The State of our Breastfeeding Friendly Childcare Programs: Ten Years After the 2011 Surgeon General's Call to Action to Support Breastfeeding

Background: Ten years ago, the U.S. Surgeon General's Call to Action to Support Breastfeeding made recommendations for childcare settings, including: (1) accommodating and supporting breastfeeding families; and (2) adopting national guidelines on breastfeeding support in childcare settings. Research Aims: To (1) describe the existing breastfeeding friendly childcare designation programs in the United States; and (2) describe how states are accommodating breastfeeding families in childcare settings. Method: The study design was cross-sectional, prospective thematic description of existing publicly available documents. A search of state breastfeeding coalitions was conducted to assess the number of states with breastfeeding friendly childcare designation programs. A definitive yes-or-no answer regarding whether each state had a program was obtained from all 50 states. For states with programs, designation materials were analyzed using thematic analysis and the framework method to compare designation components. Results: Fifteen states had evidence of breastfeeding friendly childcare designation programs and similarities exist across designation program components. Four standards were common to all 15 programs: written policy on breastfeeding, suitable space within the center where mothers can breastfeed or express their milk, educational materials, and resources on breastfeeding available to parents. Most states required self-assessment to achieve designation status. Conclusion: Research is needed to enable evidence-based programs and decision-making regarding components and processes. Federal funding should support these programs' mission, including funding research to assess how and in what circumstances these programs are improving breastfeeding-related outcomes and supporting breastfeeding families.

Automated summary

This study describes the existing breastfeeding friendly childcare designation programs in the United States and how states are accommodating breastfeeding families in childcare settings. The results show that 15 states have such programs with common components such as written policy, suitable space for breastfeeding, educational materials, and breastfeeding resources. Most states require self-assessment for designation.