technical assistance are needed to strengthen state-level breast-feeding-friendly childcare initiatives.